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Table 2 Effects of probiotics on child growth

From: Effects of probiotics on child growth: a systematic review

Section 1: In healthy children
Author, year Sample details Outcomes and units of measurement Results
Country  
Type of study  
Quality  
Firmansyah et al. 2009 [29] Intervention: Outcome: Outcome Intervention   Control Mean difference (CI) p-value
Indonesia Age: 12 months Weight, Length, Head circumference, Body Mass Index (BMI) Sample size 161   153  
RCT Sample size: 199   Weight (g/day) 7.57 ± 4.13   6.64 ± 4.08 0.93 (0.12-1.95) 0.025
Quality: Control: Units of measurement: Change in weight-for-age 0.11 ± 0.40   0.02 ± 0.40 0.09 (0.01-0.18) 0.036
Unclear risk of bias for allocation concealment Age: 12 months Weight: Weight (g) 9711 ± 1142   9643 ± 1218 Not reported Not reported
  Sample size: 194 Weight gain (g/day) Length (cm) 77.8 ± 3.0   77.9 ± 3.4 Not reported Not significant
   Change in weight-for-age after 4 months Head circumference (cm) 46.3 ± 1.3   46.4 ± 1.4 Not reported Not significant
   Weight (g) BMI (kg/m2) 16.0   15.9 Not reported Not reported
   Length: Length after 4 months (cm)      
   Head circumference: Head circumference after 4 months (cm)      
   BMI: kg/m2      
Scalabrin et al. 2009 [33] Intervention: Outcome: Outcome Intervention 1- EHF + P Intervention 2 - PHF + P Control EHF Mean difference p-value
USA Age: 14 days Weight, Length, Head Sample size 63 77 70   
RCT Sample size: circumference Weight gain (g/day) 28.4 ± 0.67 26.8 ± 0.76 27.6 ± 0.72 Not reported Not Significant
Quality: -Extensively hydrolysed formula with probiotic (EHF + P): 94 Units of measurement: Length (cm/day) 0.11 ± 0.002 0.11 ± 0.002 0.11 ± 0.002 No difference  
Low risk of bias for all parameters -Partially hydrolysed formula with probiotic (PHF + P): 98 Weight: Head circumference (cm/day) 0.05 ± 0.001 0.05 ± 0.001 0.05 ± 0.001 No difference  
   Weight gain (g/day) ANOVA, 1-tailed t-tests      
  Control: Length: change in length (cm/day)       
  Age: 14 days        
  Sample size: Extensively hydrolysed formula without probiotic (EHF): 94 Head circumference:       
   Change in head circumference (cm/day)       
Saavedra et al. 2004 [32] Intervention: Outcome: Outcome Intervention 1 (HS) Intervention 2 (LS) Control Mean difference p-value
USA Age: 3–24 months Weight and Height Sample size 39 39 40   
RCT Sample size: Units of measurement: Change in weight-for-age 0.09 ± 0.64 0.06 ± 0.72 0.16 ± 0.69 Not reported Not significant
Quality: -High Supplement probiotic in formula (HS): 39 Weight: Change in weigh-for-length 0.40 ± 0.85 0.53 ± 1.10 0.45 ± 0.75 Not reported Not significant
Unclear risk of bias in allocation concealment -Low Supplement probiotic in formula (LS): 39 change in weight-for-age z-score Change in height-for-age −0.06 ± 0.44 −0.09 ± 0.60 −0.04 ± 0.59 Not reported Not significant
  Control- formula change in weight-for-length score       
  Age: 3–24 months Height:       
  Sample size: 40 change in height- for-age z-score       
Gibson et al. 2009 [30] Intervention: Outcome: Outcome Intervention   Control Mean difference p-value
Australia Age: <10 days Weight, Length, Head Circumference, BMI Sample size: 62   62   
RCT Sample size: 72 Units of measurement: Weight gain (g/day) M(24) 33 · 6 ± 7 · 5   M(19) 31 · 6 ± 7 · 7 1.5 (−0.08-3.1) Not significant
Quality: Control: Weight : Weight gain (g/day)   F(31) 28 · 1 ± 5 · 8   F(24) 26 · 5 ± 4 · 9   
Low risk of bias in all parameters Age: <10 days Sample size: 70 Length: Length gain (mm/month) Length gain (mm/month) M(24) 35 ± 3 · 7   M(19) 37 · 3 ± 4 · 9 Not reported Not significant
   Head circumference: Change in head circumference (mm/month)   F(27) 32 · 8 ± 4   F(23) 32 ± 4 · 6   
   BMI: change in BMI per month (kg/cm2/month) Head circumference (mm/month) M(23) 18 ± 2 · 4   M(19) 17 · 5 ± 3 · 4 Not reported Not significant
