Before we can understand the role of probiotics in the body and decide whether we should give probiotic supplements to our kids, we need to take a step back and look at how the gastrointestinal (GI) system works and the ways gut health is affected by bacteria.
Bacteria and Your Gut
The human GI tract is inhabited by trillions of bacteria. In fact, our bodies contain more bacterial cells than human cells! All bacteria are not created equal, however. While some cause illness, many other types are beneficial—even essential—for good health. Along with housing all those bacteria (both good and bad), the GI tract serves as the body’s largest reservoir of immune cells, making it one of the most important lines of defense against infection. This makes sense when you think about the number of bacteria that enter our bodies through our mouths. And when we consider all the things that babies and children put into their mouths, you can begin to see why the GI tract plays such a big role in fighting off infection. Good bacteria, such as those found in probiotics, are the workhorses of the gut, maintaining a healthy environment for your immune cells so that they can function effectively to keep you from getting sick. Excellent gut health, which is closely linked to the health of your immune system, is achieved by striking a balance between the good and the bad bacteria. Both will always be present in your GI tract. Your job is to feed the good bacteria so that they can outnumber the bad guys.
Development of the Gut Microbiome
Babies begin to develop their unique intestinal bacterial profile, known as the gut microbiome, even before birth as they are exposed to bacteria in the womb. During the birth process, the gut becomes further colonized with bacteria from the mother.
A 2019 study found that 63% of infants’ gut bacteria matched their mother’s bacterial profile, demonstrating that maternal health directly affects babies’ health from birth.
Other factors that influence strains of gut bacteria in early life include exposure to antibiotics, premature birth, genetics, and nutrition. Breast milk naturally contains probiotics, and while many infant formulas have probiotics added to them, the research is unclear on whether they provide the same benefits for gut health.
Probiotics for Kids
Many food products contain probiotics, including some specifically marketed for infants and children. A few examples include:
Activia yogurt Align Daily Probiotic Supplement Culturelle for Kids with Lactobacillus rhamnosus GG DanActive yogurt drink (for kids over age 3) FlorastorKids with Saccharomyces boulardii lyo Gerber Good Start Baby Everyday Probiotic Drops Gerber Good Start GentlePro (milk-based baby formula with probiotics) NOW BerryDophilus Kids Nutramigen with Enflora LGG (elemental formula with probiotics) Yo Baby yogurt (includes extra probiotic bacteria) Yoplait Yo-Plus yogurt
Are Probiotics Helpful?
Research on the health benefits of probiotic supplements has shown mixed results, but probiotics do show promise in the following areas:
One review showed that the use of probiotics is beneficial in decreasing the duration of acute gastroenteritis (otherwise known as the stomach flu) in children. In a meta-analysis including studies of 4,755 infants, supplementation with probiotics, especially those containing multiple strains of bacteria, effectively prevented atopic dermatitis (eczema). However, no beneficial effects were seen regarding asthma, wheezing, or rhinoconjunctivitis (congestion and sneezing). A review of studies that included over 11,000 participants showed that probiotics appear to have a protective effect against antibiotic-induced diarrhea. Research is ongoing to determine the type and dosage of bacterial strains that are most effective. One meta-analysis of 11 studies showed that the use of probiotics improved abdominal pain in children with irritable bowel syndrome (IBS) and functional abdominal pain disorders (FAPD). Probiotics are also being studied for use in children with chronic constipation, Crohn’s disease, ulcerative colitis, and Helicobacter pylori infections.
Should You Give Your Child Probiotics?
Parents might assume that even if probiotics don’t help, they aren’t likely to be harmful. The American Academy of Family Physicians (AAFP) states that probiotics do appear to be safe for healthy children. However, there are many types and strains of probiotics to choose from, and the dosages can vary widely between supplements. It can be hard to figure out how much to take as well as how often to take them. Here are some things to keep in mind when deciding whether to give your kids probiotic supplements:
They are not regulated by the FDA, making it virtually impossible to know if the label accurately describes what is in the products.Although probiotics appear to be an effective treatment for the conditions listed above (particularly antibiotic-induced and infectious diarrhea), there is much we still don’t know about which strains and dosages are the most effective.There is no proven benefit to giving healthy kids probiotics regularly, and they are not approved bythe FDA as a treatment for any specific disease or condition, according to the AAFP.Gas and bloating are the most common side effects of probiotic supplements. While not harmful, these side effects can be uncomfortable.
A healthy and safe choice is to give your child a serving of yogurt daily or include other probiotic-rich foods in your family’s meals. Look for a statement on the label that the food contains “live and active cultures.” These foods will provide good bacteria to support a healthy immune system without the risk of side effects. Before giving an infant under a year old probiotic-containing formula or supplements, be sure to ask your doctor first. Also talk to your doctor before giving a supplement to your child if they are immunocompromised, as there could be a small risk of adverse side effects.
