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BET 2: Probiotics and crying time in babies with infantile colic
  1. Nina Batchelor,
  2. Jennifer Kelly,
  3. Hyun Choi,
  4. Brona Geary
  1. University Hospital Lewisham, London, UK

Abstract

A short-cut review was carried out to establish whether probiotics reduced crying time in babies with infantile colic. Using the reported searches 88 papers were found, of which five presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the best papers are tabulated. It is concluded that there is evidence that the administration of probiotics decreases the severity and duration of infantile colic when compared with placebo and some proprietary remedies.

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Clinical scenario

A mother attends the Emergency Department with her breastfed 8-week-old baby girl who is crying inconsolably. History and examination point towards a diagnosis of infantile colic. You wonder whether you should suggest a proprietary over-the-counter remedy or whether you should just say that this is a self-limiting condition. A passing paediatrician notices your dilemma and suggests probiotic therapy to reduce the baby's distress. You wonder if there is any evidence to support her advice.

Three-part question

In [babies presenting with infantile colic], is [the use of probiotics better than watchful waiting] at [reduce crying time and infant distress]?

Search strategy

MEDLINE 1950 to April 2015 using the OVID interface. EMBASE 1980 to March 2015 using the OVID interface: [Exp Probiotics or probiotics.mp OR exp Lactobacillus or Lactobacillus.mp OR probiotic bacteria.mp OR probiotic.mp] AND [Exp colic or Baby colic.mp OR Infant colic.mp OR infantile colic.mp OR colicky infants.mp] LIMIT to human AND English Language.

The Cochrane Library Issue 4 of 12, April 2015: MeSH descriptor: [Probiotics] explode all trees AND MeSH descriptor: [Colic] explode all trees 7 records 1 unique article.

Outcome

Eighty-eight papers were found from the literature search and eight journal articles were considered relevant to the research question. One was a meta-analysis including three of the other papers. There was no Cochrane review on this topic. Five papers are therefore included in the table below:

Table 2

Probiotics and crying time in babies with infantile colic

Comments

Infantile colic is a common disturbance occurring in the first 3 months of life; it is a self-limiting condition associated with parental anxiety, exhaustion and early cessation of breastfeeding. There is uncertainty regarding geographical and socioeconomic prevalence of infantile colic. Most studies use reported clinically significant benefits to babies in reduced crying times. Apart from one multicentred RCT, most other studies included small study samples. No adverse effects were reported, and probiotics were well tolerated. The search uncovered one study protocol (Sung et al 2014)6 for an individual patient data meta-analysis into this issue, but no results three were yet reported.

Clinical bottom line

There is evidence that the administration of probiotics decreases the severity and duration of infantile colic.

REFERENCES

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