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Published in: BMC Pediatrics 1/2013

Open Access 01-12-2013 | Research article

Probiotics for infantile colic: a systematic review

Authors: Jasim Anabrees, Flavia Indrio, Bosco Paes, Khalid AlFaleh

Published in: BMC Pediatrics | Issue 1/2013

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Abstract

Background

Infantile colic is a common paediatric condition which causes significant parental distress. Increased intestinal coliform colonization in addition to alteration in Lactobacillus abundance and distribution may play an important role in its pathogenesis.
The objectives of this systematic review are to evaluate the efficacy of probiotic supplementation in the reduction of crying time and successful treatment of infantile colic.

Methods

Literature searches were conducted of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials. Only randomized controlled trials enrolling term, healthy infants with colic were included. A meta-analysis of included trials was performed utilizing the Cochrane Collaboration methodology.

Results

Three trials that enrolled 220 breastfed infants met inclusion criteria, of which 209 infants were available for analysis. Two of the studies were assessed as good quality. Lactobacillus reuteri (strains-American Type Culture Collection Strain 55730 and DSM 17 938) was the only species utilized in the therapeutic intervention. Two of the trials were industry funded. Probiotic supplementation compared to simethicone or placebo significantly and progressively shortened crying times to 7 days reaching a plateau at three weeks post initiation of therapy [mean difference −56.03 minutes; 95% CI (−59.92, -52.15)]. Similarly, probiotics compared to placebo significantly increased the treatment success of infantile colic with a relative risk (RR) of 0.06; 95% CI (0.01, 0.25) and a number needed to treat of 2.

