Exploring The L. Reuteri Probiotic And Its Utility In Children

The Effects On Crying, Colic, And More.

Understanding which strains confer which benefits is very much the name of the game when it comes to the effective use of probiotics, and that sentiment certainly rings true for children as well.

In this article, I want to explore some of the evidence surrounding Lactobacillus reuteri DSM 17938, which has been studied quite extensively for use in various infant GI issues.

The three most common reasons for a pediatrician referral in the first six months post-birth are:

  • Colic
  • Gastroesophageal reflux
  • Constipation

As such, these concerns are also primary candidates contributing to various parental challenges as well as hospitalizations, pharmaceutical use, and so on.

Clearly then, any intervention that has the potential to reduce the likelihood of these events immediately becomes of interest to the medical community.

That’s where probiotics and today’s focus on Lactobacillus reuteri DSM 17938 come into play.

Preventive Probiotic?

In 2014 a study published in JAMA Pediatrics looked at the use of Lactobacillus reuteri DSM 17938 probiotic during the first three months of life to determine whether or not it had a potential preventive role in any of these major infant health concerns.

Here’s what they found in the infants treated with the probiotic vs those treated with a placebo:

  • Reduced crying time
  • Less daily episodes of regurgitation 
  • Greater number of daily bowel movements
  • Cost savings for families 

In this particular study we see some clear promise for the use of this probiotic strain as a preventative tool, but what about its utility for children who are already dealing with the aforementioned concerns?

Let’s find out.

Probiotic Use For Infants With Colic

Colic is a common infant health concern characterized by frequent and prolonged bouts of crying in an otherwise healthy child, which may also experience frequent gas.

Emerging evidence suggests that babies with colic may be more likely to be suffering from gut inflammation and dysbiosis, a theme that I’ve explored often in the adult context.

The Lactobacillus reuteri DSM 17938 probiotic has generated the most scientific interest when it comes to supplementation in babies with colic, with a 2018 meta-analysis out of the Pediatrics journal suggesting that it was useful at reducing crying/fussing time specifically in breast-fed infants.

There was not sufficient evidence available to draw conclusions about the effect of this probiotic on formula-fed infants, however.

Quite a bit of research has been done looking at probiotic supplementation in babies with colic, specifically utilizing the L. reuteri DSM 17938 strain of bacteria.

In 2018, for example, a research paper was published in the Pediatrics scientific journal which found that supplementation with the L. reuteri DSM 17938 probiotic was effective at reducing crying and fussing time specifically in breastfed infants with colic, but that not enough evidence was available to determine whether or not formula-fed infants would also benefit.

Other Digestive Concerns?

The scientific consensus around L. reuteri DSM 17938 for other infant digestive concerns is considered promising but not yet definitive.

There are randomized controlled trial data demonstrating the effectiveness of this probiotic in a number of additional contexts including:

Final Thoughts

While certainly not the only strain that has been studied or proved efficacious for various infant health concerns, the amount of available evidence on L. reuteri DSM 17938 does stand out.

There appear to be no safety concerns around its use, although the decision as to whether or not it's right for your child should be made in conjunction with their healthcare team.

 

  1. Indrio, F., Di Mauro, A., Riezzo, G., Civardi, E., Intini, C., Corvaglia, L., Ballardini, E., Bisceglia, M., Cinquetti, M., Brazzoduro, E., Del Vecchio, A., Tafuri, S., & Francavilla, R. (2014). Prophylactic use of a probiotic in the prevention of colic, regurgitation, and functional constipation: a randomized clinical trial. JAMA pediatrics, 168(3), 228–233. doi:10.1001/jamapediatrics.2013.4367 
  2. Rhoads, J. M., Collins, J., Fatheree, N. Y., Hashmi, S. S., Taylor, C. M., Luo, M., Hoang, T. K., Gleason, W. A., Van Arsdall, M. R., Navarro, F., & Liu, Y. (2018). Infant Colic Represents Gut Inflammation and Dysbiosis. The Journal of pediatrics, 203, 55–61.e3. https://doi.org/10.1016/j.jpeds.2018.07.042 
  3. Sung, V., D'Amico, F., Cabana, M. D., Chau, K., Koren, G., Savino, F., Szajewska, H., Deshpande, G., Dupont, C., Indrio, F., Mentula, S., Partty, A., & Tancredi, D. (2018). Lactobacillus reuteri to Treat Infant Colic: A Meta-analysis. Pediatrics, 141(1), e20171811. https://doi.org/10.1542/peds.2017-1811 
  4. Coccorullo, P., Strisciuglio, C., Martinelli, M., Miele, E., Greco, L., & Staiano, A. (2010). Lactobacillus reuteri (DSM 17938) in infants with functional chronic constipation: a double-blind, randomized, placebo-controlled study. The Journal of pediatrics, 157(4), 598–602. https://doi.org/10.1016/j.jpeds.2010.04.066 
  5. Cui, X., Shi, Y., Gao, S., Xue, X., & Fu, J. (2019). Effects of Lactobacillus reuteri DSM 17938 in preterm infants: a double-blinded randomized controlled study. Italian journal of pediatrics, 45(1), 140. https://doi.org/10.1186/s13052-019-0716-9 
  6. Garofoli, F., Civardi, E., Indrio, F., Mazzucchelli, I., Angelini, M., Tinelli, C., & Stronati, M. (2014). The early administration of Lactobacillus reuteri DSM 17938 controls regurgitation episodes in full-term breastfed infants. International journal of food sciences and nutrition, 65(5), 646–648. https://doi.org/10.3109/09637486.2014.898251 

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