The effect of probiotic supplements on infants with crying/fussing caused by digestive problems (colic)

ISRCTN ISRCTN92431452
DOI https://doi.org/10.1186/ISRCTN92431452
Secondary identifying numbers MIHC/2017/10/AKO2018
Submission date
27/11/2019
Registration date
10/12/2019
Last edited
28/09/2021
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Signs and Symptoms
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Infant with persistent crying/fussing is a behavioral problem in early infancy that involve long crying bouts and hard-to-soothe behavior for no apparent cause. The parents and caretakers often seek many treatments for these babies including the use of several drugs with serious side effect, vegetable fiber, lactose, sucrose solution, hypoallergenic diet, and herbal tea. But there still is no single effective and safe intervention or drug for babies’ colic. Recent studies have reported that gut microbiota in these infants is imbalanced by lower amounts of beneficial bacterial and higher amounts of harmful bacterial. Thus, several researchers have suggested that specific probiotics may be useful for improving imbalance gut bacterial and reducing babies’ crying time.
This study sought to explore the effectiveness of the two-combined probiotic strains in treating babies’ crying and fussing.

Who can participate?
Babies aged under 12 weeks, with persistent crying/fussing

What does the study involve?
Eligible colic infants are randomly allocated to receive either the two specific probiotics by oil drops as the intervention group (IG) or a reference oil drop without probiotics as the placebo group (PG). Babies’ caregivers administer five drops of one of the product orally to each infant daily for 21 days. Babies’ caregivers are taught to use the Baby’s Dietary to record the infant crying/fussing time and the frequency, the numbers of babies who were responding to the treatment, stool consistency, and frequency of stool.

What are the possible benefits and risks of participating?
The babies who are taking part in the study can decrease their crying/fussing behaviors, improve their fecal consistency and frequency and increase the caregivers’ life quality during the intervention. The two specific strains in the investigational product are very safe and suitable for infant who meeting the inclusion criteria. And if an event occurs related to the conduct of the study or the development of the test product which may affect the safety of the study subjects, the founder and the study investigator may take appropriate measures to protect the subjects against immediate hazards.

Where is the study run from?
1. Angel Children’s Hospital, Chengdu, China
2. Qingbaijiang Maternal and Child Health Hospital, China
3. Chengdu Caojiaxiang Community Healthcare Center, China
4. Huili Maternity and Child Care Center, China

When is the study starting and how long is it expected to run for?
June 2018 to November 2019

Who is funding the study?
Maternal and Infant Health and Care Science Laborotory, China

Who is the main contact?
Dr Ke Chen
263662086@qq.com

Contact information

Dr Ke Chen
Scientific

No.1617
Riyue Avenue
Qingyang district
Chengdu
610031
China

ORCiD logoORCID ID 0000-0001-7455-0900
Phone +86-028-61866036
Email 263662086@qq.com

Study information

Study designRandomized double-blinded placebo-controlled parallel-group multicentre study
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleThe efficacy of three weeks’ daily supplementation with two-combined probiotic strains on infant colic
Study objectivesIn comparison to the placebo group, the two-combined probiotic strains, B. longum CECT7894 (KABP042) and P. pentosaceus CECT8330 (KABP041), would reduce mean daily crying or fussing time, decrease daily episodes of crying or fussing, and improve the pediatric quality of life inventory after the intervention.
Ethics approval(s)Approved 05/03/2018, Institutional ethics committee of Angel Children’s Hospital (No.46-1 Section 4 South Renmin Road Wuhou District, Chengdu City, Sichuan Province, 610042, China; +86-028-67899999-8063; no email provided), ref: 2018004
Health condition(s) or problem(s) studiedColic
InterventionAll eligible colic infants are randomized to receive either the probiotics as the intervention group (IG) or a reference product without probiotics as the placebo group (PG). The probiotic formula, comprising a sunflower oil suspension of the strains B. longum CECT7894 (KABP042) and P. pentosaceus CECT8330 (KABP041), contains 1 billion Colony-Forming Units (CFU) in each drop (1:1 for the two strains). Five drops (equal to 1 billion CFU) are taken once daily preferably at the same time of the day, e.g. in the morning. The reference product (placebo) is an identical sunflower oil without probiotics. Both the probiotics and the placebo are produced by AB-Biotics S.A.

Caregivers administer five drops of the study product orally to each infant daily for 21 days. The dose is not required to be given at a fixed time or given with feeds. However, for compliance and ease of administration, each family is recommended to give the dose with the same feed each day. The total duration of follow-up for all study arms is 13 months.

Randomization:
A blocked randomization schedule that maintains a balance between treatment arms will be prepared by an independent statistician, not directly involved in the analysis of the study results. The RAND function of Excel (Microsoft, Redmond, WA, USA) will be used to generate randomly permutated codes. To minimize potential biases, the study is double-blinded whereby treatment allocation is concealed from all study investigators and participants.
Intervention typeSupplement
Primary outcome measureMean daily crying or fussing time measured using parental self-report each day of the intervention
Secondary outcome measures1. Number of daily episodes of crying or fussing measured using parental self-report each day of the intervention.
2. Infant quality of life measured using the pediatric quality of life inventory at the 7th, 14th and 21st day after the intervention
Overall study start date01/09/2017
Completion date01/11/2019

Eligibility

Participant type(s)Patient
Age groupMixed
SexBoth
Target number of participants112
Total final enrolment112
Key inclusion criteria1. Crying or fussing episodes lasting more than 3 hours per day and occurring at least 3 days per week within 7 days prior to enrollment (ROME IV criteria)
2. Less than 3 months (12 weeks) of age
3. Equal to or greater than 37 weeks of gestation at birth
4. Vaginal delivery
5. Birth weight of more than 2500g
6. Provided voluntary written informed consent from parents of the infant
Key exclusion criteria1. Average weight gain < 100 grams/week from birth to the last recorded weight
2. Major medical problems (e.g. immunocompromised disease, major developmental or genetic abnormality)
3. Gastrointestinal disorder
4. Taking antibiotics four weeks prior to enrollment
5. Using the same probiotic strains in this study two weeks prior to enrollment
6. Taking antibiotics during the intervention
Date of first enrolment01/06/2018
Date of final enrolment01/06/2019

Locations

Countries of recruitment

  • China

Study participating centres

Qingbaijiang Maternal and Child Health Hospital
Qingbaijiang
610300
China
Chengdu Caojiaxiang Community Healthcare Center
Chengdu
610084
China
Huili Maternity and Child Care Center
Huili
615100
China
Angel Children’s Hospital
Chengdu
610042
China

Sponsor information

Angel Children’s Hospital
Hospital/treatment centre

No.46-1 Section 4
South Renmin Road
Wuhou District
Chengdu
610042
China

Phone 86-13981782973
Email 263662086@qq.com
ROR logo "ROR" https://ror.org/008x2am79

Funders

Funder type

Hospital/treatment centre

Maternal and Infant Health and Care Science Laborotory

No information available

Results and Publications

Intention to publish date31/12/2019
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryData sharing statement to be made available at a later date
Publication and dissemination planPlanned publication in a high-impact peer-reviewed journal
IPD sharing planThe current data sharing plans for this study are unknown and will be available at a later date

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article 10/09/2021 28/09/2021 Yes No

Editorial Notes

28/09/2021: Publication reference added.
06/12/2019: Trial’s existence confirmed by the Maternal and Infant Health and Care Science Laboratory