Conclusions

Although L. reuteri may be effective as a treatment strategy for crying in exclusively breastfed infants with colic, the evidence supporting probiotic use for the treatment of infant colic or crying in formula-fed infants remains unresolved. Results from larger rigorously designed studies will help draw more definitive conclusions.
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Literature
2.
go back to reference Lucassen PL, Assendelft WJ, van Eijk JT, et al: Systematic review of the occurrence of infantile colic in the community. Arch Dis Child. 2001, 84: 398-403.CrossRefPubMedPubMedCentral Lucassen PL, Assendelft WJ, van Eijk JT, et al: Systematic review of the occurrence of infantile colic in the community. Arch Dis Child. 2001, 84: 398-403.CrossRefPubMedPubMedCentral
3.
go back to reference Wessel MA, Cobb JC, Jackson EB, Harris GS, Detwiler AC: Paroxysmal fussing in infancy, sometimes called colic. Pediatrics. 1954, 14: 421-435.PubMed Wessel MA, Cobb JC, Jackson EB, Harris GS, Detwiler AC: Paroxysmal fussing in infancy, sometimes called colic. Pediatrics. 1954, 14: 421-435.PubMed
4.
go back to reference Castro-Rodríguez JA, Stern DA, Halonen M, et al: Relation between infantile colic and asthma/atopy: a prospective study in an unselected population. Pediatrics. 2001, 108: 878-882.CrossRefPubMed Castro-Rodríguez JA, Stern DA, Halonen M, et al: Relation between infantile colic and asthma/atopy: a prospective study in an unselected population. Pediatrics. 2001, 108: 878-882.CrossRefPubMed
6.
go back to reference Vik T, Grote V, Escribano J, European Childhood Obesity Trial Study Group, et al: Infantile colic, prolonged crying and maternal postnatal depression. Acta Paediatr. 2009, 98: 1344-1348.CrossRefPubMed Vik T, Grote V, Escribano J, European Childhood Obesity Trial Study Group, et al: Infantile colic, prolonged crying and maternal postnatal depression. Acta Paediatr. 2009, 98: 1344-1348.CrossRefPubMed
8.
go back to reference Dennis CL, Ross L: Relationships among infant sleep patterns, maternal fatigue, and development of depressive symptomatology. Birth. 2005, 32: 187-193.CrossRefPubMed Dennis CL, Ross L: Relationships among infant sleep patterns, maternal fatigue, and development of depressive symptomatology. Birth. 2005, 32: 187-193.CrossRefPubMed
9.
go back to reference Miller AR, Barr RG, Eaton WO: Crying and motor behavior of six-week-old infants and postpartum maternal mood. Pediatrics. 1993, 92: 551-558.PubMed Miller AR, Barr RG, Eaton WO: Crying and motor behavior of six-week-old infants and postpartum maternal mood. Pediatrics. 1993, 92: 551-558.PubMed
11.
go back to reference Smart J, Hiscock H: Early infant crying and sleeping problems: a pilot study of impact on parental well-being and parent-endorsed strategies for management. J Paediatr Child Health. 2007, 43: 284-290.CrossRefPubMed Smart J, Hiscock H: Early infant crying and sleeping problems: a pilot study of impact on parental well-being and parent-endorsed strategies for management. J Paediatr Child Health. 2007, 43: 284-290.CrossRefPubMed
12.
go back to reference Miller AR, Barr RG: Infantile colic. Is it a gut issue?. Pediatr Clin North Am. 1991, 38: 1407-1423.PubMed Miller AR, Barr RG: Infantile colic. Is it a gut issue?. Pediatr Clin North Am. 1991, 38: 1407-1423.PubMed
13.
go back to reference Treem WR: Infant colic. A pediatric gastroenterologist’s perspective. Pediatr Clin North Am. 1994, 41: 1121-1138.PubMed Treem WR: Infant colic. A pediatric gastroenterologist’s perspective. Pediatr Clin North Am. 1994, 41: 1121-1138.PubMed
14.
15.
go back to reference Shenassa ED, Brown MJ: Maternal smoking and infantile gastrointestinal dysregulation: the case of colic. Pediatrics. 2004, 114: e497-e505.CrossRefPubMed Shenassa ED, Brown MJ: Maternal smoking and infantile gastrointestinal dysregulation: the case of colic. Pediatrics. 2004, 114: e497-e505.CrossRefPubMed
16.
go back to reference Lehtonen L, Korvenranta H, Eerola E: Intestinal microflora in colicky and noncolicky infants: bacterial cultures and gas–liquid chromatography. J Pediatr Gastroenterol Nutr. 1994, 19: 310-314.CrossRefPubMed Lehtonen L, Korvenranta H, Eerola E: Intestinal microflora in colicky and noncolicky infants: bacterial cultures and gas–liquid chromatography. J Pediatr Gastroenterol Nutr. 1994, 19: 310-314.CrossRefPubMed
