Infant Colic – What works: A Systematic Review of Interventions for Breastfed Infants

Harb, Tracy, Matsuyama, Misa, David, Michael and Hill, Rebecca (2016) Infant Colic – What works: A Systematic Review of Interventions for Breastfed Infants. Journal of Pediatric Gastroenterology and Nutrition, 62 5: 668-686. doi:10.1097/MPG.0000000000001075

Author Harb, Tracy
Matsuyama, Misa
David, Michael
Hill, Rebecca
Title Infant Colic – What works: A Systematic Review of Interventions for Breastfed Infants
Journal name Journal of Pediatric Gastroenterology and Nutrition   Check publisher's open access policy
ISSN 1536-4801
Publication date 2016-05
Sub-type Article (original research)
DOI 10.1097/MPG.0000000000001075
Open Access Status Not yet assessed
Volume 62
Issue 5
Start page 668
End page 686
Total pages 19
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams and Wilkins
Collection year 2017
Language eng
Formatted abstract
Objectives To determine the strength of evidence for commonly used interventions for colic in breastfed and mixed fed infants younger than 6 months of age.

Methods Searches of PubMed, CINAHL, Embase, AMED and Web of Science databases were conducted from July 2014 to July 2015. Included studies were randomised controlled trials involving mothers and their colicky infants younger than 6 months of age; assessed colic against the Wessel’s or modified Wessel’s criteria; and included phytotherapies, prescription medicines and maternal dietary interventions. Studies with less than 16 participants were excluded. Meta-analyses were conducted where data were sufficient to enable pooling. Quality was assessed against the Cochrane Risk Bias Assessment Tool.

Results A total of 17 articles met the inclusion criteria for this review. The 6 studies included for sub-group meta-analysis on probiotic treatment, notably L. reuteri, demonstrated that probiotics appear an effective treatment, with an overall mean difference (MD) in crying time at day 21 of -55.8min/d (95% CI=-64.4 to -47.3, p=0.001). The 3 studies included for subgroup meta-analysis on preparations containing fennel suggest it to be effective, with an overall MD of -72.1min/d (95%CI=-126.4 to -17.7, p<0.001).

Conclusion Probiotics, in particular L. reuteri, and preparations containing fennel oil appear effective for reducing colic, although there are limitations to these findings. The evidence for material dietary manipulation, lactase, sucrose, glucose and simethicone is weak. Further well-designed clinical trials are required to strengthen the evidence for all of these interventions.
Keyword Infant colic
Material diet
L. reuteri
Herbal teas
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

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