Updated 29 January 2014

Are probiotics for every child?

Some experts recommend that every child should be taking a daily dose of probiotics. Find out why they recommend this. And learn more about what to look out for.


Looking at the infinitely soft, dimpled skin of your baby’s body, pumping bacteria into it on a daily basis may seem an unnatural thing to do.

Yet, human beings cannot live without bacteria, and nature has arranged it so that the good bacteria (probiotics) work with us to keep the bad guys at bay.

Newborn babies get their first dose of bacteria as they pass through the birth canal, and from then, colonies of over 400 types of bacteria begin to form. It’s a slow process, but speeds up dramatically once solid foods are introduced into the diet.

The need for supplements
But if probiotics are so natural, why is there a sudden increase in the number of products on the market that offer to increase the bacteria population of our intestines?

The reasons can be outlined as follows:

  • Research methods are more advanced, offering the opportunity to create effective new products and present them in new dosage forms.
  • South Africa now has more contact with the outside world than a decade ago and we are exposed to new products from elsewhere.
  • Research indicates that our modern lifestyle and fast-food diets are not conducive to healthy intestinal flora colonies.
  • The widespread use of antibiotics for every ailment is playing havoc with the good bacteria, which is wiped out as effectively as the bad they’re aimed at destroying.

Safety considered
At what stage can we use these products for our children? If safety is our main concern, there should be no problem. Historically, bacteria have been used in the dairy industry for over a hundred years.

The best probiotics have been tested on pregnant women and on children of all ages including newborns, with no negative side-effects reported.

Depending on the health of your baby, whether you’re breastfeeding and how he or she is cared for, there may be added reasons to consider a daily dose of probiotics.

Probiotics for babies
Diarrhoea is one of South Africa’s biggest causes of death among children under the age of five. Unable to replace fluids, babies become weak and dehydrated, and the results are tragic.

It is in terms of prevention and treatment (in conjunction with oral rehydration solution) of babies with diarrhoea that probiotics work their magic most startlingly.

In one study, children aged between six and 36 months, who were hospitalised with diarrhoea, were split into two groups. One group received a probiotic called Lactobacillus reuteri and the other a placebo. Both groups also took an oral rehydration solution, essential for anyone with diarrhoea.

By the second day, the recovery rate of the probiotic group was remarkable compared to the control group.

Even when a baby has recovered from acute diarrhoea, like rotavirus diarrhoea, there is sometimes invisible damage to the digestive tract. This can cause problems with the digestion of the milk protein lactose, even if the baby tolerated milk-based formula with no problem previously.

Ongoing treatment with probiotics can help to break down the milk sugar, improving the baby’s lactose tolerance. The colonies of good bacteria will re-establish and provide the natural digestive assistance needed.

The role of modern-day living
While infections causing diarrhoea are more common in disadvantaged areas where clean water may not be freely available, people living with all the modern conveniences have other problems.

According to a theory called the hygiene hypothesis, babies who are born in very clean hospitals and come home to sparkling clean homes that are swabbed down with disinfectant may be more prone to develop allergies.

A study is currently underway that aims to show how probiotic supplementation from day one can reduce the incidence of allergies by exposing the baby to bacteria. In this way, researchers hope to prove that the immune system is stimulated as it would be if the baby was exposed to bacteria in a less clean setting.

Probiotics are already known to stimulate the immune system through direct stimulation of the cytokines that act as messengers within the immune system.

One study of infants aged four to 10 months aimed to discover exactly how effective probiotics would be in preventing a commonly recurring infection known as Crèche Syndrome.

Groups of daycare infants were given two different types of probiotics, while a control group received no special treatment. Both probiotic groups fared well, with significantly fewer antibiotics being prescribed to those babies, implying that their overall health improved.

Help for thrush
Another common problem of babyhood that may be reduced by probiotics is thrush, also known as Candida or yeast infection.

Candida is a common yeast organism that lives in all our bodies. The yeast is usually kept under control by the good bacteria. Babies are more susceptible to Candida because bottles and teats provide the perfect environment for the organism to grow. Antibiotics can also result in yeast overgrowth, as both good and bad bacteria are destroyed, but Candida is not.

Some probiotics produce a natural substance called reuterin that helps eliminate yeast infections.

By simply sucking a probiotic chew tablet (or in the case of a baby, by crushing a tablet and rubbing it into the baby's mouth) the bacteria will act in the mouth and throat area.

This should be continued for a week after the thrush symptoms have disappeared.

Probiotics and toddlers
As your baby develops into a toddler, the world becomes more open to him, and the challenges his health faces, change.

While he will have a more thriving intestinal flora colony, he will possibly be going to play school for the first time. This is where children pick up many infections, and a strong immune system is crucial.

Your child may also have become a fussy eater as do many children as they realise they have a choice. If he’s not eating a diet that contains enough vegetables and fruit, he may not have the right food stuff to feed his bacteria colony.

Replenishing with a probiotic supplement is one way to keep his immune system strong while he comes around to the joys of broccoli.

The cycle of ear infections, antibiotics and more ear infections is all too familiar to mothers of toddlers, many of whom end up with grommets. Introducing probiotics during and after antibiotic treatment may help to reduce repeat infections by building up the immune system after antibiotics have done their work.

Are all probiotics identical?
Not all probiotics are the same, as they can be made from a number of different strains. Here are a few pointers when buying probiotics:

  • Look for one that is a human strain, clearly identified with a registration number from an international culture bank such as the American Type Culture Collection (e.g. ATTC 55730). Human-strain probiotics originate from breast milk or from the intestine itself. They are then grown in fermenters to produce enough for large scale production.
  • Good probiotics will have passed safety tests and have good, proven shelf life. With the pharmacist’s help, you should choose a probiotic that can survive in the acidic environment of the stomach as it passes through on its way to the intestine. An effective probiotic will deliver 100 million cfu of good bacteria.

An independent study published in the South African Medical Journal a few years ago drew attention to the fact that not all probiotics are equal and that even if you read the label you can’t be sure you’re getting what you’re promised. Other similar international studies had shown that few products really contained what the label claimed.

The evaluation of some of the products available on the South African market shows a similar trend. Presently, our regulation is such that products listed as food supplements don’t have to undergo scrutiny before being put on the pharmacy shelves. Studies like these go a long way to help inform the consumer.

It has also been shown that some yoghurts offer a probiotic benefit, but that few deliver the consistency of dose or shelf life of a dry supplement

How easy is it to use?

  • Probiotics come in capsules, powder form, liquid oil drops, tasty chew tablets and even in drinking straws that are simply popped into the baby or toddler’s drink.
  • Probiotics are tasteless and can easily be mixed into milk or juice without the baby noticing.
  • Most pharmacies now offer a range of probiotics, so ask your pharmacist's advice about the best product for your child’s specific needs and which ones meet the criteria of a good probiotic. Also make sure there is an ATTC number on the label.


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