Probiotics...not all bacteria are bad

Microorganisms are everywhere and are an essential part of our existence. Some carry the potential for harm, like germs that make us sick, but many others have the potential for good, such as probiotics. These particular microorganisms have gained a lot of attention in the past decade and have become quite the buzzword. There is a lot of interest and ongoing research on how our gastrointestinal (GI) flora affects our everyday health and whether or not taking probiotics can improve our health.  Proponents of probiotics claim a myriad of health benefits as well as the prevention and treatment of diseases. So, what does that mean for your child and should you be giving him or her a daily probiotic supplement? Well, please allow me to help you decide what might be right for you and your family. Read on to find out more information about the use of probiotics and whether it is right for your child.

Now, in order to understand what probiotics are, it is helpful to understand your microbiome (i.e. the bacteria that inhabits our bodies) in general. Large numbers of microorganims live in and on the body. In fact, these bacteria outnumber human cells by 10 to 1. Bacteria are normally present in our intestines as well because they help us digest the food we eat, they kill microorganisms that cause disease, and they produce vitamins. At birth, infants have a sterile GI tract and that quickly changes with bacterial colonization. The gestational age of the infant, the way in which he or she was birthed (C-section vs. vaginal), and the infant’s diet all influence this process of bacterial colonization. After infancy, the GI flora doesn't change much. The intestinal mucosal defense system is an essential part of a complex immunoregulatory network that includes GI microflora. It is a widely held belief that the incidence of many diseases, both intestinal and non-intestinal, are related to impairment in the regulation or interference with the early development of the intestinal mucosal defense system.

So then, what is a probiotic? A probiotic is any food or oral supplement that contains enough microorganisms to change the microbiome of the person ingesting them with the potential for improved health. The most studied strains to date are Lactobacillus rhamnosus GG (LGG), Bifidobacterium lactis, and Streptococcus thermophilus. You may recognize these names if you're a food label reader like me. Probiotic bacteria can be ingested as a medicine or as a supplement. They can also be added to or mixed with foods or naturally exist in functional foods, which is any food that contains a probiotic, like yogurt or kimchi.

Many parents have asked whether or not probiotic supplements are okay if given daily or if they could be helpful for their infant's colic? As mentioned above, the use of probiotics in the prevention and treatment of clinical diseases is an emerging science, meaning there is still much to learn regarding the benefits and potential dangers that may exist. There have been well-conducted randomized controlled trials (RCTs) to support the use of probiotics for the treatment of acute infectious diarrhea. One study suggested that the administration of LGG significantly decreased the duration of acute rotavirus diarrhea. At this point, however, there is no evidence that routine use of a probiotic prevents acute infectious diarrhea. There have also been other studies that suggest probiotic use in the earliest phase of illness not only decreases the duration, but also the amount of diarrheal stools. Probiotics have also been useful in the prevention of antibiotic-associated diarrhea. To date, there haven't been any studies to investigate probiotic administration in the treatment of antibiotic-associated diarrhea.

There also is a lack of evidence for the efficacy of probiotics for many diseases such as eczema, chronic inflammatory bowel disease, irritable bowel disease, infantile colic and cancer. That being said, just because there is a lack of evidence currently, does not mean that with further study, potential benefits won't be established. However, for right now, the area in which probiotics have shown the greatest benefit is with the treatment of acute diarrheal illness and the prevention of antibiotic-associated diarrhea.

So what does this mean for your child and should you give him or her a daily probiotic supplement? As long as your infant or child is healthy, probiotic supplements seem to be safe. Furthermore, they seem to be beneficial in treatment of acute diarrheal illness and prevention of antibiotic-associated diarrhea. Patients that should NOT take a probiotic unless directed by their primary care provider are those who are immune-compromised; this includes ill preterm neonates and children who have intravenous catheters or other indwelling medical devices.

I hope this post was informative and answered some questions you had about probiotics. Please contact us at ABC Pediatrics if you have any further questions.
 
Information presented was adapted from:
http://pediatrics.aappublications.org/content/126/6/1217
https://nccih.nih.gov/health/probiotics/introduction.htm