     F(29) 16 · 1 ± 2 · 7   F(24) 16 ± 3   
    BMI (kg/cm2/month) M(24) 1 · 1 ± 0 · 6   M(19) 1 ± 0 · 5 Not reported Not significant
     F(27) 0 · 9 ± 0 · 5   F(23) 0 · 8 ± 0 · 4   
    ANOVA correcting for sex      
Zeigler et al. 2003 [34] Intervention: Outcome: Outcome Intervention (RP + P) Intervention (RP) Control Mean difference p-value
USA Age: 6–10 days Weight and Height Sample size 28 27 C:33   
RCT Sample size: Units of measurement: Weight gain (g/day) 28.13 ± 4.63§ 29.3 ± 5.41§ 31.05 ± 5.88§ Not Reported 0.229
Quality: RP + P Weight: g/day       
The risk of bias in adequate sequence generation, allocation concealment and blinding was unclear while there was a high risk of bias in reporting of incomplete outcome data (Bifidobacterium lactis in reduced protein formula): 40 Length: mm/day   M 13 32.1 ± 5.2 M 8 32.0 ± 4.7 M 19 32.2 ± 5.2   
     F 15 24.7 ± 4.9 F 19 28.2 ± 5.8 F 14 29.5 ± 6.9   
  RP (Reduced protein formula): 40   Length gain (mm/day) M 13 1.14 ± 0.11 M 8 1.14 ± 0.09 M19 1.16 ± 0.09 Not reported 0.377
     F 15 1.02 ± 0.07 F 19 1.06 ± 0.10 F14 1.07 ± 0.14   
  Control:       
  Age: 6–10 days       
  Sample size       
  Normal protein formula: 42       
Puccio et al. 2007 [31] Intervention: Outcomes: Outcome Intervention   Control Mean difference (90% CI) p-value
Italy Age: <14 days Weight, height, head circumference Sample size 42   55  
RCT Sample size: 65 Units of measurement: Weight (g/day) Not reported   Not reported 0.50 (−1.48 ± 2.48) Not reported
Quality: Risk of bias was unclear in both adequate sequence generation and allocation concealment Control: Weight: weight gain (g/day) Height (mm/month) M 35.1 ± 4.2   M: 35 ± 4.4 Not reported 0.1
  Age: <14 days Height: change in height (mm/month)   F 32.2 ± 4.3   F : 32.2 ± 4.6   0.1
  Sample size: 69 Head circumference: Change in head circumference (mm/month) Head circumference (mm/month) M: 17.9 ± 2.7   M : 17.4 ± 2.9 Not reported >0.1 for all
     F: 16.0 ± 2.8   F: 15.5 ± 3.0  
Huet et al., 2006 [35] Intervention: Outcomes: Outcome Intervention   Control Mean difference p-value
France Age: 1–28 days Weight, Height, Head circumference Sample size 117   86  
CCT Sample size: 117 Units of measurement: Weight gain (g/day) 29.6 ± 6.6   29.8 ± 6.3 Not reported Not significant
Quality: The study had high risk of bias in adequate sequence generation, allocation concealment and blinding. Control: Weight: weight gain (g/day) Height (cm/day) 0.110 ± 0.018   0.111 ± 0.018 Not reported Not significant
  Age: 1-28 days Height: height gain (cm/day) Head circumference(mm/day) 0.56 ± 0.12   0.55 ± 0.12 Not reported Not significant
  Sample size: 86 Head circumference: change in head circumference (mm/day)       
Gil-Campos et al. 2011 [27] Intervention: Outcomes: Outcome Intervention   Control Mean difference p-value
Spain Age: 1 month Weight, Height, Head Circumference Sample size 61   60  
RCT Sample size: 71 Units of measurement: Weight gain (g/day) 24.8 ± 5.1   25.3 ± 6.0 Not reported Not significant
Quality: There was low risk of bias in all parameters. Control: Weight: weight gain (g/day), weight at 6 months (kg), weight-for-age z-scores at 6 months Length gain (mm/day) 0.96 ± 0.3   0.90 ± 0.2 Not reported Not significant
  Age: 1 month Length: Length gain (mm/day), Length at 6 months (cm), Length for age z-scores at 6 months Head Circumference (mm/day) 0.43 ± 0.1   0.421 ± 0.1 Not reported Not significant
    Weight at 6 months (kg) 8.0 ± 0.9   7.9 ± 1.0 Not reported Not significant
  Sample size: 66 Head Circumference: Head Circumference at 6 months (cm), Head circumference z-scores at 6 months Length at 6 months (cm) 68.1 ± 3.4   66.6 ± 2.5 Not reported 0.038
    Head Circumference at 6 months (cm) 43.7 ± 1.6   43.7 ± 1.3 Not reported Not significant
    Weight for age z-scores at 6 months Not reported   Not reported Not reported p = 0.061
    Length for age z-scores at 6 months Not reported   Not reported Not reported p = 0.021
