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

Area of Science:

• Pediatrics
• Gastroenterology
• Microbiology

Background:

• Infantile colic is a common condition affecting infants, characterized by prolonged and inconsolable crying.
• Probiotics and synbiotics are increasingly explored as therapeutic options for managing infantile colic.
• Understanding the efficacy of specific probiotic strains and delivery methods is crucial for clinical practice.

Approach:

• A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted.
• Literature searches encompassed Embase, PubMed, and Web of Science from 1950 to April 2023.
• Included RCTs focused on infants under three months with infantile colic, comparing probiotics/synbiotics against placebo or no intervention.

Key Points:

• Probiotics demonstrated an average reduction of 51 minutes of crying per day (p=0.001).
• Significant crying reductions were observed in infants born vaginally (-39.30 min), those receiving Lactobacillus reuteri DSM 17938 (-64.66 min), and exclusively breastfed infants (-74.28 min).
• Other probiotic strains and mixed feeding also showed significant reductions in crying time.

Conclusions:

• All evaluated probiotic strains appear effective in treating infantile colic.
• Exclusively breastfed infants experienced a more substantial decrease in crying duration.
• Further research is needed to clarify the effectiveness of probiotics in formula-fed and cesarean-born infants.