Review: Infant Probiotics and Your Baby’s Health: A Look at the Studies and Supplements

Baby Named Bobo
Photographed by Dinhduongbe
There’s a lot of buzz about the use of probiotics for common health ailments. What about for infants? In actuality, babies are the best candidates for probiotic use as they are still building up their intestinal bacteria. Research suggests that infant probiotics could be a valuable way to support infant health and prevent future disease. We look at the studies to find out where they could be helpful and determine which products are the most useful.

Intestinal Microflora and Your Infant’s Health

The intestinal tract of an adult human provides housing and nourishment to hundreds of bacterial species. This diverse population of bacteria establishes itself early, starting from the moment the baby is born and continues after solid food is introduced. Research shows that these bacterial inhabitants influence health to a great extent. Finding out how to manipulate bacteria diversity in infants for increased health is a huge priority for scientists.

Which bacterial species will dominate the intestinal tract is determined early. Infants inherit a good part of their flora from their mothers. The first transfers occur during birth in the vaginal canal and are continued through physical contact. Breast-feeding also plays its role by providing nutrients in the form of non-digestible sugars (also known as prebiotics) that encourage the growth of beneficial bacterial species. When an infant starts eating solid foods, the diversity of bacterial species increases further1.

The intestinal flora gets right to work interacting with newborns. They have a multitude of jobs to do including communicating with the immune system, producing nutrients for cells of the intestine and fighting off invading pathogens. As one can imagine, these actions have huge outcomes for a baby’s future health. The microflora modulate our chances of developing allergic and chronic inflammatory diseases; our ability to fight off infection and, most importantly, it appears to influence our mental well-being and behavior1.

Probiotics and Prebiotics

Probiotics are any microorganism that can influence health in a positive manner. The intestinal microflora in healthy adults already contains many bacterial species that would be considered probiotic. The goal of taking probiotics is, therefore, to either introduce a beneficial species that is absent or to increase the population of one that is already there.

It is important to note that the microflora of adults is established. Although, it can subtly shift its composition in response to lifestyle and diet, it is very difficult to drastically alter it without the use of antibiotics. In adults, probiotic use only leads to temporary colonization. To keep seeing an effect, one has to keep taking them. In contrast, the microflora of infants is still in the process of developments. This makes probiotic treatment of newborns particularly interesting. Introduced probiotic species have a greater chance of gaining a permanent niche and influencing the developing immune system1.

Besides probiotics, prebiotics are also a way that can be used to make changes to the intestinal flora. Prebiotics are the indigestible sugar molecules that support the growth of different species of bacteria. They can be found in human breast milk, as well as many vegetables. Galacto-oligosaccharides (GOS) and fructo-oligosaccharides (FOS) are popularly studied vegetable-based prebiotics. Supplementation with GOS and FOS appears to have no adverse effects in babies, and it is associated with a modest increase in weight, increased stool frequency and softness and beneficial immune system changes2. It is for these reasons that they are currently added to many commercial baby formulas.

Where Infant Probiotics Have Shown Promise

Below is an overview of the some of the studies using probiotics for infant illnesses. Keep in mind that not every study is discussed and studies can be biased. For every success, there are many studies that show no results. Furthermore, many trials are financed by companies with a vested interest in the results. The general opinion of many independent researchers, however, is that probiotics look promising, but more studies need to be done to know for sure. Listed are the most interesting and potential strains according to the references that were consulted.

Colic

Colic is described as crying, fussing and irritation without obvious reasons in a healthy infant. It generally occurs during the first three months of life and usually goes away on its own. Diagnosis is based on the rule of three: episodes of crying that happen at least three hours per day, for three days per week for at least three weeks. The pathogenesis is unknown. Some speculate that it could be caused hormone problems or even maternal smoking. Another hypothesis that is gaining momentum is an abnormal composition of intestinal bacteria3.

In a concise review on new colic therapies, two main studies were mentioned that suggested that probiotics could be a possible treatment. One study treated 90 breastfed infants with Lactobacillus reuteri ATCC 55730 daily. Crying was reduced within seven days of treatment. The response rate was close to 100% (a responder was baby with 50% less crying time). The second study with a related strain, L. reuteri DSM 17938, also showed improvements3. Studies using formula with added beneficial bacteria found some success with Bifidobacterium lactis combined with Streptococcus thermophilus2.

Products that contain the L. reuteri strain that was helpful for colic are on the market and produced by BioGaia. The product is now marketed by Gerber in the United States and is called Gerber Soothe Colic Drops. It can also be bought as a formula. If you are interested in exploring the B. lactis and S. thermophilus combination, try Nestle-Gerber’s Good Start Protect Plus formula, which contains B. lactis, combined with regular yogurt (good source of S. thermophilus).

