Probiotics for Infantile Colic: Strain-Specific Efficacy

Abstract

Introduction: Infantile colic affects 20% of infants, causing distress and parental anxiety. Lactobacillus reuteri DSM 17938 is commonly used, but strain-specific evidence is required. Methods: Systematic review of 10 RCTs (n=1,501) comparing L. reuteri (≥10^8 CFU/day) versus placebo in breastfed or formula-fed infants <3 months with colic (Wessel criteria). Primary outcome: mean daily crying time at day 21. Secondary: treatment success (≥50% reduction). Results: At day 21, crying time was reduced by 51 minutes/day more than placebo (95% CI -68 to -34). Treatment success rate was 77% vs 34% (RR 2.26, NNT=3). Benefits were seen only in breastfed infants. No adverse events reported. Discussion: L. reuteri reduces crying via vagal tone modulation and anti-inflammatory effects. Formula-fed infants may require different strains. Conclusion: Lactobacillus reuteri DSM 17938 is recommended for breastfed infants with colic. Formula-fed infants need further study.