The Importance of Probiotics for Infants and Young Children
- The first three years of development are critical for establishing a healthy gut, which shapes children’s immune and digestive health across the lifespan.
- Risk factors for suboptimal gut health include caesarean delivery, preterm birth, exposure to antibiotics, and formula feeding.
- Probiotic foods and supplements can increase the number of beneficial bacteria in the gut and stimulate immune function for greater overall health.
As many parents can attest, the amount of time and effort spent trying to keep germs and bacteria out of young children’s mouths should come with benefits and a 401k. Which is why it’s difficult for many to believe that providing children with bacteria can actually help support their immune and digestive health. But it can.
To be clear, we’re not talking about just any bacteria. We’re referring to probiotics—live microorganisms that when consumed in food or dietary supplements can help maintain or restore beneficial bacteria to the digestive tract.1 A growing body of research indicates that probiotic microorganisms can provide children with a number of health benefits and set the tone for optimal wellness throughout the lifespan.2
Keep reading to learn more about the importance of gut health, why probiotics may be especially beneficial for supporting gut health in early development, and important considerations when choosing a probiotic.
Gut Health 101: Humans rely on bacteria
Truth be told, the notion that bacteria can be “good for you” really isn’t that bizarre. After all, the human body is home to roughly 40 trillion bacterial cells and other microscopic organisms; most of these microbes don’t cause disease and are actually quite useful.3,4 Although a wide variety of non-pathogenic microbes live on the skin and in the nose, mouth, and urogenital tract, the most diverse and abundant population of microbes lives in the gastrointestinal tract, or gut.
Humans rely on the population of microbes inhabiting the gut (collectively referred to as the gut microbiota) to perform important human functions that we cannot perform ourselves.5 For example, intestinal microbes synthesize essential vitamins, help digest dietary fiber and convert it into cell nutrients, and teach the immune system how to recognize and attack harmful bacteria.5 So essential is the complex and dynamic population of microbes living in the gut (and the collection of genes represented by them, known as the gut microbiome) that some scientists refer to the gut microbiota as the “forgotten organ”.6
Given its essential benefits for human functioning, health professionals often stress the importance of maintaining a healthy gut microbiome. When populated by a large and diverse range of beneficial intestinal microbes, the gut microbiome is in balance, and able to function optimally.7 Conversely, when the diversity and/or abundance of intestinal microbes is low, the gut microbiome is in a state of dysbiosis, and susceptible to a number of suboptimal health outcomes.8 This is where probiotics can help.
What are probiotics and what do they do?
Probiotics are live bacteria and yeasts that, when consumed in adequate amounts, provide benefits for immune and digestive health.1 They can be found in natural sources, such as fermented and cultured foods (e.g., yogurt, kefir, buttermilk, kimchi, sauerkraut), or supplemental forms such as liquids, powders and capsules. Although many different types of bacteria can be classified as probiotics, the majority fall into one of two broad groups: lactobacillus and bifidobacterium.
Amongst other functions, probiotics help maintain a healthy gut microbiome possibly by increasing the number of healthy microbes in the gut, stimulating immune function, and inhibiting the colonization of potential pathogens (i.e., harmful bacteria, yeasts, and protoza).9–11 In light of their potential ability to repopulate the gut with beneficial bacteria, they are often recommended for people with an unbalanced gut microbiota due to poor nutrition or the use of antibiotics.
Antibiotics are good, but can be bad for your microbiome
Antibiotics are medicines that help fight bacterial infections by either killing or inhibiting the growth of bacteria. The term antibiotics literally means “against life”—and in their case, it’s microbial life they’re after. Despite being celebrated as one of the most significant advancements in modern medicine, antibiotics indiscriminately wipe out the good bacteria with the bad, so even a single exposure can wreak havoc on gut health.12
Antibiotics can be particularly detrimental to intestinal health in early development, when babies’ gut microbiomes are still being established. What’s more, because the infant gut is believed to set the stage for the adult microbiome, early exposure to antibiotics can have long-term negative effects on children’s health and well-being.13 Our advice? Next time your child’s doctor prescribes a course of antibiotics, ask them about alternative treatment options. If the doctor believes antibiotics are necessary, ask whether probiotics would be a beneficial addition to the treatment protocol.
