What is the evidence on the efficacy of Biogaia (Lactobacillus reuteri) probiotic drops for newborns' digestion?

Evidence on Efficacy of BioGaia Probiotic Drops for Newborns' Digestion

Lactobacillus reuteri DSM 17938 (found in BioGaia drops) shows high-quality evidence for reducing hospitalization time and improving feeding tolerance in preterm infants, but has limited evidence for specific digestive benefits in healthy full-term newborns.

Evidence for L. reuteri in Preterm Infants

Benefits in Preterm Infants

• L. reuteri (DSM 17938 or ATCC 55730) demonstrates high-quality evidence for:

  • Significant reduction in necrotizing enterocolitis (NEC) in preterm infants (OR 0.55; 95% CI 0.34-0.91) 1
  • Reduced hospitalization duration (MD -7.89 days; 95% CI -11.60 to -4.17) 1
  • Improved time to full enteral feeding, though with lower quality evidence (MD -2.62 days; 95% CI -4.53 to -0.71) 1

• The American Gastroenterological Association (AGA) specifically suggests using L. reuteri (DSM 17938 or ATCC 55730) among other probiotics for preterm, low-birth-weight infants 1

Usage in US NICUs

• A 2016 survey found BioGaia was the second most commonly used probiotic product (14.3%) in very low birth weight infants in US NICUs 2
• However, the same survey noted limited evidence supporting most probiotics used in US NICUs, including BioGaia 2

Evidence for L. reuteri in Full-Term Infants

Infantile Colic

• The strongest evidence for L. reuteri in healthy full-term infants relates to infantile colic:
  • A 2007 randomized controlled trial showed L. reuteri significantly reduced crying time compared to simethicone in breastfed colicky infants 3
  • By day 28,95% of infants in the probiotic group showed improvement vs. only 7% in the simethicone group 3
  • L. reuteri is considered effective both as prophylaxis and treatment for infantile colic 4

General Digestive Health

• L. reuteri may be recommended as an adjuvant strategy for diarrhea and constipation 4
• The probiotic works through various mechanisms:
  • Production of beneficial metabolites
  • Modulation of intestinal microbiome
  • Preservation of gut barrier function
  • Regulation of host immune system 4

Important Considerations

Strain Specificity

• Probiotic effects are strain-specific - not all L. reuteri strains have the same effects 4, 5
• BioGaia specifically contains L. reuteri DSM 17938, which is one of the well-studied strains 1

Quality Control Concerns

• There are concerns about quality control in commercial probiotic products for vulnerable populations 5
• When selecting a probiotic product, consider:
  • Proper strain identification
  • Appropriate dosage
  • Product stability and storage requirements 6

Research Gaps

• More research is needed on optimal dosing, timing, and duration of administration 1, 5
• Head-to-head trials comparing different probiotic products are lacking 5

Conclusion

While L. reuteri (as found in BioGaia drops) has strong evidence for specific conditions like infantile colic and for use in preterm infants, evidence specifically addressing general digestive benefits in healthy full-term newborns is more limited. Parents should discuss with their healthcare provider whether BioGaia is appropriate for their newborn's specific digestive concerns.