Episode 10 | Safety of Probiotics in Infants

In the Clinic with Camille

a podcast for integrative practitioners

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Are probiotics safe to use in infants? 

I'm so glad you're asking this question. 

Before recommending any supplement, we should always be asking whether it's likely to be safe and effective.

This is even more important when using supplements with infants, where the stakes are higher than in many other life stages.

The short answer is that the safety profile of probiotics in infants is quite strong in many cases.

I don't recommend probiotics for all infants, but in some cases I believe that the benefits are likely to outweigh the risks. 

These cases include preterm babies at risk of necrotizing enterocolitis, infants with colic, infants who are experiencing infrequent stools, and when antibiotics have been administered. There is some evidence suggesting that probiotic administration may be helpful in preventing atopic conditions (eczema/atopic dermatitis, asthma, etc).

Please remember that probiotic activity is species- and strain-specific. Review the studies relevant to your particular case, and be sure to select a high-quality brand from a trusted source. 

Listen to the full episode above for more thoughts on this topic. 

Select References (Click to Expand)

AlFaleh, K., & Anabrees, J. (2014). Probiotics for prevention of necrotizing enterocolitis in preterm infants. The Cochrane Database of Systematic Reviews, 4, CD005496. https://doi.org/10.1002/14651858.CD005496.pub4

Guo, Q., Goldenberg, J. Z., Humphrey, C., El Dib, R., & Johnston, B. C. (2019). Probiotics for the prevention of pediatric antibiotic-associated diarrhea. The Cochrane Database of Systematic Reviews, 4, CD004827. https://doi.org/10.1002/14651858.CD004827.pub5

Karkhaneh, M., Fraser, L., Jou, H., & Vohra, S. (2020). Effectiveness of probiotics in infantile colic: A rapid review. Paediatrics & Child Health, 25(3), 149–159. https://doi.org/10.1093/pch/pxz007

Korpela, K., Salonen, A., Vepsäläinen, O., Suomalainen, M., Kolmeder, C., Varjosalo, M., Miettinen, S., Kukkonen, K., Savilahti, E., Kuitunen, M., & de Vos, W. M. (2018). Probiotic supplementation restores normal microbiota composition and function in antibiotic-treated and in caesarean-born infants. Microbiome, 6(1), 182. https://doi.org/10.1186/s40168-018-0567-4

Lerner, A., Shoenfeld, Y., & Matthias, T. (2019). Probiotics: If It Does Not Help It Does Not Do Any Harm. Really? Microorganisms, 7(4). https://doi.org/10.3390/microorganisms7040104

Ong, T. G., Gordon, M., Banks, S. S., Thomas, M. R., & Akobeng, A. K. (2019). Probiotics to prevent infantile colic. The Cochrane Database of Systematic Reviews, 3, CD012473. https://doi.org/10.1002/14651858.CD012473.pub2

Pärtty, A., Lehtonen, L., Kalliomäki, M., Salminen, S., & Isolauri, E. (2015). Probiotic Lactobacillus rhamnosus GG therapy and microbiological programming in infantile colic: A randomized, controlled trial. Pediatric Research, 78(4), 470–475. https://doi.org/10.1038/pr.2015.127

Quin, C., Estaki, M., Vollman, D. M., Barnett, J. A., Gill, S. K., & Gibson, D. L. (2018). Probiotic supplementation and associated infant gut microbiome and health: A cautionary retrospective clinical comparison. Scientific Reports, 8(1), 8283. https://doi.org/10.1038/s41598-018-26423-3

Sansotta, N., Peroni, D. G., Romano, S., Rugiano, A., Vuilleumier, P., Baviera, G., & Italian Society of Pediatric Allergy, Immunology (SIAIP), Microbiota Committee, Italy. (2019). The good bugs: The use of probiotics in pediatrics. Current Opinion in Pediatrics, 31(5), 661–669. https://doi.org/10.1097/MOP.0000000000000808

Smilowitz, J. T., Moya, J., Breck, M. A., Cook, C., Fineberg, A., Angkustsiri, K., & Underwood, M. A. (2017). Safety and tolerability of Bifidobacterium longum subspecies infantis EVC001 supplementation in healthy term breastfed infants: A phase I clinical trial. BMC Pediatrics, 17(1), 133. https://doi.org/10.1186/s12887-017-0886-9

Wickens, K., Barthow, C., Mitchell, E. A., Kang, J., van Zyl, N., Purdie, G., Stanley, T., Fitzharris, P., Murphy, R., & Crane, J. (2018). Effects of Lactobacillus rhamnosus HN001 in early life on the cumulative prevalence of allergic disease to 11 years. Pediatric Allergy and Immunology: Official Publication of the European Society of Pediatric Allergy and Immunology, 29(8), 808–814. https://doi.org/10.1111/pai.12982

Wong, C. B., Iwabuchi, N., & Xiao, J.-Z. (2019). Exploring the Science behind Bifidobacterium breve M-16V in Infant Health. Nutrients, 11(8). https://doi.org/10.3390/nu11081724

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Camille Freeman (she/her)

Hi there! I'm a clinical herbalist and licensed nutritionist specializing in fertility and reproductive health. I faciliate the Monday Mentoring community of practice and offer continuing eduation programs for highly trained herbalists & nutritionists. I'm also a professor in the Department of Nutrition at the Maryland University of Integrative Health, where I teach physiology, pathophysiology, and mindful eating.