Recent research has explored supplementation with probiotics to support gastrointestinal health in infants and children. The gut microbiome contains more than 400 species of bacteria and is important in the maintenance of gastrointestinal function. Antibiotic use in both children and adults causes a disturbance in the natural balance of the gut microbiome and may result in diarrhea, altered mucosal integrity, and changes in vitamin, mineral, and electrolyte levels.

A Cochrane study analyzed data from over six thousand participants in thirty-three studies regarding the effect of probiotic supplementation on antibiotic-associated diarrhea (AAD) in the pediatric population ages three days to 17 years. The authors reported that supplementing with higher doses (equal to or above 5 billion CFUs per day) was more effective than lower probiotic doses, and the incidence of AAD in high-dose studies was 13% as compared to 23% in the control group. Overall, the use of probiotics reduced diarrhea duration by almost one day. The species most recommended by the study to prevent AAD in children receiving antibiotics were Lactobacillus rhamnosus and Saccharomyces boulardii. 

Another common condition in the pediatric population is infant colic, which is a condition of unknown etiology that affects approximately one in five infants under three months old. It is defined as crying and/or fussing for more than three hours per day for three or more days per week. While it is believed to be self-resolving, it may have a long-term influence on sleep, allergy, and behavioral outcomes. A meta-analysis explored the effect that Lactobacillus reuteri DSM19738 may have in support of attenuation of symptoms of infant colic. The study aggregated data from 345 infants in four double-blind clinical trials and found that as compared to placebo, the group receiving probiotics experienced overall lower amounts of crying and/or fussing time. The duration of crying and/or fussing was significantly shorter in the probiotics group at follow-up. The probiotics group experienced significantly greater reductions in crying and/or fussing at days seven and twenty-one and was almost twice as likely as the placebo group to report treatment success at all time points. Overall, the probiotic group experienced a 46 minute per day reduction in crying and/or fussing from baseline. Of note, all trials included breastfed infants, and the authors of this study discuss a need for more research in formula-fed infants regarding L. reuteri DSM17938 supplementation. 

While there is more to explore about probiotic use in infants and children, modern research suggests that supplementation with certain probiotics may support infant health in the presence of colic. Probiotics may also help support healthy gastrointestinal function and have a protective effect in the prevention of antibiotic-associated diarrhea in the pediatric population. 

By Colleen Ambrose, ND, MAT