59 research outputs found
Efficacy and safety of a probiotic-mixture for the treatment of infantile colic: a double-blind, randomized, placebo-controlled clinical trial
No full textNUTRITION: Neonatal and infant nutrition
N-O-001
Efficacy and safety of a probiotic-mixture for the treatment of infantile colic: a double-blind, randomized, placebo-controlled clinical trial
Maria Elisabetta Baldassarre1, Manuela Capozza1, Valentina Rizzo1, Silvio Tafuri1, Antonio Di Mauro2, Nicola Laforgia1
1"Aldo Moro" University of Bari, Department of Biomedical Science and Human Oncology, Bari, Italy 2University of Bari "Aldo Moro", Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, Bari, Italy
Objectives and study: Infantile colic is a causes parental distress and medical effort. Recent evidences suggest that infantile colic is
low-grade systemic inflammation and Manipulation of the gut microbiota with probiotic supplementation seems to play a   therapeutic role in colic management. Aim of this study was to investigate the effectiveness and the safety of a probiotic- mixture (containing Lactobacillus plantarum DSM 24730, Streptococcus thermophilus DSM 24731, Bifidobacterium breve DSM 24732, Lactobacillus paracasei DSM 24733, Lactobacillus delbrueckii subsp. bulgaricus DSM 24734, Lactobacillus acidophilus DSM 24735, Bifidobacterium longum DSM 24736, Bifidobacterium infantis DSM 24737 and currently sold under the brand Vivomixx® in Continental Europe and Visbiome® in USA and Canada) for the treatment of infantile colic in breastfed infants, compared with placebo.
Methods: A randomized, double blind, placebo-controlled trial was conducted involving exclusively breastfed infants with colic, randomly assigned to receive a probiotic-mixture or placebo for 21 days.
A structured diary on gastrointestinal events in newborns, such as number of minutes of inconsolable crying per day, number of regurgitation episodes per day, number of bowel movements per day and stool consistency, was given to parents. Diaries, infants’ anthropometrics and type of adverse events were monitored weekly. The trial was registered to Clinicaltrial.gov at number: NCT01869426.
Results: 59 exclusively breastfed infants completed the 3 weeks of probiotic-mixture (n.28) or placebo (n.31) treatment.
Infants given probiotic-mixture showed a significant reduction in average daily episodes of fussing at the end of treatment period, compared with those receiving placebo (6,5±9,1 vs 12,7±12,7; p=0,01). Also average minutes of crying per episode on day 21 is shorter compared with infants given placebo (34,3±36,7 minutes vs 65,8±50,2 minutes; p=0,009).
Total average minutes of inconsolable crying per day throughout the study were significantly shorter among colic infant in the treatment group compared with those of placebo group and reached statistical significance at the end of treatment period (214,8±338,3 minutes vs 710,4±716,0 minutes; p=0,00).
No differences between groups are collected regarding infants’ anthropometric data, number of regurgitation episodes per day, number of bowel movements per day and stool consistency (p>0.05). No adverse events were reported related to the study intervention.
Conclusion: Administration of a probiotic-mixture for the treatment of infantile colic is safe and significantly reduces minutes of inconsolable crying per day in exclusively breastfed infants with colic
Gender-related differences in neonatal age
No full textMen and women are significantly different in their body system, and this difference has been studied in various fields of medicine. Medical research has identified a substantial group of gender-specific adult diseases, but biological differences between sexes are evident even from the beginning of pregnancy. The evaluation of gender specificities has been also extended to newborns, infants, children and adolescents. Gender-specific medicine deals with the differences between men and women both in health and diseases.
Male and female fetuses react differently to the same intrauterine environment, suggesting biological variation at cellular and molecular level. Male sex is a risk factor for adverse pregnancy outcomes. There are significant sex-related differences in relation to different outcomes in preterm newborns and in the neonatal age, as well as in the incidence of congenital malformations, response to drugs during infancy, neurological and respiratory diseases. The functional and structural development of the lungs occurs earlier in females, especially in preterm newborns.
