LAUSR

A systematic review found four double-blind randomised controlled trials comparing the probiotic Lactobacillus reuteri with placebo for 345 infants with excessive crying or fussing, which the authors called colic. Before intervention, the mean crying time was over 4 h a day. The outcome was duration of fussing or crying recorded in diaries by mothers. All infants, whether on probiotic or placebo, improved with time, spending half as long fussing or crying within 3 weeks. Breastfed infants on probiotics (n = 118) cried on average 25.4 min (95% confidence interval 3.5–47.3) less per day than infants on placebo (n = 113), P < 0.05. Formula-fed infants showed no improvement with probiotic (n = 41) compared with placebo (n = 37). The benefits of probiotic in breastfed babies, while statistically significant, were less dramatic and less clinically relevant than the authors claimed. The studies used varying definitions of colic, and two used recall at the end of the day. The authors did not provide a plausible explanation for why probiotic should work in breastfed but not formulafed infants. Reference