TY - JOUR
T1 - Lactobacillus reuteri to treat infant colic
T2 - 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
N1 - Publisher Copyright:
Copyright © 2018 by the American Academy of Pediatrics. All rights reserved.
PY - 2018/1
Y1 - 2018/1
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.
AB - 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.
UR - https://www.scopus.com/pages/publications/85040032347
U2 - 10.1542/peds.2017-1811
DO - 10.1542/peds.2017-1811
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C2 - 29279326
AN - SCOPUS:85040032347
SN - 0031-4005
VL - 141
JO - Pediatrics
JF - Pediatrics
IS - 1
M1 - e20171811
ER -