Should my Child Take Probiotics?

Written by: Dr. Selena Colarossi, RPh, PharmD, BASc

Updated: November 29th, 2022

When a child’s medication is prescribed by their doctor, most parents find comfort in knowing that both a pediatrician and a pharmacist have already weighed the risks, evaluated evidence, and determined that this medication is safe and effective to give to their child. When it comes to over-the-counter products like probiotics however, they often feel less supported.

Probiotics seem to be rising in popularity, so as a parent you’re likely questioning whether your child should take a probiotic too. You may find yourself standing in the pharmacy aisle wondering:

Are probiotics safe for my child?
Will probiotics actually help my child?
Does it matter which probiotic I give them?
Does my child really need probiotics?

This can leave you overwhelmed and heading home empty-handed. We understand the frustration, so we’re here to provide the support you are looking for. In this article, we’ll go through all the basics of probiotics in pediatrics, and help you make the most informed decision possible to keep even your littlest family members healthy, and happy!

What are Probiotics?

The human body contains a variety of microorganisms such as bacteria, fungi and viruses, that make up its microbiome. More specifically, the human gut contains several different types of bacteria, which are collectively referred to as your “gut microbiome” or “intestinal flora”¹. Normally, you have a balance of good bacteria and bad bacteria, but sometimes factors like medications or diseases can destroy this balance. Imbalanced gut bacteria can be associated with several different illnesses.

Probiotics are live microorganisms which when administered in adequate amounts, confer a health benefit on the host². Probiotics are used to replenish the good bacteria in the gut and restore the balance, which can help to treat or prevent these types of illnesses and the symptoms associated with them.

The Microbiome from Birth

To understand how probiotics can help your child, we’ll first look at how their microbiome has developed since birth.

It has generally been understood that a baby lives in a completely sterile environment in the uterus. More recent studies suggest that some bacteria are passed from the mother to the baby before birth³. What we do know for sure is that during birth, babies are exposed to vaginal, fecal, and skin microbiota, and massive bacterial colonization of the newborn occurs⁴. Colonization simply means that the bacteria now live on and in the baby. Essentially, the moment your baby is born, they have a microbiome!

Your child’s microbiome continues to develop significantly throughout the first year of life, and beyond. Factors like delivery method (C-section vs. vaginal), food source (breast vs. formula), and prenatal antibiotic exposure can impact a child’s microbiome, and compromise the natural bacterial makeup in the newborn gut⁴. Household exposures like furry pets or siblings can also speed up and change microbiome development⁵.

Needless to say, the microbiome is a complicated (and often neglected) part of the human body.

Probiotics and the Immune System

As a part of the larger microbiome, development of your child’s gut microbiota is especially important. Gut bacteria is heavily involved in keeping us healthyby helping our body fight infections⁶. You might be surprised to hear it, but a healthy gut leads to a stronger immune system. As we know, a healthy gut means a balanced gut. It’s possible that an imbalance in gut bacteria starting from birth or early childhood can put your child at risk for conditions like type 1 diabetes, eczema, asthma and allergies⁶. Likewise, a weak immune system makes them more likely to catch infections such as cold and flu viruses. Thankfully, we also know it’s possible to restore this gut balance! This is where probiotics come into play.

Benefits of Probiotics for Children

There are numerous reasons why probiotics may be beneficial for your child, but you’ll want to make sure they take the right one, for the right reason. We suggest consulting the Clinical Guide to Probiotic Products Available in Canada for a list of probiotics that have been proven to prevent, treat, or reduce the symptoms of various medical conditions. While this is all summarized in a handy probiotic chart, we’ll go through some of the more common reasons your child might need a probiotic.

Colic

Colic affects up to 28% of babies and causes significant stress for parents. For breast-fed babies, studies show that a specific probiotic strain, Lactobacillus reuteri DSM 17938, can improve colicky symptoms within 1 week of treatment. Since L. reuteri are naturally occurring in the gut, it’s thought that low levels cause pain and persistent crying. By giving your baby probiotics, you can help restore this gut bacteria to normal levels, and improve your baby’s colic⁷.

Antibiotic-Associated Diarrhea

When your child needs antibiotics, it’s usually a very stressful time. On top of worrying about fever spikes, restless nights, and doctor’s appointments, your child may develop antibiotic-associated diarrhea that lasts longer than the infection itself. Antibiotics are designed to kill off bad bacteria during an infection, but since they can’t differentiate between bad and good bacteria, they will kill both, which leads to an imbalanced gut flora and diarrhea. Specific probiotic strains, such as Lactobacillus rhamnosus GG (LGG^Ò) in Culturelle Kids Daily Probiotic, have shown to be effective in preventing antibiotic-associated diarrhea in children⁸. Making sure your child takes a proven effective probiotic from the probiotic chart such as this, when they start their antibiotics will ease the burden on both you and your child.

