Prenatal probiotic reduces risk of colic and its severity

Babies of mothers who take Lactobacillus reuteri during the last 4 weeks of pregnancy are less likely than newborns whose mothers don’t take the probiotic to develop colic. And babies of probiotic-consuming mothers who do develop colic have less severe symptoms than colicky infants whose mothers do not take the probiotic. These were the primary findings of a study conducted in 2 hospitals in Iran.

The 145 children of women who completed the trial were born to mothers from 18 to 49 years of age. At the beginning of the last 4 weeks of their pregnancy, 74 of these women were assigned to the placebo group and 71 to the intervention group. Those in the intervention group received daily doses of 1 x 10⁸ colony forming units (5 drops) of live L. reuteri LR92 DSM 26866 until they delivered their infants. Women in the control group received the placebo (9% glucose solution).

The infants were followed for 5 months by being examined every 2 weeks up to 60 days of age and every 30 days until they were 5 months old. In addition, parents filled out questionnaires to assess the severity and duration of crying and the presence of colicky pain postures, such as pulling up to the stomach, flushed face, clenched hands, and wrinkled brow.

Infants of mothers who received placebo were 2.36 times more likely to exhibit colic than those whose mothers were in the probiotic group. In addition, mean colic severity was significantly lower in the intervention group. Mode of delivery (vaginal vs cesarean delivery) and type of feeding (breastfed vs standard formula without probiotic) did not influence the frequency of colic or its severity. However, investigators noted that the comparison of formula-fed infants with breast-fed infants is unreliable because so few infants in this trial were fed with formula (Pourmirzaiee MA, et al. Eur J Pediatr. 2020;179:1619-1626).

Thoughts from Dr. Farber

We continue to search for the holy grail for treating colic. This study, while hardly definitive, may offer parents some help. Pediatricians can recommend this as an option for pregnant mothers seen in the office who already had a child with colic. L. reuteri has previously been shown to possibly treat colic in infants (eg, Contemporary Pediatrics, January 21, 2014, which you can view online at bit.ly/33d4WJP).