Your guide to: Probiotics for Children

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This article was made possible due to an unrestricted educational grant from Activia (Danone Canada). Written in collaboration with Dragana Skokovic-Sunjic BScPh RPh NCMP, AEProbio

As a parent, you want to give your baby the best start in life. You are conscious of your baby’s health and development and want to ensure they grow up happy and healthy. There is a lot of talk today about a healthy gut being the foundation for a healthy child and how probiotics can build up your baby’s gut health.  

If you didn’t know, probiotics are defined as ‘Live microorganisms which, when administered in adequate amounts confer a health benefit on the host’. In plain language, probiotics are “good microbes” that are meant to help the person taking them. These friendly microbes help us digest food, maintain health and fight disease. Many Canadians are hearing about how great probiotics are, and are looking to supplement their diet with them. 

Not every child will need to be given probiotic. Early life exposures to microbes in the world we live in, playing outside, having a pet, eating variety of food are all factors supporting good gut microbes and in turn good health. 

Evidence supports using specific probiotics as an intervention in treating or preventing very specific childhood conditions, not as a general health supplement 

For probiotics in children and young adults, clinical evidence supports the use of probiotics as an intervention for: 

  • Colicregurgitation in infants 
  • Infectious diarrheaconstipationfunctional abdominal pain 
  • Prevention of common infectious diseases (cold and flu) 
  • Prevention and adjunct to treatment of childhood eczema and atopic dermatitis 
  • Adjunct to treatment of inflammatory bowel diseases 
  • Certain liver health diseases 

With so many probiotics available on the market – how do you choose which one is best for your child? With so many products available, and so much chatter around this “hot topic”, people are becoming misinformed and are unsure what probiotics are best. It’s important to note that not ALL babies or children need to take probiotics. They are not the solution for every single problem that ails our kids, but some of the most significant and most impactful solutions can be easily obtained by using a specific probiotic under specific conditions. You need to use the right probiotic, for the right person, for the right reason. 

It’s important to note that if you are a generally healthy person (physically active, eat well, aren’t under a lot of stress) you likely do not need to take a probiotic. Not everyone needs a probiotic to stay healthy. Probiotics have only been identified as a treatment for specific conditions and for symptom relief. It’s important that you talk with your doctor, pharmacist, or dietitian FIRST before taking a probiotic, to ensure you have a proper diagnosis, or know why you are taking it. Together, you can select an appropriate probiotic that is the most suitable for you. 

With so many products available, and so much chatter around this “hot topic”, it’s no wonder that people are having trouble choosing the right probiotic. What often happens is that people will take something labelled “Probiotic”, or “live bacterial cultures”, but as these products often aren’t right for their diagnosis, the patient won’t see any health difference and assume that probiotics just don’t work… but how wrong they are…  

The issue of choosing the right probiotic for the right reasons has been addressed in the Clinical Guide to Probiotic Products. The Clinical Guide is an evidence-based decision-making tool for clinicians, which is independently prepared and updated every year. This project has been going on since 2008, and has been recognized as the only reliable resource by international healthcare associations providing health care professionals and consumers with a list of probiotic formulations that have been specifically clinically tested – so they can select the appropriate product, dose, and formulation for a specific indication. Alliance for Education on Probiotics (AEProbio) supports publishing and distribution of this Guide.  

Within the Guide, the recommendations are tied to brand names, making it easier for you to select the recommended product when purchasing in stores. Probiotic strain names and doses are also listed. Favorable published clinical evidence for the particular strain(s) presented in each product are given and include numerous gastrointestinal conditions.  

The handy acronym table makes it easy for you to find the product that has clinical evidence for your specific condition:  

AAD Antibiotic associated diarrhea – prevention  
BV Bacterial vaginosis 
C Constipation 
CDAD Clostridium difficile associated diarrhea – prevention 
CID Common infectious disease – Community acquired  
CMPA Cow Milk Protein Allergy  
HP Helicobacter pylori – Adjunct to standard eradication therapy 
IBD-P Inflammatory bowel disease – Pouchitis 
IBD-UC  Inflammatory bowel disease – ulcerative colitis – adjunct to standard therapy  
IBSIrritable Bowel Syndrome
LHLiver Health (NASH/NAFLD/MHE; as adjunct to standard therapy; see studies for specific population) 
M/AMood and Affect (symptoms related to stress/anxiety; not a substitute for standard treatment)  
OH Oral health (reductions of tonsillitis, laryngitis, and dental caries)  
TDTravelers diarrhea prevention 
VDVulvovaginal candidiasis 
WMWeight management (aids in reduction of body weight, body fat mass, and waist circumference  

There, you will also be able to compare products based on the level of evidence, as it is graded with a I, II, or III, with level I being the highest level: 

  • Level I: 
    • Evidence obtained from at least one properly designed randomize trial  
  • Level II:  
    • Evidence obtained from well-designed controlled trials without randomization 
    • Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one centre or research group 
    • Evidence obtained from multiple time series with or without intervention. Dramatic results in uncontrolled trials might also be regarded as this type of evidence. 
  • Level III:  
    • Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees.  

To make things even EASIER, the guide also includes symbols to indicate whether or not the product is gluten free and requires refrigeration.  

For example, if your child suffers from constipation – probiotics can help. Referring to the probiotic guide under the pediatric health indication –you would see that there are 4 products that have favorable published clinical evidence on relieving constipation –  all which have level I evidence: 

Online Video Demonstration

As you can see the following four probiotic brands and strains have level I evidence for constipation in children.  It also indicates the dosage form – whether it be drops, tablets, capsules, etc and the number of doses you should be taking per day.  

  1. BioGaia Protectis Baby Drops with Vitamin D 
    • L. reuteri DSM 17938 
    • 5 drops / day  
  2. BioGaia ProTectis Drops
    • L. reuteri DSM 17938 
    • 5 drops 1 tablet / day  
  3. BioGaia ProTectis chewable tablets 
    • L. reuteri DSM 17938 
    • 1 chew tab per day 
  4. Visbiome
    • mix of 8 specific strains
    • 1-2 sachets mixed with water daily 

See the full guide to review brands and strains for other conditions such as Colic, IBS/FAP (functional abdominal pain), antibiotic associated diarrhea – prevention, and much more.  

Online at Probioticchart.ca 

App Store or Google Play: PROBIOTIC GUIDE  

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