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Lactobacillus reuteri to Treat Infant Colic: A Meta-analysis.
Pediatrics. 2018 01; 141(1)Ped

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.

Authors+Show Affiliations

Murdoch Children's Research Institute, The Royal Children's Hospital, and the University of Melbourne, Melbourne, Victoria, Australia; valerie.sung@rch.org.au.Department of Mathematics, Duquesne University, Pittsburgh, Pennsylvania. University of Pittsburgh Medical Center St. Margaret's Hospital, Pittsburgh, Pennsylvania.Department of Pediatrics, Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, California.University of Toronto and The Hospital for Sick Children, Toronto, Ontario, Canada.University of Toronto and The Hospital for Sick Children, Toronto, Ontario, Canada.Ospendale Infantile Regina Margherita, Citta della Salute e della Scienza di Torino, Torino, Italy.Department of Paediatrics, The Medical University of Warsaw, Warsaw, Poland.Department of Neonatology, Nepean Hospital and Sydney Medical School Nepean, University of Sydney, Sydney, New South Wales, Australia.Department of Pediatric Gastroenterology, Paris Descartes University and Necker-Enfants Malades Hospital, Paris, France.Department of Pediatrics, University of Bari, Bari, Italy.Bacteriology Unit, National Institute for Health and Welfare, Helsinki, Finland.Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland; and.Department of Pediatrics, University of California Davis Health System, Sacramento, California.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

29279326

Citation

Sung, Valerie, et al. "Lactobacillus Reuteri to Treat Infant Colic: a Meta-analysis." Pediatrics, vol. 141, no. 1, 2018.
Sung V, D'Amico F, Cabana MD, et al. Lactobacillus reuteri to Treat Infant Colic: A Meta-analysis. Pediatrics. 2018;141(1).
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). https://doi.org/10.1542/peds.2017-1811
Sung V, et al. Lactobacillus Reuteri to Treat Infant Colic: a Meta-analysis. Pediatrics. 2018;141(1) PubMed PMID: 29279326.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lactobacillus reuteri to Treat Infant Colic: A Meta-analysis. AU - Sung,Valerie, AU - D'Amico,Frank, AU - Cabana,Michael D, AU - Chau,Kim, AU - Koren,Gideon, AU - Savino,Francesco, AU - Szajewska,Hania, AU - Deshpande,Girish, AU - Dupont,Christophe, AU - Indrio,Flavia, AU - Mentula,Silja, AU - Partty,Anna, AU - Tancredi,Daniel, PY - 2017/09/20/accepted PY - 2017/12/28/pubmed PY - 2019/1/17/medline PY - 2017/12/28/entrez JF - Pediatrics JO - Pediatrics VL - 141 IS - 1 N2 - 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. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/29279326/full_citation L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=29279326 DB - PRIME DP - Unbound Medicine ER -