In this narrative review, we describe how the sex of the fetus and the newborn can affect morbidity and mortality, both during pregnancy and after birth. Gender-related medicine can be applied to the neonatal age to evaluate disease-related sex differences. This could possibly allow for the application of preventive strategies and/or specific treatments, with a great impact on public health
ESOPHAGEAL ATRESIA AND FOOD DISORDERS: A CASE REPORT
No full textEsophageal atresia is a relatively common congenital anomaly, which is often associated with other
anomalies. We report a case of a newborn affected by esophageal atresia with significant post-operative
and long-term complications, including feeding and swallowing disorders
Macronutrients and Micronutrients in Parenteral Nutrition for Preterm Newborns: A Narrative Review
No full textPreterm neonates display a high risk of postnatal malnutrition, especially at very low gestational ages, because nutritional stores are less in younger preterm infants. For this reason nutrition and growth in early life play a pivotal role in the establishment of the long-term health of premature infants. Nutritional care for preterm neonates remains a challenge in clinical practice. According to the recent and latest recommendations from ESPGHAN, at birth, water intake of 70–80 mL/kg/day is suggested, progressively increasing to 150 mL/kg/day by the end of the first week of life, along with a calorie intake of 120 kcal/kg/day and a minimum protein intake of 2.5–3 g/kg/day. Regarding glucose intake, an infusion rate of 3–5 mg/kg/min is recommended, but VLBW and ELBW preterm neonates may require up to 12 mg/kg/min. In preterm infants, lipid emulsions can be started immediately after birth at a dosage of 0.5–1 g/kg/day. However, some authors have recently shown that it is not always possible to achieve optimal and recommended nutrition, due to the complexity of the daily management of premature infants, especially if extremely preterm. It would be desirable if multicenter randomized controlled trials were designed to explore the effect of early nutrition and growth on long-term health
Infantile functional gastrointestinal disorders and maternal psychological status: a narrative review
No full textBackground
Functional gastrointestinal disorders are often extremely distressing for the infant and parents, leading to infant discomfort and crying, parental anxiety, repeated healthcare consultations, and escalating healthcare costs.
Aim
In this narrative review, we analyzed the relationship between maternal psychological status during pregnancy and postpartum and the main infantile functional gastrointestinal disorders.
Materials and methods
The narrative review was conducted searching scientific databases for articles reporting on infantile functional gastrointestinal disorders in association with maternal depressive or anxiety disorders.
Results
Seven studies were suitable.
Discussion
Maternal psychological disorders may be correlated to infantile functional gastrointestinal disorders. Whether it is the excessive crying that favors the onset of maternal psychological disorders or, in contrast, an altered attachment style due to the maternal status that facilitates the onset of functional gastrointestinal disorders in the infant is still an open question. Recent findings revealed that both anxious and depressed mothers are more likely to have an adverse gut microbiome.
Conclusion
A healthy interaction of the mother-baby dyad is advantageous in ensuring the mental and physical development of the offspring. Gynecologists, general practitioners and pediatricians should be alert for early identification of mothers at risk with the aim to initiate timely targeted interventions. Further research on the role of microbiota and the possible therapeutic approaches with probiotics is required
The effect of on-site and on-call nurse on exclusive breastfeeding in two different hospital settings: a prospective observational cohort study
No full textBackground: Exclusive breastfeeding during postpartum hospitalization is very important for ensuring the success of breastfeeding at home. The aim of the study is to determine if the on-site nurse in rooming in improves exclusive breastfeeding ratio. Methods: We conducted a prospective observational cohort study to evaluate exclusive breastfeeding during the first three months of life in two Neonatology Units in the South of Italy with different hospital settings: Ente Ecclesiastico Miulli of Acquaviva delle Fonti with on-site nurse h24 (on-site group) and Policlinico of Bari with nurse available on call h24 from Neonatology Unit (on-call group). Results: A total of 564 mother-baby dyads were admitted from 3 January to 31 March 2018 (299 in on-site group and 265 in on-call group). In the overall population, exclusive breastfeeding rate was 76.4% at 90-days, confirming the role of nurse and rooming in, independently of modality of setting. Considering the way of delivery, in infants from cesarean section there were higher rates for exclusive breastfeeding at 30 and 90 days of life in on-site group. Conclusions: We can assume that the presence of a nurse h24 could better identify breastfeeding problems. Our study suggests the role of on-site nurse during rooming in to encourage exclusive breastfeeding until three months of life in mothers who underwent caesarean section