    Head circumference z-scores at 6 months Not reported   Not reported Not reported p = 0.453
Section 2: In under-nourished children     
Author, year Sample details Outcomes and units of measurement Results     
Country  
Type of study  
Quality  
Nutritional status         
Sazawal et al. 2010 [16] India Intervention: Outcomes: Outcome Intervention   Control Mean difference p-value
RCT Age: 1–3 years Weight, height Sample size 257   245  
Quality: The risk of bias was low for all parameters Sample size: 312 Units of measurement: Weight gain (g/year) 2,130 ± 590   2,000 ± 590 130 (30–230) 0.02
None severely malnourished Control: Weight: weight gain (g/year), change in weight for age z-score Change in weight-for-age z-score 0.34 ± 0.54   0.26 ± 0.54 0.08 (−0.02 to 0.17) 0.12
Nutritional status         
Normal Age: 1–3 years   Height (cm/year) 8.49 ± 1.41   8.28 ± 1.35 0.20 (−0.04 to 0.45) 0.09
I: 107 (34.3%) C: 95 (30.4%) Sample size: 312 Height: height gain (cm/year), change in height for age z-score after one year change in height for age z-score after 1 year 0.21 ± 0.42   0.18 ± 0.49 0.03 (−0.06 to 0.10) 0.55
Wasted    Difference in weight/height 0.44 ± 0.65   0.34 ± 0.63 0.09 (−0.01 to 0.21) 0.09
I: 15 (4.8%) C: 14 (4.5%)  
Stunted    
I: 137 (43.9%) C: 157 (50.3%)  
Wasted and stunted  
I: 53 (17.0%) C: 46 (14.7%)  
Saran et al., 2002 [13] Intervention: Outcomes: Outcome Intervention   Control Mean difference p-value
India Age: 2–5 years Weight, height Sample size 50   50  
Non-randomised controlled trial Sample size: 50 Units of measurement: Weight (g/6 months) 1,290 ± 730   810 ± 840 0.002 Not reported
Quality: high risk of bias for adequate sequence generation, allocation concealment and blinding. Control: Weight: weight gain (g per 6 months) Height: (cm/6months) 3.21 ± 1.48   1.74 ± 0.80 Not reported 0.0001
Nutritional status         
Stunted (height for age) and matched in both groups Age: 2–5 years Height: height gain (cm per 6 months)       
  Sample size: 50        
He et al., 2005 [12] Intervention: Outcomes: Outcome Intervention   Control Mean difference p-value
China Age: 3–5 years Weight, height Sample size 201   201  
RCT Sample size: 201   Gram per 3, 6 and 9 months 700 ± 430   490 ± 350 Not reported 0.01
Quality: Control: Units of measurement: Weight: Weight gain (g per 3, 6 and 9 months), Change in weight-for-age at 3, 6 and 9 months   980 ± 620   800 ± 600   0.01
There was an unclear risk of bias in adequate sequence generation and high risk of bias in both allocation concealment and blinding Age: 3–5 years   1,420 ± 760   1,200 ± 670   0.01
  Sample size: 201 Change in weight-for-age at 3, 6 and 9 months 0.139 ± 0.228   0.031 ± 0.184   0.01
Nutritional status         
Undernourished - weight for age and/or height for age were below reference values   Height: change in height for age z-scores at 9 months   0.058 ± 0.306   −0.047 ± 0.28   0.01
     0.078 ± 0.365   −0.043 ± 0.28   0.01
    Change in height for age z-scores at 9 months 0.123 ± 0.168   0.077 ± 0.175 Not reported <0.01
Surono et al. 2011 [28] Indonesia Intervention: Outcomes: Weight Outcome Intervention   Control Mean difference p-value
RCT Age: 15–54 months Units of measurement: Sample size 37   39   
  Sample size: 39 Weight: Mean gain in bodyweight after 90 days Mean bodyweight gain (g) 1280 ± 940   990 ± 990 Not reported Not reported
Quality: Control:  
There was an unclear risk of bias in adequate sequence generation, allocation concealment and blinding. Age: 15–54 monthss  
Nutritional status  
Underweight Sample size: 40  
I: 20 C: 20  
Severe Underweight  
I: 7 C:10  
Normal Bodyweight  
I:10  
C:9  
  1. No baseline differences between groups; Values presented in mean ± SD unless specified; NHCS: National Health Centre Statistics; MUAC: Mid Upper Arm Circumference.
  2. §The results of weight gain per day for both sexes were combined and presented by the authors.