Infant Colic Represents Gut Inflammation and Dysbiosis

Abstract

<div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d11123656e216">Objective</h5> <p id="P1">To dissect potential confounding effects of breast milk and formula feeding on crying + fussing, fecal calprotectin, and gut microbiota in babies with colic. We hypothesized that infant colic is associated with gut inflammation linked to intestinal dysbiosis. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d11123656e221">Study design</h5> <p id="P2">A nested case-control design of 3 of our studies was used to analyze clinical and laboratory data at presentation, comparing babies with colic with controls. All investigators other than the biostatistician were blinded during data analysis. Subjects were recruited based on their age and crying + fussy time. We screened 65 infants, 37 with colic, as defined by Barr diary (crying + fussing time &gt;3 hours daily), who were compared with 28 noncolicky infants. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d11123656e226">Results</h5> <p id="P3">Fecal calprotectin was elevated in babies with colic. For each mode of infant feeding (breast milk, formula, or breast + formula), infants’ fecal calprotectin was higher in babies with colic. Infants with colic had similar levels of fecal alpha diversity (richness) when compared with controls, and alpha diversity was lower in breast-fed babies. Beta diversity at the phylum level revealed significant differences in microbial population. A phylum difference resulted from reduced <i>Actinobacteria</i> (95% of which are <i>Bifidobacilli</i>) in babies with colic. Species significantly associated with colic were <i>Acinetobacter</i> and <i>Lactobacillus iners</i>. </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d11123656e243">Conclusions</h5> <p id="P4">Colic is linked with gut inflammation (as determined by fecal calprotectin) and dysbiosis, independent of mode of feeding, with fewer <i>Bifidobacilli</i>. ( <i>J Pediatr 2018;203:55–61</i>). </p> </div><div class="section"> <a class="named-anchor" id="S5"> <!-- named anchor --> </a> <h5 class="section-title" id="d11123656e254">Trial registration</h5> <p id="P5"> <a data-untrusted="" href="http://clinicaltrials.gov/" id="d11123656e258" target="xrefwindow">Clinicaltrials.gov</a>: <span class="generated">[Related object:]</span> <a data-untrusted="" href="https://register.clinicaltrials.gov/" id="d11123656e263" target="xrefwindow">https://register.clinicaltrials.gov/</a> and <span class="generated">[Related object:]</span> <a data-untrusted="" href="https://register.clinicaltrials.gov/" id="d11123656e268" target="xrefwindow">https://register.clinicaltrials.gov/</a>. </p> </div>