Evidence of Lactobacillus reuteri to reduce colic in breastfed babies: Systematic review and meta-analysis.
- 2021-12
- Complementary Therapies in Medicine 63
- Angela Pierina Dos Reis Buzzo Zermiani
- Ana Luiza Pelissari Peçanha de Paula Soares
- Bárbara Leticia da Silva Guedes de Moura
- Edson Roberto Arpini Miguel
- Luciana Dias Ghiraldi Lopes
- N. Santana
- T. Da Silva Santos
- I. G. Demarchi
- Jorge Juarez Teixeira
- PubMed: 34627993
- DOI: 10.1016/j.ctim.2021.102781
Abstract
Objective: To investigate evidence for the treatment of childhood colic by supplementing Lactobacillus reuteri in infants breastfed with breast milk.
Methods: The study was conducted according to the PRISMA protocol. The databases used for acquiring data were PubMed and Web of Science, applying MeSH terms and free terms. Meta-analysis was conducted using Stata ™ 12.0. The risk of bias was evaluated by the Review Manager (RevMan) 5.3 tool, and the strength of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE).
Results: Ten clinical trials were included in the review. The administration of L. reuteri (DSM 17938 or ATCC55730) was tested in infants (n = 248) versus the control/placebo group (n = 229). Eight articles were included in the meta-analysis. There was a significant response in reducing crying time (minutes/day) and treatment effectiveness (reduction ≥ 50% in average daily crying time) in the first week (p = 0.001 and p = 0.003, respectively). These results were similar in the second, third weeks (p < 0.001 for both outcomes) and fourth weeks (p<0.001 and p = 0.002, respectively). The risk of bias was low for the majority of the studies. Confidence in evidence was considered very low for crying time and low for effectiveness treatment.
Conclusions: The evidence shows that the administration of Lactobacillus reuteri to babies fed with breast milk reduces the crying time in babies diagnosed with colic. But our confidence in the effect estimate is limited.
Keywords: Breastfeeding; Colic; Crying; Lactobacillus reuteri.
Research Insights
| Supplement | Health Outcome | Effect Type | Effect Size |
|---|---|---|---|
| Lactobacillus reuteri | Reduced Crying in Infants | Beneficial | Large |
| Lactobacillus reuteri HA-188 | Improved Colic Treatment Effectiveness at Two to Three Weeks | Beneficial | Moderate |
| Lactobacillus reuteri HA-188 | Reduced Crying Duration | Beneficial | Large |
| Lactobacillus reuteri LRE02 | Reduced Colic Symptoms | Beneficial | Moderate |
| Lactobacillus reuteri LRE02 | Reduced Crying in Infants | Beneficial | Large |
| Lactobacillus reuteri MAK02L14R | Improved Colic Treatment Effectiveness at Two to Three Weeks | Beneficial | Moderate |
| Lactobacillus reuteri MAK02L14R | Reduced Crying in Infants | Beneficial | Large |
| Lactobacillus reuteri Osfortis | Reduced Crying Duration | Beneficial | Large |
| Lactobacillus reuteri SD-5865 | Reduced Crying Time in Infants with Colic | Beneficial | Moderate |
| Lactobacillus reuteri UALg-05 | Effective Colic Treatment | Beneficial | Moderate |
| Lactobacillus reuteri UALg-05 | Reduced Crying Duration | Beneficial | Large |
| Lactobacillus reuteri UALre-16 | Reduced Average Daily Crying Time by 50% or More | Beneficial | Moderate |
| Lactobacillus reuteri UALre-16 | Reduced Crying Duration | Beneficial | Large |