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Efficacy of Lactobacillus reuteri DSM 17938 in preterm newborns and infants with colic: a systematic review and meta-analysis of randomized controlled trials

Journal
Nutrition (Burbank, Los Angeles County, Calif.) (Q2)
Published
22 July 2026
Study design
Systematic review / meta-analysis of RCTs
Evidence level
Level 1, High (CEBM 1a)
Authors
Marco Bianchi, Giovanna Quatrale, Luigi Colecchia, Cesare Cremon, Marisa Piccirillo, Francesca Caron, et al.
PMID
42485904
DOI
10.1016/j.nut.2026.113327

Why clinicians should know about it

Abstract

OBJECTIVE: Early-life gut microbiota is crucial for gastrointestinal and immune development. Dysbiosis has been implicated in infantile colic and in complications of prematurity, including feeding intolerance and necrotizing enterocolitis (NEC). Lactobacillus reuteri DSM-17938 has been proposed as a strategy to modulate gut homeostasis during early infancy. METHODS: We conducted a systematic review and meta-analysis of randomized, placebo-controlled trials evaluating single-strain L. reuteri DSM-17938 in newborns and infants (0-12 mo). PubMed, Scopus, Web of Science, and the Cochrane Library were searched from 2008 to October 2025. Two separate meta-analyses were conducted for colicky infants and preterm newborns. Primary outcomes were treatment response in colic (≥50% reduction in crying time) and feeding intolerance in preterms. Secondary outcomes for preterms included daily crying time, NEC, sepsis, time to full enteral feeding, and length of hospital stay. RESULTS: About 11 randomized, placebo-controlled trials involving infants with colic (n = 555), and eight involving preterms (n = 1704) were included. In colicky infants, L. reuteri DSM-17938 significantly increased treatment response compared with placebo (OR 6.98;95% CI 2.26-21.59) and significantly reduced daily crying time (SD -2.61;95% CI -3.98 to-1.24). In preterms, probiotic supplementation reduced the incidence of feeding intolerance (OR 0.57; 95% CI 0.42-0.79) and NEC (OR 0.49; 95% CI 0.31-0.77), with earlier achievement of full enteral feeding and shorter hospitalization. No significant effect on sepsis was observed, and no safety concerns emerged. CONCLUSIONS: L. reuteri DSM-17938 may be associated with benefits in infantile colic and selected gastrointestinal outcomes in preterm newborns. Further well-designed trials are needed to confirm these findings.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.