Probiotics for management of infantile colic: a systematic review of randomized controlled trials

INTRODUCTION: Infantile colic is a common pediatric problem. The cause of infantile colic remains unclear. Treatment options are limited. Evidence suggests that probiotics might offer some benefit. The aim of the study was to systematically assess the effectiveness of probiotics supplementation in the management of infantile colic. MATERIAL AND METHODS: MEDLINE and the Cochrane Library were searched up to April 2016 for randomized controlled trials (RCTs) evaluating the efficacy of probiotics (any well-defined strain) compared with placebo for the management of infantile colic. The outcome measures of interest were treatment success and the duration of crying at the end of the intervention. RESULTS: Seven RCTs (471 participants) were included. Compared with placebo the administration of Lactobacillus reuteri DSM 17938 at a daily dose of 10(8) CFU was associated with the treatment success (relative risk = 1.67, 95% CI: 1.10–2.81, number needed to treat 5, 95% CI: 4–8) and reduced crying times at the end of the intervention (mean difference: –49 min, 95% CI: –66 to –33); however, the effect was mainly seen in exclusively breastfed infants. Other probiotics (single or in combinations) were studied in single trials only. CONCLUSIONS: Some probiotics, primarily L. reuteri DSM 17938, may be considered for the management of infantile colic. Data on other probiotics are limited.