Childhood Eczema

It might be surprising to hear, but studies show that babies given certain probiotics during infancy have a lower risk of developing eczema⁹. This relates to what we discussed earlier – the gut microbiota has a strong connection with the immune system and the development of “allergic diseases” like eczema. If you’re worried about your child developing eczema, the earlier you start them on probiotics the better!

Other

As mentioned, there are several other conditions that can be improved or prevented with children’s probiotics including: constipation, functional abdominal pain, infectious diarrhea, gastrointestinal motility, regurgitation, oral health, liver health, irritable bowel syndrome, and many more.

Children’s Probiotic Formulations

If you’re worried about your child being too young or unable to swallow pills, you should know that there are several probiotic products specifically made for children that come in convenient dosage forms. Kids probiotics also come in either packets of powder to drink, or cherry flavoured chewable tablets. Other options available on the market include probiotic drops, lozenges, or capsules. Some brands even add probiotic strains to yogurt drinks, formulas and baby cereals. Surely you’ll find something for children of all ages and all levels of pickiness!

Safety Considerations

While it may seem like probiotics can do no wrong, certain types of probiotic strains may be unsafe for high-risk children such as premature infants, or those that are severely immunocompromised¹⁰.

You should always consult a trusted healthcare professional to ensure the probiotic product you select is safe for your child. Likewise, don’t forget to mention probiotic use when going through your child’s medications with any of their healthcare professionals! This ensures that your child’s chart is as accurate as possible.

For more information, you can also check out our guide for selecting probiotics!

Download the ‘Should My Child Take Probiotics’ Infographic!

References

Vyas, U. & Ranganathan, N. (2012). Probiotics, Prebiotics, and Synbiotics: Gut and Beyond. Gastroenterology Research and Practice.
Food and Agricultural Organization of the United Nations and World Health Organization. (2002). Joint FAO/WHO working group report on drafting guidelines for the evaluation of probiotics in food. Food and Agricultural Organization of the United Nations.
Funkhouser, L. J., & Bordenstein, S. R. (2013). Mom Knows Best: The Universality of Maternal Microbial Transmission. PLOS Biology, 11(8): e1001631. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747981/
Mueller, N. T., Bakacs, E., Combellick, J., Grigoryan, Z., & Dominguez-Bello, M., G. (2015). The infant microbiome development: mom matters. Trends in Molecular Medicine, 21(2), 109-117. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464665/
Stewart, C. J., Ajami, N. J., O’Brien, J. L., Hutchinson, D. S., Smith, D. P., Wong, M. C., … Petrosino, J. F. (2018). Temporal development of the gut microbiome in early childhood from the TEDDY study. Nature, 562, 583-588. https://www.nature.com/articles/s41586-018-0617-x
Markowiak, P. & Slizewska, K. (2017). Effects of Probiotics, Prebiotics, and Synbiotics on Human Health. Nutrients, 9(9), 1021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5622781/
Savino, F., Cordisco, L., Tarasco, V., Palumeri, E., Calabrese, R., Oggero, R., Roos, S. & Matteuzzi, D. (2010). Lactobacillus reuteri DSM 17938 in infantile colic: a randomized, double-blind, placebo-controlled trial. Pediatrics, 126, e526-e533.
Szajewska, H. & Kolodziej, M. (2015). Systematic review with meta-analysis: Lactobacillus rhamnosus GG in the prevention of antibiotic-associated diarrhea in children and adults. Alimentary Pharmacology and Therapeutics, 42(10), 1149-1147. https://pubmed.ncbi.nlm.nih.gov/26365389/
Schmidt, R. M., Laursen, R. P., Bruun, S., Larnkjær, A., Mølgaard, C., Michaelsen, K. F., & Høst, A. (2019). Probiotics in late infancy reduce the incidence of eczema: A randomized controlled trial. Pediatric Allergy and Immunology, 30(3), 335-340. https://doi.org/10.1111/pai.13018
National Center for Complementary and Integrative Health. (2019). Probiotics: What You Need To Know.National Institutes of Health. https://www.nccih.nih.gov/health/probiotics-what-you-need-to-know