Probiotics for infantile colic: Is there evidence beyond doubt? A meta‐analysis and systematic review

• Published in: Acta Paediatrica Vol. 113; no. 2; pp. 170 - 182
• Main Authors: Vaz, Sáskia Ribeiro, Tofoli, Marise Helena, Avelino, Melissa Ameloti Gomes, Costa, Paulo Sérgio Sucasas
• Format: Journal Article
• Language: English
• Published: Norway Wiley Subscription Services, Inc 01-02-2024
• Subjects: Breast Feeding; Breastfeeding & lactation; colic; Colic - therapy; Emotions; Female; Humans; Infant; Infantile colic; Infants; lactobacilli; Lactobacillus reuteri; Limosilactobacillus reuteri; Meta-analysis; microbiota; Prebiotics; Pregnancy; Probiotics; Probiotics - therapeutic use; Systematic review; microbiota; lactobacilli; infant; colic; probiotics
• ISSN: 0803-5253; 1651-2227; 1651-2227
• DOI: 10.1111/apa.17036

Aim
This study is a systematic review and meta‐analysis of randomised controlled trials that employed probiotics and symbiotics for treating infantile colic.
Methods
We performed electronic systematic literature searches in Embase, PubMed and Web of Science, to identify articles published between 1950 and April 2023. Only RCT involving infants with infantile colic under 3 months were included. The treatment plan comprised 15 probiotics, which included Lactobacillus reuteri DSM 17938 and Bifidobacterium animalis lactis BB‐12. The probiotics were administered alone or in combination with a prebiotic, vs. no intervention or a placebo.
Results
Probiotics resulted in an average reduction of 51 min of crying per day (p = 0.001). Further analysis of subgroups showed that the reduction was −39.30 min for vaginal delivery (p = 0.003), −64.66 min for Lactobacillus reuteri DSM 17938 (p = 0.03), −40.45 min for other strains (p < 0.00001), −74.28 min for exclusively breastfed infants (p = 0.0003) and −48.04 min for mixed feeding (p < 0.00001).
Conclusion
All probiotic strains seem effective in treating infantile colic. Exclusively breastfed infants have demonstrated more significant reduction in crying time. However, the available evidence on the effectiveness of probiotics in formula‐fed and caesarean‐born infants is limited.