I’m becoming more of a believer in giving children probiotics. Not for everything and not for everyone; I really don’t think we should put them in the water.

Probiotics, essentially live “good” bacteria we use to supplement our diet (usually Lactobacillus Acidophilus in the US), are becoming more and more available and recommended by more and more physicians. The role microbes play in our health is a hot topic. Probiotics are thought to improve intestinal health by restoring/elevating levels of  helpful bacteria while concurrently diminishing the population of harmful ones.

Bacteria in the intestine are a normal part of our digestive health, but population counts of  bacteria living in our gut may be altered by illness, antibiotic use, ingested/modified foods, or life circumstance. What we eat and where we travel to drink water, change what lives in our gut. Research also finds that which bacteria cohabitate on our bodies may impact other illnesses outside the gut like eczema, allergies, and/or asthma.

In children, probiotic supplements may promote recovery from acute diarrhea by decreasing the number of episodes of diarrhea & the number of days. They also may help prevent the development diarrhea when children are taking antibiotics. The reality is many decisions we make affect our populations of bacteria. This starts on the day of birth. We know for example that babies born by C-section have different populations of bacteria in their poop when compared with those babies born vaginally, within a week after birth. So from the very beginning, the choices we make (or our parents make) may change the environment in our bodies. This ultimately may change our wellness. A set of doctors studied the effect of probiotics on colicky babies…

Probiotics are often found naturally in food (yogurt with active cultures) while some yogurt and commercially available foods (and infant formula) are fortified with additional cultures. You can also buy Lactobacillus capsules (or other probiotics) at drug and health food stores. How active, and how plentiful these probiotics remain in these products is up for debate. Probiotic supplements (and culture-fortified foods) are not regulated by the FDA. How much is in a capsule or packet is unknown and likely inconsistent from brand to brand or day to day. And if the probiotic cultures are dead, they may do very little to promote change in your body. As a consumer, knowing that a supplement is alive is impossible.

That being said, although the choices of probiotics are limited in the US,  the literature and research surrounding altering a child’s bacteria to preserve their health and wellness is both fascinating and promising. Outside of Lactobacillus, relatively few studies have been done with US children and probiotics. But, we’re learning a lot from our European colleagues. The risks of giving a probiotic supplement continue to prove to be very low in children with a healthy immune system. But like anything in pediatrics, there is always theoretic risk when you intervene.

An Italian study in a recent Pediatrics evaluated the benefit of probiotics for fussy or colicky babies. Researchers found positive results in breastfed infants receiving daily Lactobacillus reuteri. In Europe, probiotics are more carefully regulated than they are here in the US. So, it’s possible this data/study really isn’t applicable to our babies as we don’t have access to the same supplements. But read what they found.

In the study:

• Colic was defined using the rule of 3′s. A colicky baby is defined as one under 3 months of age who cries more than 3 hrs a day, more than 3 days a week for at least 3 weeks.
• About 50 exclusively breastfed, colicky babies were randomized into 2 groups. One group of babies was fed a placebo/inert supplement with no probiotics, while the other group got Lactobacillus daily. Parents and researchers didn’t know which babies got the bacteria (double-blind study).
• Among colicky infants who received the probiotic, there was a significant reduction in daily crying time at the end of the study (day 21) compared with placebo group.
• Crying improved by the end of the study in both groups, as is expected with colic.
• Researchers also analyzed the poop from both sets of babies and found different bacterial populations between the groups of babies. Those given the probiotic had far more Lactobacillus in their stool.
• Researchers theorize that changes in intestinal environment (bacteria, ammonia) may have changed sensory experience for babies and thus their crying behaviors.

It’s hard to prove that the bacteria fed to these babies is directly responsible for crying improvement but significant differences in the two groups were noted. And although it may seem counter-intuitive to families to feed their child bacteria, after we discuss benefits, many parents opt to supplement their children with Lactobacillus due to low cost and ease of administration (can sprinkle in anything). If your baby is a crier and you think and worry about colic, you may want to talk with your pediatrician about starting a Lactobacillus supplement. With the low risk, an improvement in crying would be good for everyone. The bottom line is I don’t think probiotics will cause a fussy baby any harm, and this is new research that indicates it may really help.

A spoonful of bacteria for baby, then.

Wendy Sue Swanson is a pediatrician who blogs at Seattle Mama Doc.

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