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Key Findings
Simonson et al. (2021) reviewed 20 randomised controlled trials and one meta-analysis of the effectiveness of probiotics in preventing colic among infants. Lactobacillus reuteri DSM 17938 was found by them to significantly reduce the time of crying and fussing in breastfed infants, with at least a 50 per cent reduction in time compared to placebos. However, results in formula-fed infants were inconsistent, partly due to the small sample sizes and inconsistent trial quality, which would not allow for a definite conclusion. The meta-analysis supported these findings by reporting several treatments needed, 2–3, which the authors considered to reflect meaningful clinical benefits. The review showed that L. reuteri was successfully and safely administered to breastfed infants with colic. No evidence could be observed concerning its administration to formula-fed infants or prophylaxis.
Safety and Prevention
No severe adverse events were found in the 15 clinical trials. Treated and controlled infants showed normal growth and development, which was highlighted by Simonson et al. (2021) as the safety predictors of normal full-term babies without any complications at birth. However, they cautioned against using probiotics in immunocompromised or acutely ill infants, which conforms to paediatric guidance. Evidence of preventive use was scanty; some trials had fewer symptoms, but no statistically significant impact in favour of routine prophylaxis use.
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I would not recommend using probiotics as a routine in a nursery of preterm infants. The reviewed studies were restricted to healthy full-term infants, which presupposes the lack of knowledge about the safety and efficacy of preterm groups. The preterm infants are more prone to infection, and probiotics would have to be monitored and controlled. Simonson et al. (2021) explained that the outcomes of the term babies cannot be applied to the preterm babies, except when a particular study is done.
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- Simonson, J., Haglund, K., Weber, E., Fial, A., & Hanson, L. (2021). Probiotics for the Management of Infantile Colic: A Systematic Review. MCN: The American Journal of Maternal/Child Nursing, 46(2), 88–96.
