Probiotics For Kids: Everything You Need To Know

Photo: Jessica Byrum

You've heard functional medicine doctors, wellness pros, and people in your own circle sing the praises of probiotics—at least in adults. But what about probiotics for kids? It turns out, some of the health benefits of these gut bacteria powerhouses do extend to children—in some cases.

While probiotics in adults have been scientifically shown to help prevent bowel diseases, strengthen your immune system, improve skin and oral health, aid mental health, and ease various distressing GI symptoms, research on probiotics for kids is still in its infancy (literally). But some studies have looked at specific applications of probiotics for kids, and there are some promising findings (and likely, more to come). Here's what you need to know.

What are probiotics?

Let's back up a bit: The gut is already home to more than 500 species of microorganisms (trillions of them in total) that help maintain balance in your digestive system, immune system, metabolism, hormones, and overall health.

When this "gut flora" is out of balance, things like stomach problems, autoimmunity, allergies, skin problems, weight gain, and depression and anxiety can manifest—to name just a few potential problems. Marvin Singh, M.D., an integrative gastroenterologist and expert on gut health, explains that, "In children, one of the key things to remember is that they have the gut microbiome of an adult by around 2.5 to 3 years of age. Therefore, the early years can be quite important, and dietary, environmental, and stress-related issues are things that are not just important for adults but important for children, as well. Just as in adults, there may be a role for probiotic use in children."

These supplements, which contain "good" bacteria, are a great tool to help maintain or rebalance the diverse and delicate ecosystem of microorganisms in your gut (and your kid's gut). The different species of friendly gut bacteria in probiotics help overpower unwelcome microorganisms (like not-so-friendly bacteria, yeast, and parasites) that try to set up camp in the intestines and wreak havoc on the body.

What strains of probiotics should kids take?

Not all probiotics are created equal—there are several different strains of probiotics (and various species within those strains).

The main strains you'll come across in probiotics for kids are Lactobacillus, Bifidobacterium, and Saccharomyces boulardii. Lactobacillus mainly lives in the small intestine (which comes right after the stomach in the digestive system), and common species include L. acidophilus, L. plantarum, and L. paracasei. Bifidobacterium is found mostly in the colon or large intestine, and common species include B. lactis and B. longum. And S. boulardii is actually a yeast (not bacteria) that can help protect the gut lining.

In addition to colonizing in different places, different strains have different roles in the body. Ultimately, the best strains and species of probiotics for kids depends on the reason they're being used.

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What are the benefits of probiotics for kids?

While probiotics for adults are often recommended for general gut health improvement, there are some specific scenarios that research backs up when it comes to probiotics for kids, especially in cases that young ones are particularly susceptible to (like stomach bugs, antibiotic-associated diarrhea, and respiratory infections picked up at day care). Here's when probiotics for kids can be helpful, according to research.

1. Reducing duration of acute gastroenteritis.

There's nothing more miserable than having a kid with a stomach bug (aside from maybe being a kid with a stomach bug). But according to a review on the benefits of probiotics for kids, certain strains can help reduce the length of the misery.

For research purposes, acute gastroenteritis is defined as a decrease in stool consistency (so, loose or liquid stools) and an increase in the frequency of bowel movements (more than three times per day), and vomiting or fever may or may not be part of the deal. The culprits behind these stomach bugs are often rotavirus or norovirus.

While probiotics didn't improve stool consistency in the studies reviewed, researchers found that Lactobacillus rhamnosus GG, S. boulardii, and L. reuteri may help reduce the duration of diarrhea in kids with acute gastroenteritis.

2. Preventing antibiotic-associated diarrhea.

If your kid's starting a round of antibiotics for, say, an ear infection, probiotics can help reduce the risk of antibiotic-associated diarrhea, according to the review on the benefits of probiotics for kids. There are two probiotic strains with good evidence behind them for this purpose: Lactobacillus rhamnosus GG and S. boulardii.

While antibiotic-associated diarrhea is usually mild and self-limiting (meaning, it'll resolve on its own), the evidence is pretty great that these probiotic strains reduce the risk altogether. Certain groups of kids might especially benefit from taking probiotics at the same time as antibiotics, such as young children, hospitalized children, and kids who've experienced antibiotic-associated diarrhea before.

