Systematic Review 2022: Effect of probiotics versus herbal remedies on infantile colic

Document Type : Original Article

Authors

1 National Nutrition Institute

2 Qaha specialized hospital, ministry of health

3 Manshyat Elbakry general hospital, ministry of health.

4 Berket El-Sabae hospital, ministry of health

5 Alexandria police hospital

6 El-menshawy general hospital, ministry of health

Abstract

Infantile colic is one of the most distressing early-life manifestations. Sudden episodes of inconsolable crying without a clear reason or treatment plan might cause parents to try incorrect methods, which can injure the infant. Many treatment strategies were developed to solve this dilemma; the effectiveness of each is still doubtful. Objective: To compare the effect of probiotics as a recent therapy in the management of infant colic and herbal remedies as one of the most commonly used strategies. By searching national and international databases, 24 randomized clinical trials RCT studies were included (19 examining the effect of probiotics, 5 for herbal remedies). Results: The most researched probiotic, Lactobacillus reuteri, exhibits statistically significant improvement and a decrease in the daily average crying time >=50% on days 7, 14, and 21. On day 7, RR (95% CI): 4.3 (2.3-8.7), P value 0.026; on day 14, RR (95% CI): 4.3 (2.3-8.7), P value< .001. A phase III, double-blind, randomized placebo-controlled trial found that the lactobacillus reuteri group cried or fussed for 49 minutes longer than the placebo group, (95% confidence interval 8 to 90 minutes, P=0.02). Fennel emulsion was the most studied in the herbal group with significant improvement to the placebo group (p< 0.01) absolute risk reduction (ARR):41% (95% CI 25 to 57). Conclusions: None of the therapies shows dramatic improvement, and probiotic supplementation's long-term effects are still a concern. More research is needed including local herbal remedies of our community.

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