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 - Funding Information:
FUndInG: This work was supported by the International Scientific Association for Probiotics and Prebiotics (ISAPP). ISAPP contributed to the costs of all
Funding Information:
teleconferences and facilitated the meetings for this collaboration in June 2014 in Aberdeen, united Kingdom, and in June 2016 in Turku, Finland. ISAPP had no role in the design or writing of this manuscript nor in the decision to submit this article for publication. Each individual trial has received funding from its own respective funding bodies. Dr Sung is supported by a national Health and Medical Research Council Early Career Fellowship (APP1125687), a Royal Australasian College of Physicians Cottrell Research Establishment Fellowship, and has been supported by a Melbourne Children’s Clinician-Scientist Fellowship. The Murdoch Children's Research Institute is supported by the Victorian Government’s Operational Infrastructure Support Program.
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 - http://www.scopus.com/inward/record.url?scp=85040032347&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85040032347&partnerID=8YFLogxK
U2 - 10.1542/peds.2017-1811
DO - 10.1542/peds.2017-1811
M3 - Review article
C2 - 29279326
AN - SCOPUS:85040032347
SN - 0031-4005
VL - 141
JO - Pediatrics
JF - Pediatrics
IS - 1
M1 - e20171811
ER -