Lactobacillus reuteri to Treat Infant Colic: A Meta-analysis

Published on Jan 1, 2018in Pediatrics5.40
· DOI :10.1542/peds.2017-1811
Valerie Sung8
Estimated H-index: 8
(University of Melbourne),
Frank D'Amico11
Estimated H-index: 11
(Duquesne University)
+ 10 AuthorsDaniel J. Tancredi42
Estimated H-index: 42
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.
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Published on Dec 1, 2017in Neurogastroenterology and Motility3.80
Massimo Martinelli12
Estimated H-index: 12
(University of Naples Federico II),
Dario Ummarino6
Estimated H-index: 6
(University of Naples Federico II)
+ 10 AuthorsClaudio Romano20
Estimated H-index: 20
(University of Foggia)
Background Infant colic (IC) is a prevalent physiological event of infants, which can disrupt the child's home environment. We aimed to investigate the effectiveness of a mixture of Matricariae chamomilla L., Melissa officinalis L. and tyndallized Lactobacillus acidophilus (HA122) compared with Lactobacillus reuteri DSM 17938 and with simethicone for the treatment of IC. Methods A multicenter randomized comparative study was conducted in infants with colic, according to Rome III criteria, who we...
Published on Jun 1, 2017in Journal of Pharmacy Practice
Anna Schreck Bird1
Estimated H-index: 1
(Creighton University),
Philip J. Gregory6
Estimated H-index: 6
(Creighton University)
+ 2 AuthorsDarren J. Hein3
Estimated H-index: 3
(Creighton University)
Objective:To evaluate whether clinical data support the safety and efficacy of probiotics for the management of infantile colic.Background:Probiotics have been suggested as a potential strategy for infantile colic, and the specific species that have been studied in healthy infants are considered to be safe.Methodology:A systematic review was conducted to identify randomized controlled trials (RCTs) evaluating the use of probiotic supplementation in infants with colic. RCTs with a primary end poi...
Published on Apr 1, 2017in Acta Paediatrica2.27
F Savino18
Estimated H-index: 18
(Boston Children's Hospital),
Andrea Quartieri10
Estimated H-index: 10
(University of Modena and Reggio Emilia)
+ 5 AuthorsMaddalena Rossi30
Estimated H-index: 30
(University of Modena and Reggio Emilia)
Aim This study compared the faecal microbial composition of formula-fed infants who did and did not have colic. Methods Faecal samples from formula-fed infants under 16 weeks of age with (n=38) and without (n=39) colic were collected at Department of Pediatrics in Turin, Italy, between February 2014 and October 2015. The pH and faecal ammonia were determined and total bacteria, bifidobacteria, lactic acid bacteria (LAB) and coliforms were quantified by fluorescent in situ hybridisation (FISH). R...
Published on May 1, 2016in Journal of Pediatric Gastroenterology and Nutrition3.02
Tracy Harb2
Estimated H-index: 2
Misa Matsuyama3
Estimated H-index: 3
+ 1 AuthorsRebecca J. Hill15
Estimated H-index: 15
Objectives: To determine the strength of evidence for commonly used interventions for colic in breast-fed and mixed-fed infants younger than 6 months. Methods: Searches of PubMed, CINAHL, Embase, AMED, and Web of Science databases were conducted from July 2014 to July 2015. Included studies were randomised controlled trials involving mothers and their colicky infants younger than 6 months; assessed colic against the Wessel or modified Wessel criteria; and included phytotherapies, prescription me...
Published on Oct 28, 2015in PLOS ONE2.78
Man Xu2
Estimated H-index: 2
(Xi'an Jiaotong University),
Jiao Wang2
Estimated H-index: 2
(Xi'an Jiaotong University)
+ 3 AuthorsXiao-Hong Liu2
Estimated H-index: 2
(Xi'an Jiaotong University)
Objective To evaluate the efficacy and safety of Lactobacillus reuteri DSM 17938 for treating infantile colic. Methods A 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-an...
Published on Oct 1, 2015in Pediatric Research2.88
Anna Pärtty8
Estimated H-index: 8
Liisa Lehtonen38
Estimated H-index: 38
+ 2 AuthorsErika Isolauri90
Estimated H-index: 90
Probiotic Lactobacillus rhamnosus GG therapy and microbiological programming in infantile colic: a randomized, controlled trial
Guo-Lin Mi1
Estimated H-index: 1
(SDU: Shandong University),
Lei Zhao1
Estimated H-index: 1
(Boston Children's Hospital)
+ 3 AuthorsJin-Ke Xu1
Estimated H-index: 1
(CDC: Centers for Disease Control and Prevention)
Infant colic, excessive crying of unknown cause, is a major burden to families and effects about 10–30 % of infants. Despite decades of research, the exact cause and treatment of infant colic has remained elusive. The use of Lactobacillus reuteri (DSM 17938) in infant colic is somewhat controversial and hence, we designed this study to evaluate its efficacy in infantile colic. We recruited predominantly or exclusively breastfed infants, aged less than 4 months in a placebo controlled observation...
Published on Jan 1, 2015in Rawal Medical Journal
Muhammad Waseem Ashraf1
Estimated H-index: 1
Saeed Bin Ayaz2
Estimated H-index: 2
+ 2 AuthorsMuhammad Shoaib3
Estimated H-index: 3
Objectives: This study aimed to assess the role of probiotics in alleviating infantile colic (IC) while targeting local population. In case of a positive outcome, its use could be suggested in pediatric health care facilities. Methodology: It was a non-blinded randomized control trial conducted at the department of pediatrics, Benazir Bhutto Hospital, Rawalpindi from 4th October 2012 to 3rd April 2013. Through non-probability consecutive sampling we included breast-fed infants of either sex of a...