Why probiotics may be critical in the early development of infants and young children
Generally speaking, humans are born with all the vital organs they need to survive—except the so-called “forgotten organ”. Unlike the liver or kidneys, the gut microbiome is non-existent at birth, and undergoes extensive development during the first few years of life. Colonization of the gut begins in early infancy and continues until age three, when the composition of the microbiota becomes adult-like.14 The most significant microbial colonization is believed to occur during delivery and shortly afterwards, when babies come into contact with the mother’s microbiota and surrounding environment.14
Whereas the intestinal microbiomes of babies delivered vaginally tend to show similarities with the mother’s vaginal microbiota; babies delivered via cesarean section do not pass through the birth canal, and are not exposed to the body’s natural method of transferring healthy bacteria from the mother to the baby.14 Consequently, babies delivered via cesarean typically experience a lower abundance and diversity of intestinal bacteria.15,16 In other words, a greater chance of dysbiosis.
In addition to mode of delivery, factors including formula-feeding, preterm birth, and early exposure to antibiotics can also affect the establishment of a healthy gut microbiota, and place babies at increased risk of dysbiosis, allergies, common infections, and pediatric illnesses.2,14
For those of you panicking because one of the above factors apply to your child—relax. Although you can’t control everything that happens in life, you can make informed decisions to help optimize a situation. If you have reason to believe that your child’s microbiota is out of balance (due to digestive issues or because one or more of the above risk factors pertain to them) talk to their pediatrician about whether supplementing with probiotics can help. An abundance of clinical research suggests that it can.
Evidence-based health benefits of probiotics in infants and young children
A growing amount of literature finds that probiotics represent a safe and effective way to support a healthy gut microbiota during early development. Below we provide some notable research findings from clinical studies conducted with infants and young children. Collectively, these studies show that regularly incorporating probiotic foods or supplements into a child’s diet can:
- Decrease the need for antibiotic treatments in children attending daycare17
- Promote a healthy immune response in babies delivered via cesarean section18
- Ameliorate symptoms of antibiotic-associated gastrointestinal distress19
- Support the immune health of infants at “high risk” for allergies and skin dysfunctions20
- Promote overall gastrointestinal health and function21
- Reduce crying time and other symptoms related to colic22
Which is better: Probiotic foods or probiotic supplements?
Parents interested in probiotics often want to know which delivery method is better: foods or supplements. Unfortunately, this is a difficult question to answer in the absence of clinical trials comparing equal doses of the same strains from each delivery method. What we do know from the growing literature on probiotics is that both foods and supplements can provide effective support for children’s gut health.17–22 Whether one delivery method is preferable to the other will likely depend on the child.
For example, if your child is relatively healthy, old enough to eat solids, and doesn’t have risk factors for dysbiosis (i.e., preterm birth, early exposure to antibiotics, caesarean delivery), then probiotic foods should be sufficient for encouraging a healthy gut.23 However, if your child is not old enough for solids and/or you have reason to believe that that their gut microbiome is significantly out of balance, you may want to consider supplements. This is because acquiring enough live probiotic bacteria to make an impact on gut health may be less challenging with supplements than food sources—particularly for young children who eat fewer foods, and less of them.24,25 Ultimately, whether and how you decide to incorporate probiotics into your child’s diet should be decided during a conversation with their pediatrician.
Are probiotics safe for children?
Studies show that probiotics are generally safe for most children, with several possible exceptions including preterm infants, children with compromised immune systems, and children using intravenous medical devices.26,27 However, even if your child is healthy enough to take probiotics, there are inherent risks of infection and sepsis associated with introducing bacteria into the body. Although cases of serious side effects are extremely rare, it is advisable to speak to your child’s pediatrician about whether they are a suitable candidate for probiotics before exposing them to either foods or supplements.28
Also, because different probiotic strains have different clinical effects and safety profiles, you should also ask your child’s doctor about specific strains they recommend. Well-researched strains that appear to be safe for most children include:
Set your child up for immune and digestive wellness
In summary, a number of factors can disrupt the establishment of a healthy gut in early development, with potentially grave consequences for life-long health. Considering how essential a healthy gut microbiota is for human functioning, providing your child with probiotic foods or supplements may represent a prudent strategy for helping them stay on the path the towards long-term immune and digestive wellness.
Colonization: The presence of bacterial communities in or on a host organism (e.g., the intestines, mouth, skin).
Microbe: A microorganism which may exist in its single-celled form or in a colony of cells; different types of microbes include bacteria, algae, non-living viruses, fungi, and protozoa.
Sepsis: Life-threatening condition that arises when the body's responses to an infection causes harm to its own tissues and organs.