Lactase for infantile colic: A systematic review of randomized clinical trials

Infantile colic is excessive crying for no apparent reason in an otherwise healthy infant. Although its physiopathology is not completely understood, therapies usually target gastrointestinal symptoms. This systematic review of randomized controlled trials (RCTs) analyzes the efficacy of lactase supplementation in infantile colic. PubMed, Embase, and Cochrane were searched for RCTs evaluating lactase supplementation in infants up to 6 months old with infantile colic. Out of six RCTs including 394 patients, three reported a significantly shorter crying time in the lactase group than in the placebo group, while the other three found no significant difference between groups. Of the two studies that performed the hydrogen breath test, only one reported a significant reduction in exhaled hydrogen levels. The pharmacological approach to infantile colic remains debatable, and new studies with standardized diagnostic criteria and outcomes are required to guide lactase supplementation in clinical practice. What is Known Infantile colic is the excessive, difficult-to-soothe, poorly understood crying in an otherwise healthy infant. Multiple etiologies have been proposed, but the precise origin of infantile colic remains obscure. Management of infantile colic includes dietary modifications, probiotics, parental education, positioning, and enzyme replacement, with no consensus on the ideal approach.What is New Despite new evidence suggesting the role of lactase supplementation in infantile colic, its efficacy in reducing excessive crying remains uncertain. Hydrogen breath testing in colicky infants showed conflicting results after lactase supplementation. image