Published on Jan 1, 2015in The Journal of Pediatrics3.74
Kim Chau3
Estimated H-index: 3
(U of T: University of Toronto),
Eddy Lau2
Estimated H-index: 2
(U of T: University of Toronto)
+ 4 AuthorsGideon Koren80
Estimated H-index: 80
Objective To investigate the effectiveness of Lactobacillus reuteri DSM 17938 for the treatment of infantile colic in breastfed Canadian infants, compared with placebo. Study design A randomized, double-blind, placebo-controlled trial was conducted involving 52 infants with colic, according to modified Wessel criteria, who were assigned at random to receive L reuteri DSM 17938 (10 8 colony-forming units) (n = 24) or placebo (n = 28) for 21 days. Daily crying and fussing times were recorded in a ...
Cited By23
Published on Jun 22, 2019in Archives of Disease in Childhood3.16
May Rivas‐Fernandez1
Estimated H-index: 1
Ana Diez Izquierdo + 1 AuthorsAlbert Balaguer13
Estimated H-index: 13
Maria is a 1.5-month-old healthy baby born at 39 weeks, mainly breastfed, although she has been fed artificial formula on a few occasions. In the last 2 weeks, she has been brought to the clinic with episodes of intense crying which last from 3 to 5 hours/day and occur 4–5 times a week. Her parents are finding it hard to soothe and calm her during these episodes, and find it very distressing. She undergoes a normal clinical examination and there do not seem to be any other associated conditions....
Published on Jul 1, 2019in The Lancet Child & Adolescent Health
Celine Perceval (Vrije Universiteit Brussel), Hania Szajewska64
Estimated H-index: 64
(Medical University of Warsaw)
+ 2 AuthorsYvan Vandenplas52
Estimated H-index: 52
(Vrije Universiteit Brussel)
Summary The gastrointestinal microbiome is a hot topic in clinical research. Beneficial effects of selected probiotics in the prevention of gastrointestinal disorders are mainly restricted to acute gastroenteritis, antibiotic-associated diarrhoea, infantile colic, and necrotising enterocolitis. However, no broad consensus exists to recommend the use of probiotics in the prevention of these conditions, mainly because of the different design of the studies done so far, resulting in little evidence...
Published on Jul 11, 2019in Nature Reviews Gastroenterology & Hepatology23.57
Mary Ellen Sanders31
Estimated H-index: 31
Daniel Merenstein24
Estimated H-index: 24
(GUMC: Georgetown University Medical Center)
+ 2 AuthorsRobert A. Rastall49
Estimated H-index: 49
(University of Reading)
Probiotics and prebiotics are microbiota-management tools for improving host health. They target gastrointestinal effects via the gut, although direct application to other sites such as the oral cavity, vaginal tract and skin is being explored. Here, we describe gut-derived effects in humans. In the past decade, research on the gut microbiome has rapidly accumulated and has been accompanied by increased interest in probiotics and prebiotics as a means to modulate the gut microbiota. Given the im...
Published on Jul 9, 2019in Nutrients4.17
Tu T. Mai , Dat Q. Tran33
Estimated H-index: 33
+ 2 AuthorsYuying Liu12
Estimated H-index: 12
Human breast milk (HBM) may have beneficial effects on Lactobacillus reuteri DSM 17938 (LR 17938) -mediated immunomodulation. We aimed to determine the effects of HBM on proliferation of LR 17938 in vitro and its associated proteins and metabolites in culture, in order to provide mechanistic insights into the health benefits of LR 17938. LR 17938 was cultured anaerobically in MRS bacterial culture media, HBM (from 6 mothers), and 2 types of cow-milk formula. The colony-forming unit (CFU) was cal...
Published on Jan 8, 2019in Developmental Psychobiology1.85
Janice M. Kan2
Estimated H-index: 2
(UNSW: University of New South Wales),
Caitlin S. M. Cowan5
Estimated H-index: 5
(UCC: University College Cork)
+ 1 AuthorsNadine A. Kasparian19
Estimated H-index: 19
(UNSW: University of New South Wales)
National Heart Foundation of Australia (Future Leader Fellowship - Grant Number: 101229); National Health and Medical Research Council (Grant Number: APP1081001); Commonwealth Fund (Harkness Fellowship in Health Care Policy & Practice); University of New South Wales and Sydney Partnership for Health, Education, Research and Enterprise (2017 Seed Funding)
Published on Jun 20, 2019in Headache3.75
Amy A. Gelfand13
Estimated H-index: 13
(UCSF: University of California, San Francisco),
Dawn C. Buse34
Estimated H-index: 34
(Albert Einstein College of Medicine)
+ 3 AuthorsI. Elaine Allen6
Estimated H-index: 6
(UCSF: University of California, San Francisco)
Published on Jun 27, 2019in Nutrients4.17
Susan Mills16
Estimated H-index: 16
Jonathan A. Lane + 3 AuthorsCatherine Stanton74
Estimated H-index: 74
Modulation of the human gut microbiota through probiotics, prebiotics and dietary fibre are recognised strategies to improve health and prevent disease. Yet we are only beginning to understand the impact of these interventions on the gut microbiota and the physiological consequences for the human host, thus forging the way towards evidence-based scientific validation. However, in many studies a percentage of participants can be defined as ‘non-responders’ and scientists are beginning to unravel ...
Published on Jun 3, 2019in Journal of General Internal Medicine4.61
Daniel Merenstein24
Estimated H-index: 24
(Georgetown University),
John Guzzi (Georgetown University), Mary Ellen Sanders31
Estimated H-index: 31