17.
go back to reference Savino F, Cresi F, Pautasso S, et al: Intestinal microflora in breastfed colicky and non-colicky infants. Acta Paediatr. 2004, 93: 825-829.CrossRefPubMed Savino F, Cresi F, Pautasso S, et al: Intestinal microflora in breastfed colicky and non-colicky infants. Acta Paediatr. 2004, 93: 825-829.CrossRefPubMed
18.
go back to reference Savino F, Bailo E, Oggero R, et al: Bacterial counts of intestinal Lactobacillus species in infants with colic. Pediatr Allergy Immunol. 2005, 16: 72-75.CrossRefPubMed Savino F, Bailo E, Oggero R, et al: Bacterial counts of intestinal Lactobacillus species in infants with colic. Pediatr Allergy Immunol. 2005, 16: 72-75.CrossRefPubMed
19.
go back to reference Savino F, Cordisco L, Tarasco V, et al: Molecular identification of coliform bacteria from colicky breastfed infants. Acta Paediatr. 2009, 98: 1582-1588.CrossRefPubMed Savino F, Cordisco L, Tarasco V, et al: Molecular identification of coliform bacteria from colicky breastfed infants. Acta Paediatr. 2009, 98: 1582-1588.CrossRefPubMed
20.
go back to reference Savino F, Cordisco L, Tarasco V, et al: Antagonistic effect of Lactobacillus strains against gas-producing coliforms isolated from colicky infants. BMC Microbiol. 2011, 11: 157-Doi: 10.1186/1471-2180-11-157CrossRefPubMedPubMedCentral Savino F, Cordisco L, Tarasco V, et al: Antagonistic effect of Lactobacillus strains against gas-producing coliforms isolated from colicky infants. BMC Microbiol. 2011, 11: 157-Doi: 10.1186/1471-2180-11-157CrossRefPubMedPubMedCentral
21.
go back to reference Aloisio I, Santini C, Biavati B, et al: Characterization of Bifidobacterium spp. strains for the treatment of enteric disorders in newborns. Appl Microbiol Biotechnol. 2012, 96: 1561-1576.CrossRefPubMed Aloisio I, Santini C, Biavati B, et al: Characterization of Bifidobacterium spp. strains for the treatment of enteric disorders in newborns. Appl Microbiol Biotechnol. 2012, 96: 1561-1576.CrossRefPubMed
23.
24.
go back to reference Savino F, Pelle E, Palumeri E, et al: Lactobacillus reuteri (American Type Culture Collection Strain 55730) versus simethicone in the treatment of infantile colic: a prospective randomized study. Pediatrics. 2007, 119: e124-e130.CrossRefPubMed Savino F, Pelle E, Palumeri E, et al: Lactobacillus reuteri (American Type Culture Collection Strain 55730) versus simethicone in the treatment of infantile colic: a prospective randomized study. Pediatrics. 2007, 119: e124-e130.CrossRefPubMed
25.
go back to reference Savino F, Cordisco L, Tarasco V, et al: Lactobacillus reuteri DSM 17938 in infantile colic: a randomized, double-blind, placebo-controlled trial. Pediatrics. 2010, 126: e526-e533.CrossRefPubMed Savino F, Cordisco L, Tarasco V, et al: Lactobacillus reuteri DSM 17938 in infantile colic: a randomized, double-blind, placebo-controlled trial. Pediatrics. 2010, 126: e526-e533.CrossRefPubMed
26.
go back to reference Szajewska H, Gyrczuk E, Horvath A: Lactobacillus reuteri DSM 17938 for the Management of Infantile Colic in Breastfed Infants: A Randomized, Double-Blind, Placebo-Controlled Trial. J Pediatr. 2013, 162: 257-262.CrossRefPubMed Szajewska H, Gyrczuk E, Horvath A: Lactobacillus reuteri DSM 17938 for the Management of Infantile Colic in Breastfed Infants: A Randomized, Double-Blind, Placebo-Controlled Trial. J Pediatr. 2013, 162: 257-262.CrossRefPubMed
27.
go back to reference Egervärn M, Danielsen M, Roos S, Lindmark H, Lindgren S: Antibiotic susceptibility profiles of Lactobacillus reuteri and Lactobacillus fermentum. J Food Prot. 2007, 70: 412-418.PubMed Egervärn M, Danielsen M, Roos S, Lindmark H, Lindgren S: Antibiotic susceptibility profiles of Lactobacillus reuteri and Lactobacillus fermentum. J Food Prot. 2007, 70: 412-418.PubMed
28.
29.
