Children May Benefit From Probiotics, Prebiotics

Nov. 29, 2010 -- Adding probiotics or prebiotics to children’s diets may have some potential in treating viral diarrhea and preventing antibiotic-associated diarrhea, but more research is needed to determine how effective these supplements may be, according to a new clinical report from the American Academy of Pediatrics.

Overall, the authors of the report suggest that probiotics or prebiotics may offer some benefits to healthy children and infants, but they should not be given to children who are chronically or seriously ill or who have compromised immune systems.

Probiotics are supplements or enhanced foods that contain living microorganisms, such as yogurt with lactobacillus, that change the bacterial balance in the human body. The idea is to boost the kind of helpful bacteria in the body that can destroy harmful bacteria and reduce infection. Prebiotics are supplements or foods that cannot be normally digested by the gut and that promote probiotic bacterial growth, such as the compounds like oligosaccharides that are found in human breast milk and are added to some infant formulas.

The Findings

In the December issue of Pediatrics, authors of a new clinical report outline the benefits and risks of children taking probiotics and prebiotics. Reviewing the current medical literature, the authors report that:

• Infants and children who ate probiotic foods -- mainly yogurt -- early on while having diarrhea from acute viral gastroenteritis experienced a shorter duration of diarrhea by about one day.
• Other studies showed that probiotics were modestly effective in preventing antibiotic-associated diarrhea in healthy children when compared with a placebo. However, there is no evidence that probiotics treat antibiotic-associated diarrhea.
• There is some preliminary evidence to suggest probiotics may help prevent necrotizing enterocolitis or death of intestinal tissue in infants born weighing more than 1,000 grams.
• There is no conclusive evidence to suggest probiotics treat intestinal conditions, such as Crohn’s disease, irritable bowel syndrome, or constipation, as well as colic, and allergies in children.
• Infant formulas enhanced with probiotics or prebiotics do not appear to cause harm in healthy infants, but there’s insufficient evidence to suggest they offer any clinical benefits.
• Prebiotics  may help reduce atopic eczema in healthy children, although more research is needed before prebiotics in infant formula would be recommended to help reduce infections.
• It’s unclear if probiotics or prebiotics offer any long-term protection against allergies.

In the U.S., products marketed as dietary supplements such as  probiotics do not require pre-market review or approval from the FDA.  Probiotic or prebiotic products marketed to treat a specific clinical condition are classified as biologic products and require FDA approval. Manufacturers of infant formulas do have to comply with regulations to ensure safety and compliance with the law.

“As with antibiotics,” the authors write, “the use and efficacy of probiotics and prebiotics should be supported by evidence-based medicine.”