Lactobacillus Reuteri as Treatment for Colic: A Meta-Analysis That Will Not Make You
DrLewisFirst, MD, MA, Editor-in-Chief, Pediatrics
Perhaps you’ve read somewhere that probiotics are effective treatment for colic. Perhaps
you’ve read just the opposite. When multiple studies appear with smaller numbers of
patients, it’s tough to know what to believe—which is why Sung et al. (10.1542/peds.2017-1811) opted to do a meta-analysis to determine whether in aggregate one can make any conclusions
about the effectiveness of one probiotic—lactobacillus reuteri to treat colic.
The authors did a systematic review to find four randomized controlled trials involving
giving this probiotic to infants with colic and then studying outcomes such as duration
of crying and fussing and whether symptoms resolved by 21 days of treatment. The
results indicate some value to this therapy in breast-fed but not formula fed infants.
Does this calm the controversy down enough to make recommending a probiotic like
lactobacillus reuteri a standard of care for colic? Not necessarily—at least according
to an accompanying commentary by Dr. Ian St. James-Roberts from University College
in London (10.1542/peds.2017-3445), who notes the benefits but also the limitations of using meta-analysis to determine
In the base of this study, Dr. St. James-Roberts raises issues of geographic variations
in the results and in turn in the microbiomes of infants such that this one probiotic
may not be the solution for all babies. This study on treatment and the commentary
are crying out for your attention—so check both out and then let us know if you’d
consider or are already using probiotics to treat colic in your practice. You can
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