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What are the benefits of baby probiotics?
If you search for baby probiotics in shops and online you will find a wide range of products. What do these supplements claim to do, and are these claims supported by evidence?
What do probiotics do for babies?
"The first five years of a child's life are essential for the optimal development of their gut microbiome. Baby probiotics may aid with this development," advises Dr Nirusa Kumaran, medical director and founder of Elemental Health Clinic.
The gut microbiome (also called gut flora) refers to the microbes (bacteria, fungi and yeasts) that live in your digestive system. If you have enough of the right kind of microbes, they help to keep your gut - and the rest of you - healthy. Having the wrong balance of microbes is called dysbiosis, which has been linked to a wide variety of medical conditions, from irritable bowel syndrome to type 2 diabetes and allergy-related conditions such as eczema and asthma.
Probiotics are live healthy bacteria and yeasts which have been shown to contribute to a healthy gut microbiome. The term 'probiotics' is also commonly used to refer to foods or food supplements which contain high quantities of these healthy microbes.
Probiotics and gut health
A healthy gut is better at keeping harmful substances out and is less prone to inflammation. It may help to protect against both short-term digestive issues - like diarrhoea - and long-term digestive issues - like IBS (irritable bowel syndrome).
"As 70% of the immune system is found in the gut, it can also aid with the development of the immune system in babies," adds Kumaran.
This is why an increasing number of parents are attempting to boost their child's probiotic levels - the "good gut bacteria" - by taking baby probiotics during pregnancy, and after birth through baby probiotics. These products are now widely available in formulas, foods, and supplements marketed for babies and toddlers.
The theory versus the evidence
When all babies are born, they have a sterile gut (a gut containing no bacteria). After birth, baby probiotics and other bacteria are introduced to the gut through the breast milk or baby formulas, and later through the food they eat. By the time they are one year old, each child has their own distinct gut microbiome.
Experts believe that this first year of development may be critical for long-term gut health; probiotics play a key role in forming a healthy digestive system. This allows your child to absorb essential nutrients and promotes a healthy immune system. This may help to prevent certain diseases in later life.
This is why parents who have babies diagnosed with - or who are high-risk for - certain diseases, may wish to supplement with baby probiotics. A high probiotic count can provide benefits to everyone and many parents are choosing to use probiotics for babies.
Despite the surge in popularity of baby probiotics in recent years, the evidence of their benefits is somewhat mixed.
Evidence in support: "There has been some evidence for the use of baby probiotics for the use in infant colic, eczema, asthma, and food allergies," explains Kumaran. "On a personal note, my daughter was five weeks old when she was diagnosed with severe eczema and soon after she was diagnosed with multiple food allergies. We used oral probiotics which I found were very helpful for improving her skin and also played a part in reducing the number of her food allergies."
Evidence against: several studies, including one in 2018 with 86 participating mothers, found that a course of baby probiotics did not result in any measurable health outcomes.
Does my baby need probiotics?
One reason for this mixed bag of evidence is that more research is needed into different probiotic strains. This could help scientists better determine which strains of baby probiotics might be most effective for certain diseases.
If you're concerned about your baby and eczema, asthma, infant colic, food allergies, or any digestive issues, you may want to talk to your doctor or pharmacist before considering using baby probiotics as dietary supplements. As well as being able to recommend other treatments that are proven to be effective, your doctor may also advise on the best type of probiotic for your baby's needs.
Examples of baby probiotics for health conditions
The World Allergy Organization (WAO) recommends that pregnant and breastfeeding women can take probiotics for babies who have a high risk of eczema. This is because there is "clear evidence" that probiotic supplements could help to prevent eczema in babies.
However, even in studies with the most positive outcomes, the correct probiotic strain, timing, duration, and dosage are still largely undetermined. It's these important factors which may explain why other studies have produced no positive results in babies with eczema.
Another theoretical benefit of probiotics for babies is that they may help prevent high-risk children from developing food allergies.
Results have been conflicting: in one systematic review of 10 studies, four of the five studies that looked at babies taking probiotics after birth failed to show any significant reduction in the risk of food allergies for babies at high risk. The other five studies included prebiotics given to the pregnant mother and in some cases probiotics for the baby as well. Most of these showed minor improvements in allergies which were not large enough to be counted as significant.
The influential Cochrane database, which reviews the science behind a wide range of claims, is unconvinced by the evidence. They conclude that there is not enough evidence to recommend adding probiotics to infant feeds to prevent food reactions.
The evidence for baby probiotics as a treatment for colic is conflicting. While there are some studies that found babies with colic cried less after a course of probiotics, many reviews have concluded that the evidence for this is unclear and very limited.
Are probiotics safe for babies?
Baby probiotics are generally considered safe for infants," says Kumaran. "However, there is still a relative lack of evidence for their use. Generally, the advice is not to use probiotics in premature infants."
It's also worth bearing in mind that probiotics for adults and children are classed as a supplement by the National Institutes of Health (NIH). Therefore, unlike medications, baby probiotics are not regulated or subject to a high standard of testing to prove their effectiveness and safety.
Do breastfed babies need probiotics?
Breast milk is already a natural, good source of probiotics for babies, along with providing many other important nutrients. However, adding more probiotics to your child's diet may have added benefits. Much of the research into baby probiotics has looked at the potential health outcomes for breastfed babies.
How do you give probiotics to your baby?
Baby probiotics come in many forms, including powders and liquid drops. You can add baby probiotics to breast milk, sterile water, or formula for your baby to drink, or you can put probiotic drops directly into your baby's mouth.
Using with breastfeeding
- When adding baby probiotics to breast milk, make sure you don't heat the bottle over 37°C (Celsius), which is 100°F (Fahrenheit), to avoid destroying the good bacteria.
- Your baby needs to drink this mix within six hours for the probiotics to work.
- Alternatively, you may choose to put probiotic drops on your breast before nursing your child.
Using with formula
- You can add baby probiotics to their formula. Again, don't heat the formula over 37°C before adding the supplement.
- Probiotics in formula may keep longer than six hours.
- Many formulas already contain added probiotics.
How long does it take for baby probiotics to work?
Just as it's unclear how useful different baby probiotic strains are, it's also hard for experts to say with certainty how long they need to be taken. If you do notice improvements in your baby's health, it's likely that this will be after a few weeks at least. Probiotics are considered safe to use for an extended period.