Probiotics for Infant Colic: What Trials and Pediatric Bodies Say

Start here: crying in a young baby needs a check first

Colic is a label for a baby who cries a lot with no obvious cause. The NHS (UK) describes it as crying for more than 3 hours a day, 3 days a week, for at least 1 week in an otherwise healthy baby. [1] Because many other things cause crying (hunger, reflux, constipation, allergy, illness), a pediatrician or health visitor should confirm that it is colic before anything is tried. [1]

Get urgent care if the baby looks unwell. The NHS lists a weak or high-pitched cry, or a cry that does not sound like the baby's normal cry, as a reason for immediate emergency care. [1] In the US, call 911. The NHS also says to see a doctor if a baby is not growing or putting on weight as expected or still has colic symptoms after 4 months. [1] This page does not replace that.

This page is information only. It does not tell any parent to give a product to a baby. Whether to use a probiotic in an infant is a decision for the baby's pediatrician.

What the NHS says

The NHS (UK) says remedies such as anti-colic drops and herbal or probiotic supplements are not recommended and that there is no evidence they help colic. [1] The NHS advice instead lists comfort measures such as holding the baby, winding after feeds and gentle rocking, and support for parents. [1] Other sources read the research on one specific strain differently, described next.

The research is mostly about one strain

The best-known colic trials tested one strain: Limosilactobacillus reuteri DSM 17938 (formerly Lactobacillus reuteri). A 2024 meta-analysis also pooled trials of 15 different probiotics, so results for the strain and for the group are described separately. [2] The amounts below are what the trials used; they are not advice.

How to read this. In the pooled analysis and in the two small trials, benefit was seen mainly in breastfed infants. [3][5][6] The Melbourne trial, which included breastfed and formula-fed babies, found no benefit with the same strain and amount. [4] Results for one strain do not carry over to other strains or to other products; see why one strain's result does not transfer and the L. reuteri evidence profile.

What pediatric and review bodies say

• ESPGHAN (Europe), 2023: the pediatric gastroenterology society made strain-specific recommendations on several conditions including infant colic, and said probiotics with no documented health benefit should be discouraged. [8] It makes such recommendations only when at least two randomized trials exist for a similar, well-defined strain. [8] The abstract we read does not give the colic wording, so we do not quote it here.
• NCCIH (US): describes a 2018 review in which L. reuteri DSM 17938 was linked to successful colic treatment, mainly in exclusively breastfed infants. [9]
• Review of reviews and guidelines (2020): found probiotics had the strongest evidence for crying time in breastfed infants, but noted that three national guidelines did not reflect this and recommended education, reassurance and clinical evaluation. [10]

Questions for the pediatrician

• Is this colic, or could it be reflux, a milk allergy or an infection?
• Is there a reason a probiotic would be a problem for this baby (prematurity, a central line, a weakened immune system, a recent illness)?
• If a specific product is suggested, which strain and what evidence?
• Which comfort measures and parent supports are available?

Never stop or change a medicine a doctor has prescribed for a baby without asking the prescriber.