In recent years, probiotics have been discussed increasingly often, especially in the context of young children's health. Parents often hear that ‘it is worth giving probiotics’, but what does that actually mean? Are they all the same? Most importantly, which strains can genuinely support the health of babies and children?
What Are Probiotics?
Probiotics are 'good bacteria' that, when administered in appropriate amounts, provide health benefits to the host, meaning us and our children. They most commonly belong to the genera Lactobacillus and Bifidobacterium, although there are others. One point is crucial: the effects of probiotics depend on the specific strain, not merely on the bacterial genus. It is like dogs: dachshunds and Labradors are both dogs, but they are very different. The same applies to probiotics.
Why are probiotics important for children?
A child’s digestive system, especially during the first year of life, is still developing. The gut microbiota (all the microorganisms living in the intestines) plays a key role not only in digestion, but also in immunity, metabolism and even neurological development.
Which strains have proven effects?
Here are some of the most frequently studied and discussed probiotic strains:
- Lacticaseibacillus rhamnosus GG (LGG)
The source describes LGG as one of the most extensively studied probiotic strains. It claims that the strain supports immune function, helps reduce diarrhoea, particularly antibiotic-associated diarrhoea, may reduce allergy risk and has shown benefits in children with atopic dermatitis.
- Bifidobacterium lactis (BB-12)
The source claims that the product supports a healthy gut microbiota, may ease infant colic and constipation, and is safe and well tolerated by young babies.
- Lactobacillus reuteri DSM 17938
This strain has gained popularity because of its effectiveness in relieving infant colic. Research shows that it may reduce crying time in babies by as much as 50%.
- Saccharomyces boulardii
It is a yeast, not a bacterium, but it has a probiotic effect. It is particularly effective in treating diarrhoea, including antibiotic-associated and rotavirus-related diarrhoea.
Is it worth giving probiotics preventively?
It depends. In a healthy, breastfed child with no health problems, the microbiota develops naturally and supplementation is not necessary. In particular situations, however, such as gastrointestinal problems, diarrhoea or atopic dermatitis, a selected probiotic strain may be very helpful.
In 2023, the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) published updated guidelines on the use of probiotics in treating selected gastrointestinal diseases in children. These recommendations, developed on the basis of the available scientific evidence, apply only to specific probiotic species and strains that have been evaluated in at least two randomised controlled trials (RCTs).
The use of probiotics in the treatment of infantile colic
Based on the available data, ESPGHAN has issued recommendations for only two probiotic strains: Limosilactobacillus reuteri (formerly Lactobacillus reuteri), designated L. reuteri DSM 17 938, and Bifidobacterium animalis subsp. lactis BB-12 (B. lactis BB-12). Both probiotics are available on the Polish market.
L. reuteri DSM 17938
The use of L. reuteri DSM 17 938 at a dose of 1 × 10⁸ CFU per day for at least 21 days may be considered for treating colic in breastfed infants. This is a weak recommendation, and the certainty of the evidence was assessed as moderate. Use of this strain increases the likelihood of therapeutic success (defined as a reduction in the number of crying episodes by ≥50%) and shortens the amount of time the child spends crying or fussing by an average of 25 minutes per day. In formula-fed infants, the effectiveness of this probiotic remains inconclusive.
B. lactis BB-12
The use of B. lactis BB-12 at a dose of 1 × 10⁸ CFU per day for 21–28 days may also be considered in the treatment of colic in breastfed babies. This recommendation is also weak, and the certainty of the evidence was rated as moderate. The use of B. lactis BB-12 increases the likelihood of therapeutic success and reduces the child's mean daily crying time by 35–45 minutes.
Preventing infant colic
The source says that ESPGHAN guidance does not recommend probiotics for preventing infant colic because the evidence is insufficient, specifically because there are not at least two randomised controlled trials of the same probiotic strain.
The source says that, because studies are limited and data insufficient, ESPGHAN did not make recommendations for other probiotic strains in treating infant colic. It adds that some other experts or scientific organisations may consider a specific strain when at least one credible randomised controlled trial has reported efficacy.
How do you choose a good probiotic?
- Pay attention to the strain — it is not enough for a probiotic to state only ‘Lactobacillus’; the full identification matters, for example Lacticaseibacillus rhamnosus GG.
- Choose clinically tested products, preferably with clear information about the number of live bacterial cultures and the recommended use.
Probiotics may support a child's immunity and health, but selecting the appropriate strain is crucial. Not every probiotic works in the same way, so it is worth choosing well-studied strains intended for a specific purpose. Supporting gut health is presented as an investment in lifelong health and should be approached carefully.
Emilia Adamczyk, midwife and sensory-integration therapist