Probiotics and Functional Gastrointestinal Disorders in Pediatric Age: A Narrative Review
No full textAssessment and management of pain are essential components of pediatric care. Pain in pediatric age is characterized by relevant health and socio-economic consequences due to parental concern, medicalization, and long-term physical and psychological impact in children. Pathophysiological mechanisms of nociception include several pathways in which also individual perception and gut-brain axis seem to be involved. In this narrative review, we analyze the rational and the current clinical findings of probiotic use in the management of functional gastrointestinal disorders (FGID) in pediatric age, with special focus on infantile colic, irritable bowel syndrome, constipation, and gastroesophageal reflux. Some specific probiotics showed a significant reduction in crying and fussing compared to placebo in breastfed infants with colic, although their exact mechanism of action in this disorder remains poorly understood. In irritable bowel syndrome, a limited number of studies showed that specific strains of probiotics can improve abdominal pain/discomfort and bloating/gassiness, although data are still scarce. As for constipation, whilst some strains appear to reduce the number of hard stools in constipated children, the evidence is not adequate to support the use of probiotics in the management of functional constipation. Similarly, although some probiotic strains could promote gastric emptying with a potential improvement of functional symptoms related to gastroesophageal reflux, current evidence is insufficient to provide any specific recommendation for the prevention or treatment of gastroesophageal reflux. In conclusion, probiotics have been proposed as part of management of pain in functional gastrointestinal disorders in pediatric age, but mechanisms are still poorly understood and evidence to guide clinical practice is currently inadequate
Dysbiosis and Prematurity: Is There a Role for Probiotics?
No full textHealthy microbiota is a critical mediator in maintaining health and it is supposed that
dysbiosis could have a role in the pathogenesis of a number of diseases. Evidence supports the hypothesis that maternal dysbiosis could act as a trigger for preterm birth; aberrant colonization of preterm infant gut might have a role in feeding intolerance and pathogenesis of necrotizing enterocolitis. Despite several clinical trials and meta-analyses, it is still not clear if modulation of maternal and neonatal microbiota with probiotic supplementation decreases the risk of preterm birth and its complications
Acute Bronchiolitis: Is There a Role for Lung Ultrasound?
No full textViral bronchiolitis is a common cause of lower respiratory tract infection in the first year of life, considered a health burden because of its morbidity and costs. Its diagnosis is based on history and physical examination and the role of radiographic examination is limited to atypical cases. Thus far, Lung Ultrasound (LUS) is not considered in the diagnostic algorithm for bronchiolitis
Shorter Time to Full Preterm Feeding Using Intact Protein Formula: A Randomized Controlled Trial
No full textBACKGROUND: This study was carried out to evaluate enteral feeding advancement and tolerance in preterm infants receiving one of two marketed formulas: intact protein preterm formula (IPF) or extensively hydrolyzed formula (EHF) for the first 14 feeding days. METHODS: Primary outcome was days to full enteral feeding (≥140 mL/kg/day). Per protocol analyses included the following: all participants who met study entrance criteria and completed study feeding (primary) and those who received ≥75% enteral intake from study formula (subset). Mothers were encouraged to provide their breast milk. RESULTS: Of the 65 enrolled (IPF: n = 32; EHF: n = 33), 60 completed study feeding per protocol (IPF: n = 30; EHF: n = 30), 37 (62%) received predominantly breast milk, and 23 (38%) received ≥75% study formula intake (IPF: n = 11; EHF: n = 12). No group differences were detected in tolerance measures. No necrotizing enterocolitis (NEC) was reported. Median time to achievement of full enteral feeding was significantly shorter for the IPF vs. EHF group (day 10 vs. 14, p < 0.05) (subset analysis). Mean enteral intake significantly increased by day 14 for the IPF group (p < 0.05), reflecting group divergence as achieved feeding volumes increased. CONCLUSIONS: Results suggest shorter time to full enteral feeding and higher feeding volume achieved by study end in preterm infants receiving intact protein preterm formula versus extensively hydrolyzed formula
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