Abstract

Infantile colic (IC) is a common condition characterised by excessive crying in the early months of life and has a substantial impact on the quality of life of caregivers. The objective of this study was to assess the safety and effects of probiotics for infantile colic.

We searched MEDLINE, EMBASE, Cochrane Library from inception to Jul 2024. RCTs comparing probiotics to any control in infant with colic were considered. The primary outcomes were treatment success, crying time, the number of cases of IC, and withdrawals due to adverse events. RoB 1 and GRADE were used for risk of bias and certainty of the evidence assessment.

There were 45 RCTs (n=3475) eligible for inclusion. Bifidobacterium animalis is more effective than placebo in achieving treatment success (relative risk [RR] 2.65, 95%CI 1.95 to 3.62, high certainty). Lactobacillus reuteri; mixture of Bifidobacterium longum and Pediococcus pentosaceus; and a synbiotic probiotic mixture of 7 strains maybe more effective than placebo in achieving treatment success with low certainty of evidence. B. animalis may lead to less crying time compared to placebo (MD -36.04 min/day, 95% CI, -29.39 to -42.68, low certainty) (figure 1). Meta-regression indicated that treatment effect of probiotics compared to placebo decreased over time. Moderate-certainty evidence suggests probiotics probably increase treatment success in exclusively breastfed infants compared with placebo. (RR 2.05, 95%CI 1.70 to 2.46).

High, moderate and low certainty evidence across probiotic specimens and follow up times suggest efficacy in the treatment of infantile colic. Future research should explore their mechanisms within the microbiome.