When do Children and Probiotics Meet?
Probiotics are live microorganisms which, when ingested in adequate amounts, have a beneficial effect on the consumer’s health. Interest in probiotics is increasing as their role in health is better understood.
Infants are born with sterile digestive systems, but the intestines quickly become colonized with bacteria. Gestational age, method of delivery, and early diet have profound effects on the composition of the intestinal flora. According to the American Academy of Pediatrics, a suboptimal bacterial colonization of the intestines may be a factor in chronic medical conditions, such as atopic diseases (asthma, eczema) and autoimmune diseases (multiple sclerosis, type I diabetes). The early colonization in infants may be a determining factor in a child’s long-term, overall health.
Lactobacillus, bifidobacterium, and streptococcus strains are the most common probiotics used in children. They can multiply and overwhelm disease-causing organisms, and are thought to produce metabolic byproducts that support the functions of the immune system. Some powdered infant formulas include the organisms Bifidobacterium lactis and Lactobacillus rhamnosus GG. They have not been found to be harmful, but there is no evidence of positive effects. Their use is not routinely recommended. There are no studies comparing health effects of probiotics with breastfeeding.
Probiotics should not be given to children who are seriously or chronically ill until their safety is established. An optimal duration of probiotic supplementation, optimal dosages, or species, are not known.
Benefits of Probiotics for Children
Indications for the use of probiotics in children include the following:
Children and Probiotics: Acute infectious diarrhea
The use of probiotics may reduce the duration of symptoms by one day in children with diarrhea from acute gastroenteritis caused by a virus, if the treatment starts when symptoms start. LGG is the most effective probiotic reported for this purpose. Routine administration of probiotics to prevent infectious diarrhea in children is not recommended and is not supported by evidence. There is a new vaccine for rotavirus immunization. It is more effective than the use of probiotics for preventing infectious diarrhea in infants.
Children and Probiotics: Antibiotic-associated diarrhea
There is some evidence that the use of probiotics can prevent antibiotic-associated diarrhea, but there is no evidence that it is effective for treatment.
Children and Probiotics: Atopic diseases
There is some evidence supporting the maternal use of probiotics during pregnancy, and the continuation of therapy in the mother while breastfeeding, to reduce the occurrence and severity of allergic-type conditions in children. Probiotic use for the treatment of eczema has not been proven effective.
Children and Probiotics: Necrotizing enterocolitis (NEC)
Preterm infants often have abnormal colonization of the intestine, possibly because of restricted feedings via the gastrointestinal tract and treatment with antibiotics. The combination of these factors increase risk of necrotizing enterocolitis in preterm infants. There is some evidence to support the use of probiotics in very-low-birth-weight infants for prevention of NEC, however, the amount and specific type of probiotic has not been determined.
Children and Probiotics: Chronic inflammatory bowel disease
Up to 70 percent of children with chronic inflammatory bowel disease are routinely given probiotics as complementary medicine or replacement therapy, instead of prescribed medications for management of Crohn’s disease or ulcerative colitis. The long-term benefit of probiotics for management of chronic inflammatory bowel disease in children is uncertain; it is not recommended.
Children and Probiotics: Other conditions
More research is needed to determine the effects of probiotics on irritable bowel syndrome, constipation, colic, gastritis, and a variety of conditions in children.
If you’re looking for a basic background explanation about probiotics, you’re invited to read this article: What are Probiotics?
Children and Probiotics: References
- Armstrong C. Practice Guidelines: AAP Reports on Use of Probiotics and Prebiotics in Children. Am Fam Physician. 2011 April 1;83(7):849-852
- Kligler B, Probiotics in children, Pediatr Clin North Am 01-Dec-2007; 54(6):949-67
- Charrois, TL et al, Probiotics. Pediatr. Rev. 2006; 27;137-139