From infant formula to fruit-flavored gummies to drinkable yogurt, baby probiotics now come in all kinds of foods, beverages, and supplements for very young kids. Widely hyped as being good for their gut and boosting immunity, probiotics are beneficial bacteria that, in theory, balance out the potentially harmful microbes living in their digestive tracts. Beyond that, infant probiotics are promoted to help with common conditions such as colic, eczema, and antibiotic-associated diarrhea. But that’s all according to marketing. Are any of these benefits backed by solid science? And if they are, with thousands of probiotic strains available and countless types of products to choose from, how can parents know which probiotic to give their kids?
First, some baby microbiome background: All babies are born with trillions of bacteria and other microorganisms that live throughout their bodies but predominantly in their gut. Most of these bugs are friendly, meaning they help kids stay healthy, but some others, if allowed to proliferate, can make them sick.
External factors such as diet, disease, and certain medications — most notably antibiotics — can throw the microbial balance out of whack, enabling hazardous microbes to manifest. This doesn’t always result in a child becoming ill — the body has its own defenses to fend off infection — but it certainly can. For example, when taking antibiotics, which wipe out the gut’s good bacteria along with the bad, about 25 to 30 percent of children develop diarrhea, which can turn severe and even become life-threatening.
Here’s where probiotics come in: When taken as a dietary supplement or included in certain foods, these live microorganisms replenish the gut with good bacteria to help balance out the microbiome. By doing so, they may assist in staving off or reducing the severity of sickness.
But unfortunately, it’s not as simple as saying probiotics, in general, are good for specific health effects, as product marketers might want us to believe. There is a vast array of probiotic strains, most belonging to either the Lactobacillus or Bifidobacterium group, and each strain within those groups has its own unique characteristics, functions, and potential health perks. Therefore, the health benefit of probiotics will depend on the specific strain and its intended purpose, as well as how much good-quality research has been conducted on that strain.
While probiotic science has exploded over the past 10 or 15 years, there are still so many unknowns about how these little buggers work and how they may help us out. “We have theories for why probiotics work, but we do not know the exact mechanisms,” says Dan Merenstein, M.D., a probiotics expert and director of research programs in the department of family medicine at Georgetown University. “We don’t even know what a healthy microbiome really is, so we can’t say that [balancing it] has specific benefits.”
This is why, aside from a few probiotic strains shown to be effective for certain health conditions, it’s too soon to say with certainty that all babies and toddlers will benefit from taking daily probiotics. Some could benefit, says Merenstein, but there haven’t been enough clinical trials done on children to know for sure. For instance, he says probiotics seem to do some general good for the immune system and gastrointestinal health. But from the existing research, it’s difficult to tease out exactly why or how they are helping — or which strains are actually effective.
That said, based on the research that has been done, we do know that probiotics are overwhelmingly safe, with few if any negative side effects reported. And although many more clinical trials are needed, it seems that most strains hold the potential to do something positive for health. But again, is this enough proof to make it worth giving a relatively healthy baby or toddler a daily probiotic?
“When we get into whether probiotics are helpful for healthy kids, it’s sort of like multivitamins,” Merenstein says. “My kids take multivitamins, but the data supporting them is pretty poor. The evidence is not there, but at the same time, multivitamins are not going to hurt them.” However, Merenstein points out that probiotics are considerably more expensive than most kids’ multis, meaning parents would be paying a lot for products that won’t hurt their children — but may not help them much either.
Baby Probiotics for Specific Conditions
While we’re still years away from knowing whether all babies and toddlers should take probiotics daily, there is good, solid science showing that certain strains can, in fact, help with certain health issues. A few examples:
Diarrhea: Runny poop is not uncommon among infants and young children, but if diarrhea persists, it can lead to dangerous dehydration. Diarrhea is even more likely if a child is taking antibiotics for an ear infection or other ailment. Fortunately, several studies show that a few select strains help prevent or alleviate diarrhea. These include Lactobacillus rhamnosus GG, or LGG, found in Culturelle Kids Daily Chewables, Culturelle Daily Probiotic Packets, and MetaKids Baby Probiotic drops, as well as Saccharomyces boulardi lyo CNCM 1-745, available in FlorastorKids Daily Probiotic Supplement.
Colic: “The probiotic L. reuteri DSM 17938 has been well studied for infants with colic, and the best studies are those done on breastfed babies,” Merenstein says. “It won’t get rid of colic completely, but it will decrease crying time.” Some research suggests L. reuteri DSM 17938 may also relieve gastrointestinal upset associated with colic. This strain is found in BioGaia Protectis products, available as drops for infants or chewable tabs for older children, as well as Gerber Soothe Probiotic Colic Drops, Gerber Good Start Soothe Powder Infant Formula, and Pedia-Lax Probiotic Yums.
Eczema: Research suggests that LGG may also reduce eczema and other food-allergy-related flareups. “If a child is at high risk for eczema and allergies — if there is a family history, for example — then consider giving it to your child and the rest of your family as a preventative measure,” Merenstein says. Multiple studies also suggest that babies of women who took probiotics while pregnant are less likely to develop eczema. The evidence includes a Finnish trial published in The Lancet that showed LGG, specifically, was effective.
Gastrointestinal issues: Beyond easing diarrhea, probiotics may also help children with symptoms caused by irritable bowel syndrome, constipation or ulcerative colitis. There is some evidence L. reuteri DSM 17938 may benefit in these cases. And for children old enough to consume yogurt or yogurt drinks, L. plantarum 299v (found in three Goodbelly products), L. casei Paracasei CNCM I-1518 (found in DanActive Actimel), and B. lactis CNCM I-2494 (found in Activia yogurt) might be beneficial, although these strains have been studied in adults not children.
How to Buy Baby Probiotics
To help you shop for specific products that have proven helpful for various conditions, check out the 2020 Clinical Guide to Probiotic Products Available in the USA. Updated each year to capture the latest science, this is the guide that many doctors consult before recommending particular probiotics for kids. “If you want to know which probiotic to give Johnny when he is on antibiotics or has ulcerative colitis, that site does really good job,” Merenstein says. Yet it’s still smart to run this buy your child’s doctor before buying a product.
Merenstein also advises parents to check out the International Scientific Association for Probiotics and Prebiotics’ website. This research-based organization has created several short, easy-to-understand videos and infographics on how probiotics work and how to choose the best products.
As a final note, Merenstein says that when shopping for probiotics, always check the Supplement Facts panel to make sure the strain or strains are listed precisely. Each probiotic name should include the genus (such as Lactobacillus, sometimes shortened to L.), the species (such as reuteri), and a set of numbers or letters to indicate the exact strain.
“If a label doesn’t list three names for the probiotic, then the company isn’t being entirely truthful, and you really can’t know what’s in the product,” Merenstein says. “For example, if it says just Lactobacillus or acidophilus, or it says only L. reuteri with no number after it, then you don’t know what you’re getting. That doesn’t mean that product won’t do a child any good, but without all the information, it’s hard to tell.”