Probiotic shows promise to reduce colic in breastfed babies: Meta-analysis

The probiotic Lactobacillus reuteri has the potential to provide some reduction in crying in exclusively breastfed babies less than three months old, new data reveals.

The cause of colic, which affects one in five families, is unkown and so far no effective treatment has been found.

But a new international study led by the Murdoch Children’s Research Institute (MCRI), in collaboration with 11 other institutions around the world, found the probiotic Lactobacillus reuteri has the potential to provide some reduction in crying in exclusively breastfed babies under the age of three months.

Researchers found compared to a placebo, the probiotic group was two times more likely to reduce crying by 50 per cent, by the 21st day of treatment, for the babies who were exclusively breastfed.

They assessed four double-blind trials involving 345 infants with colic (174 probiotic, 171 placebo).

Intervention effects

Writing in Pediatrics, the journal of the American Academy of Pediatrics, they stated: "The probiotic group averaged less cry/fuss time than placebo at all time points. The probiotic group was almost twice as likely as placebo to experience treatment success at all time points. Intervention effects were dramatic in breastfed infants, but insignificant in 21 formula-fed infants."

Lead author from MCRI and pediatrician Dr Valerie Sung said in the last decade, many studies have looked at the role of probiotics in treating colic.

"One particular strain, Lactobacillus reuteri (L reuteri) DSM 17938, has shown promise, but results have been conflicting," she said.

The meta-analysis included data from trials in Italy, Poland, Canada and Australia. The Australian trial, also led by Dr Sung, was the largest and only to include iboth breastfed and formula-fed babies which showed L reuteri to be ineffective.

However, when combined with the other three trials, it is clear that L reuteri is effective for babies with colic who are exclusively breastfed.

Case by case

Dr Sung said while the study was hopeful, the lack of studies on formula-fed babies meant it should not be considered an automatic cure.

“We did find evidence that L reuteri is effective in breastfed babies with colic. The role of L reuteri in formula-fed babies with colic cannot be determined due to lack of studies.”

“Ultimately the effectiveness of this treatment will need to be assessed on a case by case basis. It is also important to remember that each probiotic strain works differently. L reuteri is the only probiotic strain that may help crying babies who are breastfed.”

The study was supported by the International Scientific Association for Probiotics and Prebiotics.

It concluded: "Lactobacillus reuteri DSM17938 is effective and can be recommended for breastfed infants with colic. Its role in formula-fed infants with colic needs further research."

Source: Pediatrics

doi: 10.1542/peds.2017-1811

"Lactobacillus reuteri to treat infant colic: A meta -analysis"

Authors: Valerie Sung, et al.