Respiratory Infections

Probiotics may help prevent the common cold and ear infections. L. rhamnosus GG (LGG) and B. lactis Bb-12 supplementation in a randomized double blind trial resulted in lowered incidence of ear and respiratory infection4. Another study with B. lactis Bb-12 alone also had reductions in respiratory infections5. In a study using infants older than four months, L. salivarius combined with formula seemed to be promising2. A study using the prebiotics, GOS and FOS, also found a reduced frequency of colds but no effect on ear infections6.

Finding an infant probiotic combining LGG and B. lactis Bb-12 is difficult. An option that contains related strains along with a few others is Jarrow Formula’s – Baby’s Jarro-Dophilus. Lactobacillus salivarius can be found together with a multitude of other strains in Klaire Labs’ Ther-Biotic Infant Formula.

Eczema

In a huge population study in Norway, researchers looked at the development of several diseases in 40,614 children. Those that had mothers that consumed probiotic milk during pregnancy and were also given probiotics as children had a reduced incidence of eczema7. In a current review on the use of the probiotics to prevent eczema in infants, which examined 23 studies, it was suggested that the best way to prevent allergy is to take probiotics while pregnant and to provide them after birth. They found that Lactobacillus rhamnosus strains were the best candidates for the prevention of eczema8. The effects could be seen until at least two years of age8.

Supplements with L. rhamnosus strains include FloraBABY and Jarrow Formulas’ Baby probiotic.

Diarrhea

Diarrhea can be caused by either bacterial or viral pathogens. In young infants, viral diarrhea is usually the problem. Diarrhea is particularly dangerous in babies due to the risk of dehydration. There is evidence that beneficial bacteria can provide help in the form of prevention as well as treatment in, otherwise, healthy children.

A recent review looking at infant probiotics for the prevention and treatment of acute diarrhea found that B. lactis and LGG were good candidates for the prevention of acute diarrhea6. Another review, which combined data from a multitude of studies with a variety of bacterial species, suggested that treatment with probiotics can shorten a bout of diarrhea by approximately 24 hours6. The yeast, Saccharomyces boulardii is well-studied in this regard and appears to be well-suited for shortening the duration of viral diarrhea in babies6.

Products that contain either B. lactis or L. rhamnosis strains  are listed above in the previous sections. Saccharomyces boulardii is found in a product called Florastor Kids. However, it is recommended only after two months of age.

Conclusions

Probiotics appear to be safe for infants with no reported adverse events2. That said, it’s still wise to be cautious. It is important to choose only baby probiotic formulations and avoid types made for adults. Luckily, there are many good quality probiotics for babies on the market. And, for those who wish to take a more simple approach, there is always just plain yogurt, which has been known for years to help minor infant ailments.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment.

Please note that the product links included in this article are my affiliate links.

References

1.         Collado MC, Cernada M, Bauerl C, Vento M, Perez-Martinez G. Microbial ecology and host-microbiota interactions during early life stages. Gut Microbes 2012; 3(4): 352-365.

2.         Braegger C, Chmielewska A, Decsi T, Kolacek S, Mihatsch W, Moreno L et al. Supplementation of infant formula with probiotics and/or prebiotics: a systematic review and comment by the ESPGHAN committee on nutrition. J Pediatr Gastroenterol Nutr 2011; 52(2): 238-250.

3.         Savino F, Tarasco V. New treatments for infant colic. Curr Opin Pediatr 2010; 22(6): 791-797.

4.         Rautava S, Salminen S, Isolauri E. Specific probiotics in reducing the risk of acute infections in infancy–a randomised, double-blind, placebo-controlled study. Br J Nutr 2009; 101(11): 1722-1726.

5.         Taipale T, Pienihakkinen K, Isolauri E, Larsen C, Brockmann E, Alanen P et al. Bifidobacterium animalis subsp. lactis BB-12 in reducing the risk of infections in infancy. Br J Nutr 2011; 105(3): 409-416.

6.         Weichert S, Schroten H, Adam R. The role of prebiotics and probiotics in prevention and treatment of childhood infectious diseases. Pediatr Infect Dis J 2012; 31(8): 859-862.

7.         Bertelsen RJ, Brantsaeter AL, Magnus MC, Haugen M, Myhre R, Jacobsson B et al. Probiotic milk consumption in pregnancy and infancy and subsequent childhood allergic diseases. J Allergy Clin Immunol 2013.

8.         Kuitunen M. Probiotics and prebiotics in preventing food allergy and eczema. Curr Opin Allergy Clin Immunol 2013; 13(3): 280-286.