Probiotics for management of infantile colic: a systematic review of randomized controlled trials

Abstract

IntroductionInfantile colic is a common pediatric problem. The cause of infantile colic remains unclear. Treatment options are limited. Evidence suggests that probiotics might offer some benefit. The aim of the study was to systematically assess the effectiveness of probiotics supplementation in the management of infantile colic.Material and methodsMEDLINE and the Cochrane Library were searched up to April 2016 for randomized controlled trials (RCTs) evaluating the efficacy of probiotics (any well-defined strain) compared with placebo for the management of infantile colic. The outcome measures of interest were treatment success and the duration of crying at the end of the intervention.ResultsSeven RCTs (471 participants) were included. Compared with placebo the administration of Lactobacillus reuteri DSM 17938 at a daily dose of 108 CFU was associated with the treatment success (relative risk = 1.67, 95% CI: 1.10–2.81, number needed to treat 5, 95% CI: 4–8) and reduced crying times at the end of the intervention (mean difference: –49 min, 95% CI: –66 to –33); however, the effect was mainly seen in exclusively breastfed infants. Other probiotics (single or in combinations) were studied in single trials only.ConclusionsSome probiotics, primarily L. reuteri DSM 17938, may be considered for the management of infantile colic. Data on other probiotics are limited.

The therapeutic efficacy of Bifidobacterium animalis subsp. lactis BB‐12® in infant colic: A randomised, double blind, placebo‐controlled trial

“…The clinical effect on daily average crying time was already evident on the first week of treatment in infants receiving BB‐12. All these variables have been considered as clinically relevant in previous clinical trials and meta‐analyses …”

“…All these variables have been considered as clinically relevant in previous clinical trials and meta-analyses. [21][22][23] The results are well in line with data of a previous open-labelled trial reporting that BB-12, added to a low lactose partially hydrolysed whey formula, decreased the duration of crying time in infants with colic. 8 Also the results on stool pattern are well in line with the data from previous trials showing that BB-12 has a beneficial action on transit time and stool consistency.…”

Infantile Colic—The Perspective of German and Polish Pediatricians in 2020

“…Second, it has been described that the gut microbiota of colicky infants exhibits a slower bacterial colonization, a reduced microbiota diversity and a lower microbiota stability [ 14 ]. Third, a number of studies has shown that the administration of certain probiotics or synbiotics significantly alleviates infantile colic symptoms, an effect that most likely is related to their effects on the disturbed gut microbiota [ 15 , 16 , 17 , 18 , 19 ]. Fourth, gut and systemic inflammatory markers were significantly increased in colicky babies when compared with controls, which could well be the result of the production of inflammatory lipopolysaccharides (LPS) by proteobacteria found in elevated levels [ 12 , 20 ].…”

“…However, there is no conclusive clinical evidence that simethicone has significant effects in colicky babies [ 4 ]. As described above, more promising results have been obtained for treatment with probiotics and synbiotics [ 15 , 16 , 17 , 18 , 19 ]. Non-pharmaceutical interventions comprise changes of parental behavior, feeding adjustments and a number of other approaches (e.g., abdominal massage, osteopathy).…”

The Effect of Probiotics on Symptoms, Gut Microbiota and Inflammatory Markers in Infantile Colic: A Systematic Review, Meta-Analysis and Meta-Regression of Randomized Controlled Trials

“…The incidence ratio to experienced relief was almost two times higher in the intervention group at different study points but significant in only breast-fed newborns. In the same year, a meta-analysis was conducted by Dryl and Szajewska [68] with seven RCTs and a cohort of 471 colicky participants, and found that crying reduction was significantly more probable in newborns taking probiotics and the number needed to treat was 5 (95% CI: 4-8). On average, newborns receiving probiotics cried about 50 minutes shorter when compared to newborns taking placebos.…”