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Probiotics for preventing and treating infant regurgitation: A systematic review and meta-analysis
Jann P Foster1,2,3, Hannah G Dahlen1, Sabina Fijan4
1School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia.
Insights
Probiotics may reduce infant regurgitation episodes and increase stools per day. While promising for infant health, further research is needed due to study limitations and heterogeneity.
Area of Science:
- Pediatrics
- Gastroenterology
- Microbiology
Background:
- Infant regurgitation is a common issue causing parental distress and healthcare system burden.
- Probiotics are increasingly recognized for their potential therapeutic effects in infants.
- Existing evidence on probiotic efficacy for infant regurgitation requires systematic evaluation.
Purpose of the Study:
- To systematically review and meta-analyze the efficacy of probiotic supplementation for preventing and treating infant regurgitation.
- To assess the impact of probiotics on regurgitation episodes, stool frequency, and body weight in infants.
Main Methods:
- A systematic literature search was conducted across major databases (MEDLINE, CINAHL, Cochrane Central Register).
- Inclusion criteria focused solely on randomized controlled trials (RCTs).
- Meta-analysis was performed using Cochrane Collaboration methodology, assessing heterogeneity.
Main Results:
- Meta-analysis of three RCTs (N=560) showed a significant reduction in daily regurgitation episodes with probiotics (MD: -1.79; 95% CI: -3.30 to -0.27), despite high heterogeneity (96%).
- Meta-analysis of two RCTs (N=488) indicated a significant increase in stools per day at one month with probiotics (MD: 1.36; 95% CI: 0.99 to 1.73), with moderate heterogeneity (69%).
- Meta-analysis of two RCTs (N=112) found no significant difference in body weight between probiotic and placebo groups (MD: -91.88g; 95% CI: -258.40 to 74.63), with minimal heterogeneity (23%).
Conclusions:
- Probiotic therapy shows promise for managing infant regurgitation, with evidence suggesting benefits in reducing episodes and improving stool frequency.
- However, the current evidence base is limited by small study sizes and significant heterogeneity, necessitating cautious interpretation.
- Further robust, well-controlled RCTs are warranted to confirm the efficacy and safety of probiotics for infant regurgitation, supporting their potential as a non-invasive, cost-effective health strategy.
Abstract:
Infant regurgitation is common during infancy and can cause substantial parental distress. Regurgitation can lead to parental perception that their infant is in pain. Parents often present in general practitioner surgeries, community baby clinics and accident and emergency departments which can lead to financial burden on parents and the health care system. Probiotics are increasingly reported to have therapeutic effects for preventing and treating infant regurgitation. The objective of this systematic review and meta-analysis was to evaluate the efficacy of probiotic supplementation for the prevention and treatment of infant regurgitation. Literature searches were conducted using MEDLINE, CINAHL, and the Cochrane Central Register of Controlled trials. Only randomised controlled trials (RCTs) were included. A meta-analysis was performed using the Cochrane Collaboration methodology where possible. Six RCTs examined the prevention or treatment with probiotics on infant regurgitation. A meta-analysis of three studies showed a statistically significant reduction in regurgitation episodes for the probiotic group compared to the placebo group (mean difference [MD]: -1.79 episodes/day: 95% confidence interval [CI]: -3.30 to -0.27, N = 560), but there was high heterogeneity (96%). Meta-analysis of two studies found a statistically significant increased number of stools per day in the probiotic group compared to the placebo group at 1 month of age (MD: 1.36, 95% CI: 0.99 to 1.73, N = 488), with moderate heterogeneity (69%). Meta-analysis of two studies showed no statistical difference in body weight between the two groups (MD: -91.88 g, 95% CI: 258.40-74.63: I2 = 23%, N = 112) with minimal heterogeneity 23%. Probiotic therapy appears promising for infant regurgitation with some evidence of benefit, but most studies are small and there was relatively high heterogeneity. The use of probiotics could potentially be a noninvasive, safe, cost effective, and preventative positive health strategy for both women and their babies. Further robust, well controlled RCTs examining the effect of probiotics for infant regurgitation are warranted.
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