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Maria is a 1.5-month-old healthy baby born at 39 weeks, mainly breastfed, although she has been fed artificial formula on a few occasions. In the last 2 weeks, she has been brought to the clinic with episodes of intense crying which last from 3 to 5 hours/day and occur 4–5 times a week. Her parents are finding it hard to soothe and calm her during these episodes, and find it very distressing. She undergoes a normal clinical examination and there do not seem to be any other associated conditions. As such, infantile colic seems to be the most probable cause of her current distress. Her parents have read that certain probiotics might help her, but you are very uncertain and want to know more.
Structured clinical question
In infantile, colic (patient) does routine administration of any strain of probiotics (intervention) effectively decreases the intensity or duration of these episodes of excessive crying (outcome) without increasing the risks of sepsis or diarrhoea?
We searched Ovid MEDLINE via PubMed, EMBASE and NHS evidence (up to December 2018 week 3). The advanced search mode was used including the terms infantile colic OR infant colic OR excessively crying OR fuss behaviour OR feeding problems OR sleeping problems OR infant* colic* AND probiotics OR Lactobacillus OR Bifidobacterium OR Saccharomyces. This search yielded 28 results. The results were limited to humans. Only English or European-language publications were examined.
These included the Cochrane Database of Systematic Reviews (current issue) in the Cochrane Library, Tripdatabase, Dialnet and Scopus. They provided one additional reference.
These articles were independently screened by two authors (MR and AD), identifying three relevant papers. All references were screened, identifying one further article.
The details of the included studies are provided in table 1: (summary of search results).
Infantile colic affects ~20% of …
Contributors MR and AB conceived the study, developed the search strategy, contributed to data collection, abstraction and interpretation. MR drafted the first manuscript. ADI and PC contributed to data collection, interpretation and provided critical revisions to the manuscript. All authors approved the final version of the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.
Patient consent for publication Not required.
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