Probiotics in children

Probiotics are live microorganisms that are claimed to have health benefits when consumed,usually by improving or restoring the gut flora.Probiotics are generally considered safe for consumption,but in rare cases may cause bacteria-host interactions and unwanted side effects.There is little evidence that probiotics confer the health benefits they claim.

Health effects

Diarrhea

Since many methods of preventing diarrhea have side effects (for example, intussusception with the rotavirus vaccine), scientists are now turning to probiotics as a supplement in the treatment of acute diarrhea.In a review of 34 blinded, randomized, placebo-controlled trials related to diarrhea and probiotics,it was concluded that an overall reduction in antibiotic-associated diarrhea was 8%, and a 34% reduction in travelers' diarrhea among other types of acute diarrhea.These figures reflect protection against diarrhea in subjects including adults and children.In children (age < 18 years),7 of 12 trials conducted in healthcare settings showed a 57% reduction in acute diarrhea.There was no significant difference in the protective effect of the strains, namely Saccharomyces boulardii, L. rhamnosus GG,L.acidophilus and L.bulgaricus.Probiotics were found to be effective in treating acute infectious diarrhea in children when a review was completed in 2001 involving more than 700 children with acute diarrhea aged 1 to 48 months.A 2002 review showed that lactic acid bacteria reduced the average duration of acute diarrhea by 0.7 days and the number of bowel movements by 1.6 on the second day of treatment.Lactobacillus doses of more than 10 billion colony-forming units were most effective during the first 48 hours of diarrhea.In addition,there is evidence that probiotics may prevent gastroenteritis (also known as stomach flu) in children and infants, which can also lead to diarrhea.

Antibiotic-associated diarrhea 

The disease can often be caused by Clostridium difficile, a bacterium that sometimes causes severe diarrhea called

pseudomembranous colitis.In a review of six trials involving 766 children aged 1 month to 6 years related to antibiotic-associated diarrhea,there was an overall reduction in AAD when the children were fed probiotics.Compared with placebo, the reductions ranged from 28.5 percent to 11.9 percent; in fact, one in seven fewer patients developed AAD when they took the probiotic along with the antibiotic.Antibiotics given to children in the trials included amoxicillin,penicillin and erythromycin.Evidence showed that S. boulardi was the most protective against AAD in children,with Lactobacillus GG second and a mixture of S.thermophilus and B.lactis relatively last.The jury is still out on how probiotics reduce the risk of AAD from any particular type of antibiotic.One of the proposed mechanisms for how probiotics protect against AAD is by modulating the composition of the organism in the gut.Studies involving Lactobacillus acidophilus and Bifidobacterium have shown that these microorganisms inhibit the growth of facultative anaerobes,which tend to increase during antibiotic treatment.The results suggest that probiotics can modify and prevent changes in the gut microbiota caused by antibiotics.

Viral diarrhea

Viral diarrhea refers to the type of diarrhea caused by rotavirus, a virus that often affects young children and infants.Certain types of probiotics are also effective in treating viral diarrhea in hospitalized children, according to a meta-analysis of nine previous studies conducted in Canada,Thailand and Finland.The subjects in these studies ranged in age from 1 month to over 36 months.The results of the study showed that the duration of the disease was shortened by an average of 0.7 days after the children were treated with lactic acid bacteria.Although how probiotics do this is largely unknown, two mechanisms have been proposed.The first mechanism suggests that Lactobacilli promote the production of intestinal mucins (glycosylated proteins), which protect the body from intestinal infections.

Persistent diarrhea

A 2013 review suggested that probiotics are effective in treating persistent diarrhea in children,but more research is needed.Persistent diarrhea is an acute onset followed by episodes lasting 14 days or more; it is an important cause of morbidity and mortality in children under five in developing countries.The study showed a four-day reduction in average duration and a shorter hospital stay; fewer bowel movements by day five.

Allergy

Probiotics are often used in nursing mothers and their young children to prevent eczema,but there is some doubt about the strength of the evidence supporting this practice.

Security

“The correlation between systemic infection and probiotic intake is rare and occurs in patients with underlying medical conditions.”

Rarely,probiotic intake may lead to immunocompromised and critically ill Children develop bacteremia,fungemia,and sepsis.Ingestion of lactic acid bacteria has no side effects.