Probiotic Lactobacillus reuteri May Reduce Crying Time in Infants with Colic Symptoms
Colic can be stressful for newborns and new parents alike. Previous research has suggested that L. reuteri may reduce symptoms compared to simethicone in colicky infants (Pediatrics 2007 Jan;119(1):e124). A new blinded, placebo-controlled trial with 50 infants provides further support for the efficacy of probiotics. Infants aged 2-16 weeks old with fussy crying episodes lasting at least 3 hours over at least 3 days (modified Wessel's criteria for colic diagnosis) were randomized to L. reuteri vs. placebo for 21 days. L. reuteri was given as 108 colony-forming units in 5 drops of oil suspension, 30 minutes before morning feeding. All infants had been exclusively breastfed, and mothers were asked to avoid cow's milk during the trial. At baseline, the median crying time was 370 minutes per day for the L. reuteri group and 300 minutes per day for controls (not significant). At 21 days follow-up, the L. reuteri group had significantly reduced crying time (median total crying time 35 minutes per day vs. 90 minutes per day, p = 0.022) (level 2 [mid-level] evidence). The proportion of infants with at least 50% reduction in crying time from baseline was significantly higher in the L. reuteri group at 7, 14, and 21 days (Pediatrics 2010 Aug 16 early online).
For more information, see the Infantile colic topic in DynaMed.
Tai Chi May Improve Symptoms and Sleep in Patients with Fibromyalgia
Fibromyalgia can be hard to treat, and patients may suffer symptoms for years despite treatment. The American Pain Society recommends muscle-strengthening and stretching exercises as well as sleep and anti-anxiety medications as part of a multidisciplinary treatment approach (National Guideline Clearinghouse 2005 Sep 19:7298). A recent randomized trial with 66 patients with fibromyalgia suggests that tai chi might be helpful for both pain and sleep disturbance symptoms. Patients (mean age 50 years) were randomized to classic Yang-style tai chi vs. a control intervention (wellness education and stretching) for 60 minutes twice weekly for 12 weeks. All patients were instructed to practice activity at home for 20 minutes each day, and patients in the tai chi group were encouraged to maintain tai chi practice using an instructional DVD until follow-up at 24 weeks. The primary outcome was clinically-meaningful change in symptom severity defined as an improvement of > 8 points on the 100-point Fibromyalgia Impact Questionnaire. The tai chi group had a significantly higher rate of patients achieving clinically-meaningful improvement (79% vs. 39%, p < 0.001, NNT 3) (level 2 [mid-level] evidence). The mean improvements from baseline were 27.8 points in the tai chi group vs. 9.4 points for controls at 12 weeks and 28.6 vs. 10.2 at 24 weeks (both p < 0.001). Tai chi was also associated with significant improvement in sleep quality, patient-reported global assessments, and both mental and physical SF-36 scores. Improvements in symptom severity were maintained in the tai chi group at 24-week follow-up (N Engl J Med 2010 Aug 19;363(8):743).
For more information, see the Fibromyalgia topic in DynaMed.