One study reviewed also found that S. boulardii prevented diarrhea associated with Clostridium difficile (or C. diff.) in kids.

You might be thinking, wouldn't an antibiotic automatically kill off probiotics? Well, research hasn't definitively answered what the best time to take a probiotic is when antibiotics are also involved. But the review notes that the S. boulardii strain is resistant to antibiotics used for bacterial infections, and since the Lactobacillus rhamnosus GG strain was also effective in randomized controlled trials, it's safe to assume these bacteria survive antibiotics as well.

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3. Preventing respiratory tract infections.

Anywhere that groups of kids gather (like at day care centers) can feel a bit like, well, a petri dish for infections. But a review on the use of probiotics to prevent respiratory infections in children determined that taking probiotics can be a good way to fend off these illnesses in kids.

While probiotics don't seem to have an effect on the duration of respiratory tract infections, the review found that taking probiotics decreased the number of study participants who had even one respiratory tract infection, and they also missed fewer days of school. While some of these studies didn't look at specific strains (which is a bit of a research drawback), the only strain that was singled out and had positive results in more than one randomized controlled trial was Lactobacillus rhamnosus GG, according to the review on the benefits of probiotics in kids.

These review authors also mention that kids who probably benefit most from taking a probiotic containing Lactobacillus rhamnosus GG are young kids and kids who have recurring respiratory tract infections during the winter.

4. Managing irritable bowel syndrome.

Kids with functional gastrointestinal disorders like irritable bowel syndrome may also benefit from probiotics, a review found. A meta-analysis of nine trials in children and adolescents found several probiotic strains that increase treatment success (which might also include cognitive behavioral therapy and hypnotherapy). The three strains or products with good success were Lactobacillus rhamnosus GG, Lactobacillus reuteri DSM 17938, and VSL#3 (a therapeutic probiotic that's been proved to help with conditions like ulcerative colitis, pouchitis, and irritable bowel syndrome in adults).

The researchers also found that a mixture of Bifidobacterium infantis M-63, Bifidobacterium breve M-16V, and Bifidobacterium longum BB536 is associated with better control over abdominal pain in kids with IBS and a higher quality of life compared to placebo (because, hey, IBS can really put a damper on a kid's daily life).

What are the best probiotics for kids?

While the research on probiotics for kids isn't as developed as probiotics for adults (so science hasn't said that they're beneficial for all kids to take, from a preventive standpoint), if you're looking for a probiotic for kids, there are a few things to keep in mind.

To make sure you're getting a quality probiotic for kids, look for products that contain the same strains that have been used in studies (ideally with a similar CFU value that was used in the study—that stands for "colony-forming units"). For example, you might've noticed Lactobacillus rhamnosus GG pop up several times in the positive study results for certain issues, like preventing respiratory tract infections and managing irritable bowel syndrome. Many probiotics designed for kids include this strain and species (as they should).

It's also important to remember that probiotics are pretty delicate (they're live bacteria, so they need to be able to survive the manufacturing process, your storage method, and ultimately, your stomach acid before they can colonize in your intestines). To make sure you're getting a high-quality product that's, well, still alive (and safe for kids), look for professional brands recommended by health care professionals or brands that undergo third-party testing.

Dr. Singh recommends exercising caution when using probiotics in children, especially those who are immunocompromised because, although rare, there can be complications. The main concern, however, is contamination and quality of the products. "I suggest consulting with your pediatrician before making a particular choice of probiotic for your child," Dr. Singh says. "There are certain probiotics that are better for particular conditions. Always try to stick to well-trusted companies and look on the labels for certifications like NSF, USP, QAI, and/or GMP certified. Additionally, beware of added sugars that are often included in children's probiotics, especially the chewable kinds."

Considering the many benefits of probiotics for adults that have been studied and proved, it's no wonder probiotics for kids are getting attention—and as more research is published, chances are, more benefits will be found.

Ready to learn more about how gut health is the foundation for the health of your entire body? Register now for our FREE Functional Nutrition Webinar with Dr. Vincent Pedre.

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