Childhood Constipation

I usually note that most doctors are decades behind the medical research and it is always the patient that suffers.  Pediatricians seem to be the worst of the bunch when it comes to common infant problems.

Of course, I AM generalizing here based on feedback from patients as well as the recommendations that parents are given from pediatricians.  While some pediatricians may disagree, I can easily back this statement up with medical research on topics such as colic, infant feeding, vaccination, reflux, antibiotic use and, my all time favorite, probiotics.

These conditions continue to be treated with antiquated approaches that run completely contrary to the medical research.  The appropriate use of probiotics alone are running some 100 YEARS behind the research.  If you asked the average pediatrician about the dangers of antibiotics you would get an answer related to diarrhea or skin reactions and not even a vague notion about a lifelong disruption to the immune system leading to autoimmune conditions, allergies and gastrointestinal problems.

Why the rampage?  It relates to this particular study.  In this study done in Italy (which may be saying something that it was not actually done in the US), researchers gave 589 term infant either  L reuteri DSM 17938 (a specific type of probiotic) or a placebo daily for 90 days.  Parents were asked to follow the number of episodes of regurgitation, duration of inconsolable crying (minutes per day), number of evacuations per day, number of visits to pediatricians, feeding changes, hospitalizations, visits to a pediatric emergency department for a perceived health emergency, pharmacologic interventions, and loss of parental working days.  Here’s what they found:

1. Crying time was almost cut in half by the probiotics (38 vs 71 minutes).
2. The episodes of regurgitations per day was also almost cut in half by the probiotics (2.9 vs 4.6).
3. The number of evacuations per day increased with the probiotics (4.2 vs 3.6).
4. The use of probiotics led to an average cost savings per patient of $118.71 for the family and an additional $140.30 for the community.

For something as simple, inexpensive and safe as probiotics that have this drastic of an impact (and, if you’re a parent who has dealt with a colicky infant, “drastic” can not begin to describe what that extra sleep can mean!).  The frustration for me is that, despite a large body of evidence that having a good healthy bacterial flora is of critical importance to a newborn, probiotics will still be relegated to the back burner and used long after prescriptions like Prilosec have failed.

All of this is on top of the clear fact that having these bacteria present in the first few years of life is of the absolute most critical importance for a healthy development of the immune system, so supplementation at this young age will have very long-lasting, positive effects.  Conversely, antibiotics will destroy the bacteria that are so essential to a newborns healthy development.