Probiotics in Children

Probiotics are relatively new to mainstream Western medicine. The idea is ingesting “good for you” bacteria to obtain health benefits.

Russian physician Ilya Metchnikoff is recognized as presenting the concept of probiotics to the western world. He correlated longevity with regular ingestion of milk fermented with lactic-acid bacteria.

During World War 1, Alfred Nissle isolated a strain of Ecoli from a soldier who did not get shigellosis during an outbreak. He subsequently successfully used the strain to treat other cases of infectious diarrhea.

Today, probiotics are promoted to increase longevity, treat irritable bowel disease, cure eczema and boost the immune system. Current research does not support these assertions.

Probiotics are increasing recognized as a safe, viable treatment for diarrhea. Probiotics have been shown to shorten the course of infectious diarrhea.

There are a wide variety of probiotics on the market.

- Lactobacillus are the main microbes in most yogurt products.

- Florastor uses a yeast Sacchoromyces boulardii

- Activia yogurt employs Bifidobacterium lactis

- Culturelle contains Lactobacillus GG

- Enfamil recently added Lactobacillus GG to Nutramigen

- Kefir is a yogurt like drink that contains yeast in addition to a variety of bacteria

Most research to date has focused on Lactobacillus alone or along with Bifidobacterium. While they appear safe, there is limited evidence on safety. It is unclear which probiotics are the most effective. It is possible that specific infections are best addressed by certain probiotics.

Most cases of diarrhea will pass without need for a probiotic. I do recommend probiotics for prolonged diarrhea, for antibiotic caused diarrhea, or for diarrhea in individuals with complicated medical issues.

I have recommended probiotics in my practice for only 5 years. Overall, my patients are unafraid of the concept, pleased with the results and report few side effects. I love the concept of giving bacteria for health purposes. It contradicts mainstream thought from years ago that “all germs are bad”. It reminds me once again that everything is best in moderation.

Written June 2011 by
Dr. Gordon, Orlando Pediatrician

Sources

Allen SJ, Martinez EG, Gregorio GV, Dans LF. “Probiotics for treating infectious diarrhea”. Cochrane Database of Systematic Reviews 2010, Issue 11. Art. No.: CD003048. DOI: 10.1002/14651858.pub3

Safety of Probiotics Used to Reduce Risk and Prevent or Treat Disease. Structured Abstract. Agency for Healthcare Research and Quality, Rockvillle, MD. http://www.ahrq.gov/clinic/tp/probiotictp.htm

Verna Elizabeth C. MD and Lucak, Susan MD, “Use of Probiotics in Gastrointestinal Disorders”. Posted 2/09/11; Ther Adv Gastroenerology. 2010; 3(5):307-319. 2010 Sage Publications, Inc.