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Lactase for infantile colic: A systematic review of randomized clinical trials
Angélica Luciana Nau1, Amanda Santiago Bassan2, Alessandra Bacelar Cezar3
1Division of Pediatric Gastroenterology, Hospital Jaraguá, Jaraguá do Sul, Brazil.
Insights
Lactase supplementation shows mixed results for treating infantile colic, with some studies indicating reduced crying time and others finding no significant difference. Further research is needed to clarify its efficacy.
Area of Science:
- Pediatrics
- Gastroenterology
- Evidence-based Medicine
Background:
- Infantile colic is characterized by excessive crying in healthy infants, with unclear physiopathology.
- Current therapies often focus on gastrointestinal symptoms.
- Lactase supplementation is explored as a potential treatment targeting lactose digestion.
Purpose of the Study:
- To systematically review randomized controlled trials (RCTs) assessing the efficacy of lactase supplementation for infantile colic.
- To evaluate the impact of lactase on crying duration and gastrointestinal symptoms in infants.
Main Methods:
- Systematic review of RCTs sourced from PubMed, Embase, and Cochrane databases.
- Included infants up to 6 months old diagnosed with infantile colic.
- Analyzed data from six RCTs involving 394 participants.
Main Results:
- Three of the six RCTs reported a significant reduction in crying time with lactase supplementation compared to placebo.
- The remaining three RCTs found no significant difference in crying time between the lactase and placebo groups.
- Hydrogen breath tests showed inconsistent results, with only one study reporting a significant reduction in exhaled hydrogen levels.
Conclusions:
- The efficacy of lactase supplementation for infantile colic remains inconclusive.
- The pharmacological approach to infantile colic requires further investigation.
- Standardized diagnostic criteria and outcome measures are necessary for future studies on lactase supplementation.
Abstract:
Infantile colic is excessive crying for no apparent reason in an otherwise healthy infant. Although its physiopathology is not completely understood, therapies usually target gastrointestinal symptoms. This systematic review of randomized controlled trials (RCTs) analyzes the efficacy of lactase supplementation in infantile colic. PubMed, Embase, and Cochrane were searched for RCTs evaluating lactase supplementation in infants up to 6 months old with infantile colic. Out of six RCTs including 394 patients, three reported a significantly shorter crying time in the lactase group than in the placebo group, while the other three found no significant difference between groups. Of the two studies that performed the hydrogen breath test, only one reported a significant reduction in exhaled hydrogen levels. The pharmacological approach to infantile colic remains debatable, and new studies with standardized diagnostic criteria and outcomes are required to guide lactase supplementation in clinical practice.
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