Abstract
ObjectiveTo evaluate the efficacy and safety of Lactobacillus reuteri DSM 17938 for treating infantile colic.MethodsA systematic literature retrieval was carried out to obtain randomized controlled trials of L. reuteri DSM 17938 for infantile colic. Trials were performed before May 2015 and retrieved from the PubMed, EMBASE, Cochrane library, CNKI, WanFang, VIP, and CBM databases. Data extraction and quality evaluation of the trials were performed independently by two investigators. A meta-analysis was performed using STATA version 12.0.ResultsSix randomized controlled trials of 423 infants with colic were included. Of these subjects, 213 were in the L. reuteri group, and 210 were in the placebo group. Lactobacillus reuteri increased colic treatment effectiveness at two weeks (RR = 2.84; 95% CI: 1.24–6.50; p = 0.014) and three weeks (relative risk [RR] = 2.33; 95% CI: 1.38–3.93; P = 0.002) but not at four weeks (RR = 1.41; 95% CI: 0.52–3.82; P = 0.498). Lactobacillus reuteri decreased crying time (min/d) at two weeks (weighted mean difference [WMD] = –42.89; 95% CI: –60.50 to –25.29; P = 0.000) and three weeks (WMD = –45.83; 95% CI: –59.45 to –32.21; P = 0.000). In addition, L. reuteri did not influence infants’ weight, length or head circumference and was not associated with serious adverse events.Conclusions Lactobacillus reuteri possibly increased the effectiveness of treatment for infantile colic and decreased crying time at two to three weeks without causing adverse events. However, these protective roles are usurped by gradual physiological improvements. The study is limited by the heterogeneity of the trials and should be considered with caution. Higher quality, multicenter randomized controlled trials with larger samples are needed.
Highlights
Infantile colic, often described as excessive crying, is prevalent in the first three months of life, in approximately 20% of infants [1]
Lactobacillus reuteri increased colic treatment effectiveness at two weeks (RR = 2.84; 95% confidence interval (CI): 1.24–6.50; p = 0.014) and three weeks but not at four weeks (RR = 1.41; 95% CI: 0.52–3.82; P = 0.498)
Lactobacillus reuteri decreased crying time at two weeks and three weeks (WMD = –45.83; 95% CI: –59.45 to –32.21; P = 0.000)
Summary
Often described as excessive crying, is prevalent in the first three months of life, in approximately 20% of infants [1]. Simethicone, a safe, over-the counter drug for decreasing intraluminal gas, has been promoted as an agent to decrease colicky episodes in the 1990s [6], anticholinergic drugs, dicyclomine, herbal teas and cimetropium, have been used to treat infantile colic, but they did not show obvious improvement in the treated group. Other treatments, such as: placing colicky infants in car-ride simulators or near a clothes dryer or vacuum cleaner [7] did not reach treatment goal. In 2014, Sung and colleagues [12] concluded that L. reuteri was ineffective in both breastfed and formula-fed infants with colic
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