Are probiotics helpful to prevent infections in infants?

We know that infants who go to daycare tend to have more runny noses, coughs, and stomach bugs than those who stay at home.  The risk is up to two to three times greater, especially in young children under the age of 2, due to overcrowding and sharing of toys.  What can parents and caregivers do to prevent these infections? Probiotics may seem to be the latest health trend in children, but are they effective in infants?

What are probiotics?
Probiotics are live microorganisms or "good bacteria" found in your gut that may help prevent infections and balance your gut bacteria. Probiotics may contain a variety of bacteria, but two of the most common groups are Lactobacillus and Bifidobacterium. Probiotics can be found in supplements, foods including yogurt, aged cheeses, kefir and some non-dairy foods such as miso, tempeh and sauerkraut, or added to foods.

How effective are probiotics?
The U.S. Food and Drug Administration has not approved any probiotics for preventing or treating infections. Studies have been mixed on whether probiotics can prevent infections, as well as reduce days absent from school or child care in healthy preschool children.

Researchers recently looked at preventing infections by providing probiotics daily to infants, ages 8 to 14 months, for 6 months who attend daycare.  It was found that despite the increased intake of probiotics, the risk of infection did not decrease compared to infants that did not receive the supplement. This may have been due to the protective effect of breast milk rather the probiotic supplement. Infants who are breast fed may already have a healthy balance of gut bacteria and may not benefit additionally to probiotic use.

Additional probiotic claims include:

Are probiotics safe?
Research is still needed to confirm the effectiveness of using probiotics, but they have been found to be safe in healthy people, with limited side effects.  Common complaints may be mild, such as gas and bloating.  However, they are not recommended in critically ill patients or in people who recently had surgery, very sick infants, or in those with a weakened immune systems.

What can parents do?
Even though researchers showed that probiotics did not prevent infections in breast fed infants, age may be factor in determining if they will help. Changes in diet and stopping breastfeeding are factors that affect gut bacteria in children older than 4 years.  This indicates that older children may benefit from probiotics compared to infants who are breastfed or use formula containing probiotics.

It's important to note that not all probiotics are treated the same. Parents need to find specific probiotic strains for their child's specific condition.  The probiotic guide as a useful tool to select specific probiotic strains.  For example, the L. rhamnosus GG strain is specific to IBD or diarrhea.

You have to be careful when selecting foods or supplements containing probiotics since they will vary on the strain type and amount.  Foods with naturally occurring probiotics should be eaten regularly, but foods containing added probiotics, such as Special K cereal and other food products may not be the best choice.  Families can use the International Probiotic Association as an additional resource to choose the right probiotic.

The bottom line is that probiotics may be helpful for gut health and the benefits may out-weigh the risks.  It is recommended to speak to your child's health care provider or registered dietitian nutritionist before starting any supplement.