Risk factors include:

• Complications of pregnancy
• Bacterial vaginosis
• Poor Apgar scores and resuscitation
• Delayed first breastfeeding
• Long stay in the maternity hospital
• Purulent infections

CAUSES of COLIC

Incorrect breastfeeding technique contributes to the excessive swallowing of a large amount of air (aerophagia), which is one of the primary causes of colic. Crying while feeding, bloating, unwillingness to eat, and vomiting are all signs of aerophagia. Due to the immaturity of the nervous regulation of the swallowing process, moderate aerophagia is commonly seen in children during the first months of life. Aerophagia is more common in premature children. Dyskinetic events in the large intestine, which are most commonly encountered after or during a meal, might also be a cause of colic.

Increased gas production may induce colic in children. Intestinal gas is accompanied by intestinal spasms and, as a result, discomfort and straining of the intestinal wall during eating or digesting. The endocrine system, in addition to the neurological system, is in charge of regulating the function of the gastrointestinal tract. A number of hormone-like chemicals (gastrin, secretin, cholecystokinin, motilin, and others) regulate the gastrointestinal tract's motor and secretory activities.

Colic can also be caused by a mother's poor diet when breastfeeding her child, as well as a woman's lifestyle during pregnancy. The occurrence of colic has been suggested in the literature as a reaction of the child's body to an unfavorable psycho-emotional environment. Excessive crying in children aged 2 weeks to 3 months, the typical period when excessive crying peaks and subsides, is believed to be caused by the developing gut flora. This is also the time when bacteria colonise the previously sterile gut, and it has been suggested that this process may cause discomfort or pain in some infants.

PROBIOTICS AS A PREVENTATIVE

Acid blockers are commonly used to treat babies with colic, however they are inefficient, misused, and overdosed, and may lead to bacterial overgrowth in the small intestine. A novel and safe therapy option, such as L. reuteri, is a welcome addition to the pediatrician's toolkit. It has been shown that using L. reuteri reduces the risk of infection by pathogenic microorganisms. In addition, the conversion of dietary L-histidine to biogenic amine histamine by some strains of L. reuteri can suppress the gene expression of proinflammatory cytokines, which may suppress the production of tumor necrosis factor (TNF), inflammatory cytokines, and a stimulus for the production of various vitamins.

Macro and micronutrients, hormones, growth factors, cytokines, immunoglobulins, and microbes are all found in breast milk. Lactobacilli isolated from breast milk, as commensal bacteria, have been demonstrated to inhibit the development of pathogenic microbes by the production of antibiotic components and competitive exclusion. Furthermore, the mother's microbiota makeup is proposed as an early source for the formation of the baby's microbiome.

CONCLUSION

Lactobacillus reuteri is effective and safe for the treatment of infant colic.

REFERENCES

• Hjern, A, et al, 2020. A systematic review of prevention and treatment of infantile colic. Acta Paediatrica, Volume 109, Issue 9, September 2020, pages 1733-1744.
• Zermiani, A, et al, 2021. Evidence of Lactobacillus reuteri to reduce colic in breastfed babies: Systematic review and meta-analysis. Complementary Therapies in Medicine; Volume 63, December 2021.