STRAIN-SPECIFIC EFFICACY OF PROBIOTICS IN MANAGEMENT OF INFANTILE COLIC – A LITERATURE REVIEW
Abstract
Introduction and purpose: Functional gastrointestinal disorders (FGIDs), such as infantile colic (IC), are conditions that occur without any identified structural or biochemical abnormalities. It is estimated that nearly 20% of infants under five months of age experience infantile colic, which is characterized by episodes of excessive crying that are difficult to soothe. The condition causes significant emotional and economic impact on families and healthcare systems. This review aims to analyse efficacy of various probiotic strains in managing symptoms of infantile colic.
Results: Probiotic strains vary in the effects on treating infantile colic. The most extensively analysed probiotic for IC is Limosilactobacillus reuteri DSM 17938 (formerly named Lactobacillus). However, its effectiveness in formula-fed infants is still questionable. Other strains, including Bifidobacterium animalis subsp. lactis BB-12, Bifidobacterium breve CECT7263, and combinations such as Bifidobacterium longum KABP042 with Pediococcus pentosaceus KABP041 have shown promising results, often outperforming L. reuteri and even pharmacological treatments for example with simethicone.
Conclusions: Probiotic therapy offers a safe and promising approach to reducing symptoms of infantile colic, especially in breastfed infants. However, its efficacy is strain-dependent and not universal. Further large-scale, high-quality randomized controlled trials are necessary to establish standardized recommendations and explore long-term outcomes. Personalized probiotic interventions targeting the infant gut microbiota may be included in the future of colic management.
References
Benninga, M. A., Nurko, S., Faure, C., Hyman, P. E., St James Roberts, I., & Schechter, N. L. (2016). Childhood functional gastrointestinal disorders: Neonate/Toddler. Gastroenterology, 150(6), 1443-1455.e2. https://doi.org/10.1053/j.gastro.2016.02.016
Wessel, M. A., Cobb, J. C., Jackson, E. B., Harris, G. S., & Detwiler, A. C. (1954). PAROXYSMAL FUSSING IN INFANCY, SOMETIMES CALLED “COLIC.” PEDIATRICS, 14(5), 421–435. https://doi.org/10.1542/peds.14.5.421
Vandenplas, Y., Hauser, B., & Salvatore, S. (2019). Functional Gastrointestinal Disorders in Infancy: Impact on the health of the infant and family. Pediatric Gastroenterology Hepatology & Nutrition, 22(3), 207. https://doi.org/10.5223/pghn.2019.22.3.207
Vandenplas, Y., Abkari, A., Bellaiche, M., Benninga, M., Chouraqui, J. P., Çokura, F., Harb, T., Hegar, B., Lifschitz, C., Ludwig, T., Miqdady, M., De Morais, M. B., Osatakul, S., Salvatore, S., Shamir, R., Staiano, A., Szajewska, H., & Thapar, N. (2015). Prevalence and health outcomes of functional gastrointestinal symptoms in infants from birth to 12 months of age. Journal of Pediatric Gastroenterology and Nutrition, 61(5), 531–537. https://doi.org/10.1097/mpg.0000000000000949
Mahon, J., Lifschitz, C., Ludwig, T., Thapar, N., Glanville, J., Miqdady, M., Saps, M., Quak, S. H., Wijnkoop, I. L., Edwards, M., Wood, H., & Szajewska, H. (2017). The costs of functional gastrointestinal disorders and related signs and symptoms in infants: a systematic literature review and cost calculation for England. BMJ Open, 7(11), e015594. https://doi.org/10.1136/bmjopen-2016-015594
Ellett, M., Schuff, E., & Davis, J. B. (2005). Parental perceptions of the lasting effects of infant colic. MCN the American Journal of Maternal/Child Nursing, 30(2), 127–132. https://doi.org/10.1097/00005721-200503000-00011
Vik, T., Grote, V., Escribano, J., Socha, J., Verduci, E., Fritsch, M., Carlier, C., Von Kries, R., & Koletzko, B. (2009). Infantile colic, prolonged crying and maternal postnatal depression. Acta Paediatrica, 98(8), 1344–1348. https://doi.org/10.1111/j.1651-2227.2009.01317.x
Smarius, L. J. C. A., Strieder, T. G. A., Loomans, E. M., Doreleijers, T. a. H., Vrijkotte, T. G. M., Gemke, R. J., & Van Eijsden, M. (2016). Excessive infant crying doubles the risk of mood and behavioral problems at age 5: evidence for mediation by maternal characteristics. European Child & Adolescent Psychiatry, 26(3), 293–302. https://doi.org/10.1007/s00787-016-0888-4
Indrio, F., Dargenio, V. N., Francavilla, R., Szajewska, H., & Vandenplas, Y. (2023). Infantile Colic and Long-Term Outcomes in Childhood: A Narrative Synthesis of the evidence. Nutrients, 15(3), 615. https://doi.org/10.3390/nu15030615
