How to Choose the Best Probiotic for your Child

Probiotics are a hot topic these days, among parents and doctors alike! Once thought to only influence gut heath, we now know that maintaining a healthy population of gut bacteria (a.k.a. microbiota) is essential to good health. There are many influences on our gut bacteria ranging from how we enter the world (vaginal vs. c-section) to the foods we eat and keeping them happy and healthy is important!Confused about which probiotics to use? You’re not alone! While we’d like to find a “one size fits all” probiotic, that’s probably not going to be the case as diversity is key to having a happy healthy gut.  But, there are some strains that may be more useful in certain conditions.

First, let’s talk about how to choose a probiotic:

Probiotic foods vs. capsules and powders

• Foods like yogurt and kefir naturally contain probiotics, but sometimes not enough to provide a distinct clinical benefit.  And, depending on how the food was handled and stored, may not contain enough to produce a noticeable effect. But do include a variety of fermented foods such as yogurt, sauerkraut and kefir as part of your child’s diet.
• Most kids probiotics are offered in a liquid or powder form, but some are also available as a chewable tablet.  All of these are ok, as long as they contain the strain(s) you’re looking for and the correct amounts.

Refrigerated vs. shelf-stable

• Refrigerated products are usually superior to shelf-stable products, so always look for those. There are some shelf-stable products that are clinically effective, but they often only contain 1 or 2 strains, and in lesser amounts than those found in the refrigerated section.

Research into the use of probiotics for treating specific conditions is ongoing. Here’s a summary of what we know.

Antibiotic-associated diarrhea

Antibiotics can indiscriminately kill bacteria, including the “good guys” resulting in diarrhea, and research strongly supports the use of probiotics for treating this common side effect (1).   If you or your child experience this common side-effect, you should look for a probiotic that contains one or all of the following:

• Lactobacillus reuteri protectis
• Lactobacillus rhamnosus GG
• Saccharomyces boulardii

The above strains are found in several commercially available probiotics. But, in my experience most available probiotics should help alleviate diarrhea due to antibiotics.

Eczema/Atopic Dermatitis

Several studies and reviews have looked at the role of probiotics in preventing and treating atopic dermatitis. While some of the research has provided mixed reviews, many studies have found that infant at risk for developing eczema have benefited from taking probiotics with the  Lactobacillus rhamnosus GG strain (2). Other beneficial strains include Bifidobacterium lactis and Lactobacillus acidophilus (3)And, the protective effect of probiotics may be strongest when given to pregnant mothers.  Three studies using Lactobacillus rhamnosus GG given to pregnant women for 2-4 weeks before labour and continued treatment post-birth found significantly lower rates of eczema/atopic dermatitis during the first 2 years of life(4,5,6) so we probably want to make sure that Moms are getting a good supply of these beneficial bacteria before baby is even born.

Infantile Colic

Colic is difficult to understand, and even more difficult to treat.  As a parent who has lived through colic, I know and understand the desperation in trying to find a solution.  One treatment which has been shown to be effective is using a specific strain of bacteria, Lactobacillus reuteri DSM 17938. A recent Canadian study of 52 infants found that  using this probiotic significantly reduce colic symptoms and crying (7). So, if you’re baby has colic, it’s well worth trying a probiotic.

Immune Health

As parents, we’re always looking for ways to reduce the number of colds and flus that find their way into our lives! Maintaining a healthy population of gut bacteria, along with a healthy diet and lifestyle may be key to staying healthy during cold and flu season. A recent meta-analysis of probiotic use in children and adults  revealed significantly fewer numbers of days of illness per person, shorter illness episodes by almost a day, and fewer numbers of days absent from day care/school/work (8).These are just a few of the many reasons to include “good bacteria” in your child’s diet. If you have specific concerns about the types and amounts of probiotics to give your children, talk to a Naturopathic Doctor for guidance. 

1. Johnston BC, Goldenberg JZ, et al. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev. 2011;11:CD004827.
2. Kalliomaki M, Salminen S, et al. Probiotics in primary prevention of atopic disease: a randomised placebo controlled trial. Lancet. 2001;357:1076–1079.
3. Gerasimov S. Probiotic supplement reduces atopic dermatitis in preschool children: a randomized, double-blind, placebo-controlled, clinical trial. Am J Clin Dermatol. 2010; 11(5):351-61.
4. Doege K, Grajecki D, et al. Impact of maternal supplementation with probiotics during pregnancy on atopic eczema in childhood—a meta-analysis. Br J Nutr. 2012;107:1–6.
5. Rautava S, Kalliomaki M, Isolauri E. Probiotics during pregnancy and breast-feeding might confer immunomodulatory protection against atopic disease in the infant. J Allergy Clin Immunol. 2002;109:119–121.
6. Boyle RJ, Ismail IH, et al. Lactobacillus GG treatment during pregnancy for the prevention of eczema: a randomized controlled trial. Allergy 2011;66: 509–516.
7. Chau, Kim et al. Probiotics for Infantile Colic: A Randomized, Double-Blind, Placebo-Controlled Trial Investigating Lactobacillus reuteri DSM 17938  The Journal of Pediatrics , Volume 166 , Issue 1 , 74 – 78.e1
8. King, Sarah et al. “Effectiveness of Probiotics on the Duration of Illness in Healthy Children and Adults Who Develop Common Acute Respiratory Infectious Conditions: A Systematic Review and Meta-Analysis.” The British Journal of Nutrition 112.1 (2014): 41–54. PMC. Web. 4 Mar. 2016.