Lactobacillus reuteri to treat infant colic: A meta-analysis

Valerie Sung, Frank D'Amico, Michael D. Cabana, Kim Chau, Gideon Koren, Francesco Savino, Hania Szajewska, Girish Deshpande, Christophe Dupont, Flavia Indrio, Silja Mentula, Anna Partty, Daniel Tancredi

Research output: Contribution to journalReview article

56 Scopus citations

Abstract

Context: Lactobacillus reuteri DSM17938 has shown promise in managing colic, but conflicting study results have prevented a consensus on whether it is truly effective. Objective: Through an individual participant data meta-analysis, we sought to definitively determine if L reuteri DSM17938 effectively reduces crying and/or fussing time in infants with colic and whether effects vary by feeding type. Data Sources: We searched online databases (PubMed, Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature, the Database of Abstracts of Reviews of Effects, and Cochrane), e-abstracts, and clinical trial registries. Study Selection: These were double-blind randomized controlled trials (published by June 2017) of L reuteri DSM17398 versus a placebo, delivered orally to infants with colic, with outcomes of infant crying and/or fussing duration and treatment success at 21 days. Data Extraction: We collected individual participant raw data from included studies modeled simultaneously in multilevel generalized linear mixed-effects regression models. Results: Four double-blind trials involving 345 infants with colic (174 probiotic and 171 placebo) were included. The probiotic group averaged less crying and/or fussing time than the placebo group at all time points (day 21 adjusted mean difference in change from baseline [minutes] -25.4 [95% confidence interval (CI): -47.3 to -3.5]). The probiotic group was almost twice as likely as the placebo group to experience treatment success at all time points (day 21 adjusted incidence ratio 1.7 [95% CI: 1.4 to 2.2]). Intervention effects were dramatic in breastfed infants (number needed to treat for day 21 success 2.6 [95% CI: 2.0 to 3.6]) but were insignificant in formula-fed infants. Limitations: There were insufficient data to make conclusions for formula-fed infants with colic. Conclusions: L reuteri DSM17938 is effective and can be recommended for breastfed infants with colic. Its role in formula-fed infants with colic needs further research.

Original languageEnglish (US)
Article numbere20171811
JournalPediatrics
Volume141
Issue number1
DOIs
StatePublished - Jan 1 2018
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Sung, V., D'Amico, F., Cabana, M. D., Chau, K., Koren, G., Savino, F., Szajewska, H., Deshpande, G., Dupont, C., Indrio, F., Mentula, S., Partty, A., & Tancredi, D. (2018). Lactobacillus reuteri to treat infant colic: A meta-analysis. Pediatrics, 141(1), [e20171811]. https://doi.org/10.1542/peds.2017-1811