Huttenhower, C., Gevers, D., Knight, R., Abubucker, S., Badger, J. H., Chinwalla, A. T., Creasy, H. H., Earl, A. M., Fitzgerald, M. G., Fulton, R. S., Giglio, M. G., Hallsworth-Pepin, K., Lobos, E. A., Madupu, R., Magrini, V., Martin, J. C., Mitreva, M., Muzny, D. M., Sodergren, E. J., . . . White, O. (2012). Structure, function and diversity of the healthy human microbiome. Nature, 486(7402), 207–214. https://doi.org/10.1038/nature11234
Collado, M. C., Rautava, S., Aakko, J., Isolauri, E., & Salminen, S. (2016). Human gut colonisation may be initiated in utero by distinct microbial communities in the placenta and amniotic fluid. Scientific Reports, 6(1). https://doi.org/10.1038/srep23129
Bäckhed, F., Roswall, J., Peng, Y., Feng, Q., Jia, H., Kovatcheva-Datchary, P., Li, Y., Xia, Y., Xie, H., Zhong, H., Khan, M. T., Zhang, J., Li, J., Xiao, L., Al-Aama, J., Zhang, D., Lee, Y. S., Kotowska, D., Colding, C., Tremaroli V., Yin Y., Bergman S., Xu X., Madsen L., Kristiansen K., Dahlgren J., & Wang, J. (2015). Dynamics and Stabilization of the Human Gut Microbiome during the First Year of Life. Cell Host & Microbe, 17(5), 690–703. https://doi.org/10.1016/j.chom.2015.04.004
Odiase, E., Frank, D. N., Young, B. E., Robertson, C. E., Kofonow, J. M., Davis, K. N., Berman, L. M., Krebs, N. F., & Tang, M. (2023). The Gut Microbiota Differ in Exclusively Breastfed and Formula-Fed United States Infants and are Associated with Growth Status. Journal of Nutrition, 153(9), 2612–2621. https://doi.org/10.1016/j.tjnut.2023.07.009
Hill, C., Guarner, F., Reid, G., Gibson, G. R., Merenstein, D. J., Pot, B., Morelli, L., Canani, R. B., Flint, H. J., Salminen, S., Calder, P. C., & Sanders, M. E. (2014). The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nature Reviews Gastroenterology & Hepatology, 11(8), 506–514. https://doi.org/10.1038/nrgastro.2014.66
Szajewska, H., Canani, R. B., Domellöf, M., Guarino, A., Hojsak, I., Indrio, F., Lo Vecchio, A., Mihatsch, W. A., Mosca, A., Orel, R., Salvatore, S., Shamir, R., Van Den Akker, C. H. P., Van Goudoever, J. B., Vandenplas, Y., & Weizman, Z. (2022). Probiotics for the Management of Pediatric Gastrointestinal Disorders: Position Paper of the ESPGHAN Special Interest Group on Gut Microbiota and Modifications. Journal of Pediatric Gastroenterology and Nutrition, 76(2), 232–247. https://doi.org/10.1097/mpg.0000000000003633
Savino, F., Garro, M., Montanari, P., Galliano, I., & Bergallo, M. (2017). Crying Time and RORγ/FOXP3 Expression in Lactobacillus reuteri DSM17938-Treated Infants with Colic: A Randomized Trial. The Journal of Pediatrics, 192, 171-177.e1. https://doi.org/10.1016/j.jpeds.2017.08.062
Sung, V., Hiscock, H., Tang, M. L. K., Mensah, F. K., Nation, M. L., Satzke, C., Heine, R. G., Stock, A., Barr, R. G., & Wake, M. (2014). Treating infant colic with the probiotic Lactobacillus reuteri: double blind, placebo controlled randomised trial. BMJ, 348(apr01 2), g2107. https://doi.org/10.1136/bmj.g2107
Moreno-Villares, J. M., Andrade-Platas, D., Soria-López, M., Colomé-Rivero, G., Lamban, A. C., Martinez-Figueroa, M. G., Espadaler-Mazo, J., & Valverde-Molina, J. (2024). Comparative efficacy of probiotic mixture Bifidobacterium longum KABP042 plus Pediococcus pentosaceus KABP041 vs. Limosilactobacillus reuteri DSM17938 in the management of infant colic: a randomized clinical trial. European Journal of Pediatrics, 183(12), 5371–5381. https://doi.org/10.1007/s00431-024-05806-x
Nocerino, R., De Filippis, F., Cecere, G., Marino, A., Micillo, M., Di Scala, C., De Caro, C., Calignano, A., Bruno, C., Paparo, L., Iannicelli, A. M., Cosenza, L., Maddalena, Y., Della Gatta, G., Coppola, S., Carucci, L., Ercolini, D., & Canani, R. B. (2019). The therapeutic efficacy of Bifidobacterium animalis subsp. lactis BB‐12® in infant colic: A randomised, double blind, placebo‐controlled trial. Alimentary Pharmacology & Therapeutics, 51(1), 110–120. https://doi.org/10.1111/apt.15561
Maldonado-Lobón, J., Blanco-Rojo, R., Maldonado, J., Ali, M., Almazán, M., Suanes-Cabello, A., Callejón, E., Jaldo, R., Benavídes, Negrillo, A., Sañudo, A., Rodríguez, C., Bañuelos, O., Fonollá, J., & Olivares, M. (2021). Efficacy of bifidobacterium breve CECT7263 for Infantile Colic treatment: an open-label, parallel, randomised, controlled trial. Beneficial Microbes, 12(1), 55–68. https://doi.org/10.3920/bm2020.0105
Delcourt, H., Huysentruyt, K., & Vandenplas, Y. (2024). A synbiotic mixture for the management of infantile colic: A randomized trial. European Journal of Pediatrics, 184(1). https://doi.org/10.1007/s00431-024-05860-5
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