go back to reference Rosander A, Connolly E, Roos S: Removal of antibiotic resistance gene-carrying plasmids from Lactobacillus reuteri ATCC 55730 and characterization of the resulting daughter strain, L. reuteri DSM 17938. Appl Environ Microbiol. 2008, 74: 6032-6040.CrossRefPubMedPubMedCentral Rosander A, Connolly E, Roos S: Removal of antibiotic resistance gene-carrying plasmids from Lactobacillus reuteri ATCC 55730 and characterization of the resulting daughter strain, L. reuteri DSM 17938. Appl Environ Microbiol. 2008, 74: 6032-6040.CrossRefPubMedPubMedCentral
30.
go back to reference Lucas A, St J-RI: Crying, fussing and colic behaviour in breast- and bottle-fed infants. Early Hum Dev. 1998, 53: 9-18.CrossRefPubMed Lucas A, St J-RI: Crying, fussing and colic behaviour in breast- and bottle-fed infants. Early Hum Dev. 1998, 53: 9-18.CrossRefPubMed
31.
go back to reference Rhoads JM, Fatheree NY, Norori J, et al: Altered fecal microflora and increased fecal calprotectin in infants with colic. J Pediatr. 2009, 155: 823-828. e1CrossRefPubMed Rhoads JM, Fatheree NY, Norori J, et al: Altered fecal microflora and increased fecal calprotectin in infants with colic. J Pediatr. 2009, 155: 823-828. e1CrossRefPubMed
32.
33.
go back to reference Dunn AG, Gallego B, Coiera E: Industry influenced evidence production in collaborative research communities: a network analysis. J Clin Epidemiol. 2012, 65: 535-543.CrossRefPubMed Dunn AG, Gallego B, Coiera E: Industry influenced evidence production in collaborative research communities: a network analysis. J Clin Epidemiol. 2012, 65: 535-543.CrossRefPubMed
34.
go back to reference Spinler JK, Taweechotipatr M, Rognerud CL, et al: Human-derived probiotic Lactobacillus reuteri demonstrate antimicrobial activities targeting diverse enteric bacterial pathogens. Anaerobe. 2008, 14: 166-171.CrossRefPubMedPubMedCentral Spinler JK, Taweechotipatr M, Rognerud CL, et al: Human-derived probiotic Lactobacillus reuteri demonstrate antimicrobial activities targeting diverse enteric bacterial pathogens. Anaerobe. 2008, 14: 166-171.CrossRefPubMedPubMedCentral
35.
go back to reference Lin YP, Thibodeaux CH, Pena JA, et al: Probiotic Lactobacillus reuteri suppress proinflammatory cytokines via c-Jun. Inflamm Bowel Dis. 2008, 14: 1068-1083.CrossRefPubMed Lin YP, Thibodeaux CH, Pena JA, et al: Probiotic Lactobacillus reuteri suppress proinflammatory cytokines via c-Jun. Inflamm Bowel Dis. 2008, 14: 1068-1083.CrossRefPubMed
36.
go back to reference Liu Y, Fatheree NY, Mangalat N, et al: Human-derived probiotics Lactobacillus reuteri strains differentially reduce intestinal inflammation. Am J Physiol Gastrointest Liver Physiol. 2010, 299: G1087-G1096.CrossRefPubMedPubMedCentral Liu Y, Fatheree NY, Mangalat N, et al: Human-derived probiotics Lactobacillus reuteri strains differentially reduce intestinal inflammation. Am J Physiol Gastrointest Liver Physiol. 2010, 299: G1087-G1096.CrossRefPubMedPubMedCentral
37.
go back to reference Smits H, Engering A, van der Kleij D, et al: Selective probiotic bacteria induce IL-10-producing regulatory T cells in vitro by modulating dendritic cell function through dendritic cell-specific intercellular adhesion molecule 3-grabbing nonintegrin. J Allergy Clin Immunol. 2005, 115: 1260-1267.CrossRefPubMed Smits H, Engering A, van der Kleij D, et al: Selective probiotic bacteria induce IL-10-producing regulatory T cells in vitro by modulating dendritic cell function through dendritic cell-specific intercellular adhesion molecule 3-grabbing nonintegrin. J Allergy Clin Immunol. 2005, 115: 1260-1267.CrossRefPubMed
38.
go back to reference Sung V, Hiscock H, Tang M, et al: Probiotics to improve outcomes of colic in the community: Protocol for the Baby Biotics randomised controlled trial. BMC Pediatr. 2012, 12: 135-Doi: 10.1186/1471-2431-12-135CrossRefPubMedPubMedCentral Sung V, Hiscock H, Tang M, et al: Probiotics to improve outcomes of colic in the community: Protocol for the Baby Biotics randomised controlled trial. BMC Pediatr. 2012, 12: 135-Doi: 10.1186/1471-2431-12-135CrossRefPubMedPubMedCentral
Metadata
Title
Probiotics for infantile colic: a systematic review
Authors
Jasim Anabrees
Flavia Indrio
Bosco Paes
Khalid AlFaleh
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2013
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/1471-2431-13-186

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