Limosilactobacillus reuteri DSM 17938-Containing Infant Formulas and the Associations with Gastrointestinal Tolerance: A Cross-Sectional Observational Study

Abstract

Limosilactobacillus (L.; previously Lactobacillus) reuteri has been shown to influence gastrointestinal (GI) tolerance. This study was a secondary analysis of GI tolerance data from a multi-country, cross-sectional, observational study in healthy infants using the validated Infant Gastrointestinal Symptom Questionnaire (IGSQ) and a gut comfort questionnaire. Breastfed infants (BFI; n = 760) were compared to formula-fed infants receiving either L. reuteri-containing formula (FFI + LR; n = 470) or standard formula without any probiotic or prebiotic (FFI-Std; n = 501). The IGSQ composite scores (adjusted mean ± SE) in FFI + LR (22.17 ± 0.39) was significantly lower than in FFI-Std (23.41 ± 0.37) and similar to BFI (22.34 ± 0.30;), indicating better GI tolerance in FFI + LR than in FFI-Std. Compared with FFI-Std, FFI + LR had lower reports of difficulty in passing stools (11% vs. 22%; adjusted-odds ratio (OR) (95%CI) = 0.46 (0.31–0.68)), fewer hard stools (mean difference = −0.12 (−0.21, −0.02)) and less physician-confirmed colic (OR = 0.61 (0.45–0.82)), and similar to BFI. Parent-reported crying time (mean difference = −0.15 (−0.28, −0.01)), frequency of spitting-up/vomiting (mean difference = −0.18 (−0.34, −0.03)), volume of spit-up (mean difference = −0.20 (−0.32, −0.08)) and fussiness due to spitting-up/vomiting (mean difference = −0.17 (−0.29, −0.05)) were lower in FFI + LR versus FFI-Std and similar to BFI. In this study, L. reuteri-containing formula was associated with improved digestive tolerance and behavioral patterns.

Alleviating Gasto-Intestinal Discomfort in Infants: Quest for Effective Interventions

“…A recent (2023) real world study conducted across 6 countries reported significantly lower scores of the validated Infant Gastrointestinal Symptom Questionnaire (IGSQ) in formula-fed 6-16 weeks old infants receiving either L. reuteri-containing formula than those fed standard formula and comparable to breastfed infants. 69 Based on the evidences, the guidelines recommend that if the use of probiotic is considered, L. reuteri DSM 17938 is the only strain shown to be effective in the treatment of infantile colic in breastfed infants. The use of probiotics in children seems to be safe in general, even when provided in high doses.…”

Lactobacillus reuteri in digestive system diseases: focus on clinical trials and mechanisms

“…Growing data has revealed that the etiology of disorders of the digestive system is strongly influenced by disrupted gut microbes (Quaglio et al, 2022). Various L. reuteri strains have been investigated in digestive system diseases like IC, diarrhea, constipation, FAP, IBD, CRC, as well as liver diseases, and the findings are generally promising (Dias et al, 2021;Saviano et al, 2021;Werlinger et al, 2022;Happy Tummy et al, 2023).…”

“…L. reuteri DSM 17938 treatment can increase circulating FoxP3 concentration and reduce fecal calprotectin, indicating the underlying mechanisms of L. reuteri to improve colic may be linked to the property of alleviating inflammation (Savino et al, 2018a;Savino et al, 2018b). According to a recent secondary analysis research based on a large observational study, L. reuteri-containing formula was superior to standard formula without probiotics in preventing infant colic, similar to breast feeding (Happy Tummy et al, 2023). Furthermore, the probiotic potential of L. reuteri DSM 17938 given at a dosage of 1×10 8 CFU per day for 90 days to prevent IC is demonstrated by two RCT studies in newborns (Indrio et al, 2014;Savino et al, 2015).…”