Effectiveness of probiotics in infantile colic: A rapid review

Mohammad Karkhaneh; Lexa Fraser; Hsing Jou; Sunita Vohra

doi:10.1093/pch/pxz007

Effectiveness of probiotics in infantile colic: A rapid review

Paediatr Child Health. 2020 Apr;25(3):149-159. doi: 10.1093/pch/pxz007. Epub 2019 Apr 3.

Authors

Mohammad Karkhaneh¹, Lexa Fraser², Hsing Jou¹, Sunita Vohra³

Affiliations

¹ Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta.
² Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Manitoba.
³ Department of Pediatrics, Medicine, and Psychiatry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta.

Abstract

Background: Infantile colic (IC) is a troubling condition with limited treatment options for young infants. This rapid review aims to synthesize the evidence for probiotics in the treatment and prevention of IC in healthy term infants.

Methods: We searched in MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews for systematic reviews (SRs), and randomized control trials (RCTs) published between January 1, 2000 and July 11, 2018. Trials were included if they recruited healthy full-term infants who received probiotics for treatment or prevention of colic. The quality of evidence was assessed using GRADE criteria. As supplementary information, the safety of probiotics in infants was searched within the reviewed studies and other recent publications.

Results: We identified four SRs and meta-analyses that included six RCTs, and found an additional three RCTs evaluating probiotics for the treatment of IC. One SR and six RCTs were identified for prevention of IC; four of the RCTs were included in the SR and two were published later. The probiotic Lactobacillus reuteri was used in the majority (five of eight) of treatment trials, and was found to significantly reduce crying in colicky breast-fed infants compared to placebo. Only two of the six prevention trials showed a significant decrease in crying time compared to placebo, although another two trials showed other benefits of probiotics, including reduced use of medications (simethicone and cimetropium bromide) and physician visits. No adverse events were identified in the included studies; other research suggests probiotics are generally safe in healthy children.

Conclusion: This rapid review identified limited but favourable evidence of benefit of using probiotics for the treatment of IC in full-term breast-fed infants. While routine use of probiotics for treating or preventing IC cannot yet be recommended, it can be an option to manage IC.

Keywords: Infant colic; Paediatrics; Probiotics; Review.

Publication types

Review