What is the best probiotic for kids?

When babies are born, they have a sterile digestive system. During birth, then from breastmilk or formula and later on from food, probiotic bacteria are introduced. These bacteria make up an important part of your littles ones health and different experiences and exposures throughout her childhood will affect how their digestive system is colonised.

A guest post by Gabriella Goodchild www.healthfuldietitian.co.uk

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What are probiotics?

Probiotics are live cultures or ‘friendly bacteria’, naturally found in many foods or available as a supplement. 

They may have health benefits for children, helping to maintain a healthy digestive system and the right balance of bacteria. They could also help conditions such as Irritable Bowel Syndrome (IBS), constipation, colic, diarrhoea and tummy pain.

The research in adults shows that they have also helped with insomnia, preventing migraine, beating stress and anxiety, boosting the immune system, helping manage emotions and improving memory and learning.

The best probiotic for kids by Gabriella Goodchild
The best probiotic for kids by Gabriella Goodchild

Why do we need them?

Daily probiotic intake has shown to be beneficial for digestive health, by helping to restore the right balance between good and bad bacteria. 

The friendly bacteria from probiotics, compete with bad bacteria in the gut and help remove it, resulting in a healthier digestive system. 

Which foods have probiotics in?

Foods containing probiotics include live yoghurt, kefir (a fermented milk drink), sauerkraut, kimchi (a fermented spicy Korean dish) and pickled gherkins. 

Should children be eating more of these foods?

If possible, but getting children to eat more high probiotic foods could be challenging, as sauerkraut and pickled gherkins are not typically children’s favourite foods! Some fermented or pickled foods may also be high in salt and therefore unsuitable for children. 

Probiotic supplements for babies
Probiotic supplements for babies

Supplements or food, which is better?

Both have a place in keeping tummy’s happier and healthier. Where possible, it’s always good to get what we need from food but when this isn’t always practical, a probiotic supplement is another way to get the beneficial live cultures. 

Are all probiotics the same? 

No. There are different strains of probiotics and each may have a different effect on the body. One of the most common strains are the Lactobacillus species. Some probiotic supplements contain one main strain and others contain a number of different strains. 

Do probiotic supplements really contain billions of probiotics?

Probiotics are counted by the number of colonies of live cultures. These are known as Colony Forming Units or (CFU’s). Probiotics normally contain at least one billion CFU’s.  

Many kids probiotics contain 3 – 6 billion CFU’s. 

What are prebiotics?

Probiotics and prebiotics are different. Prebiotics are parts of foods that are difficult to digest and are found in foods such as garlic, onions, leeks, asparagus and bananas. Prebiotics assist the friendly bacteria by acting as food for the friendly bacteria to thrive. 

Are probiotics safe for children?

From all the research into probiotics for children, no serious side effects have been found from taking a daily probiotic supplement [1]. However, probiotics are not suitable for all children, especially those with medical conditions which may cause weakened immune systems.

Probiotics can cause side effects, including nausea, rashes, constipation or bloating. These are usually mild and temporary but will vary for each child. 

Always take advice from your child’s GP or Registered Dietitian prior to starting a new supplement or if you are concerned about any side effects. 

Probiotics for constipation with babies
Probiotics for constipation with babies

Which probiotics are best for constipation?

Constipation can be very distressing for both parent and child. Research into probiotics and constipation has been quite inconsistent, some declaring that there is not enough evidence [13] and others have found that probiotics could help constipation in some children, particularly by helping them go to the toilet more often [4].  

However, if you did want to trial probiotics for your little one, there are two probiotics which may help with constipation [4]. These are;  Lactobacilli and Bifidobacteria. One or both strains are found in: 

In addition, research published in 2020 found that the strain Bacillus Coagulans may help constipation and the associated symptoms for some children. 

This is found in the probiotic gummy;

  • Bioglan Smart Kids Vitagummies (age 4 plus). 

Probiotics may also help with tummy aches and improving the consistency of stools. 

They have been found to be particularly useful alongside other treatment options such as the stool softener Lactulose [5]

Probiotics for diarrhoea with babies
Probiotics for diarrhoea with babies

Are there probiotics for diarrhoea?

Research has looked at how probiotics could help diarrhoea, caused by tummy bugs such as Gastroenteritis. 

Two strains may help reduce the duration of diarrhoea [7];  Lactobacillus Rhamnosus, found in:

Also, the friendly bacteria called Saccharomyces Boullardii may be helpful. It is found in: 

Although this is in capsule form, the manufacturers state that the capsule can be opened and the contents can be mixed with cold food or drink.

Unfortunately, there’s not enough evidence that probiotics can prevent tummy bugs before they happen [6].

Of course, the usual advice to treat diarrhoea must still be followed. This includes plenty of fluid to prevent dehydration. 

Signs of dehydration with babies
Signs of dehydration with babies

Signs of dehydration include:

  • less urine than usual (such as dry nappies)

  • darker colour urine

  • less responsive behaviour and alertness or a sunken fontanelle (soft spot on your babies head). 

Rehydration drinks such as Dioralyte may be suitable for some children, especially those over 5 years.

Breastfed babies should continue to be fed and may need extra feeds.

Bottle-fed babies should be offered sips of cooled boiled water in between their feeds. 

Seek medical advice for;

  • all babies under 12 months or children under 5 years with any signs of dehydration

  • children over 5 years with ongoing signs of dehydration

  • children or babies with bloody diarrhoea, or if diarrhoea continues for more than 7 days. 

Children may also experience persistent diarrhoea for other reasons. You should always seek advice from your GP for persistent diarrhoea in children. There is little evidence that probiotics may be able to help with diarrhoea not caused by a tummy bug [8]

Should my child take probiotics after antibiotics?

For some children, antibiotics can change the balance of bacteria in their gut, which can cause diarrhoea. There is some evidence that the same probiotic strains; Lactobacillus Rhamnosus and Saccharomyces Boulardii, thought to help diarrhoea after tummy bugs, may also help prevent diarrhoea caused by antibiotics in some children [7]

However, this does not seem to help all children and researchers are unsure why this is the case. As probiotics aren’t harmful, you could consider trying them to see if they help your little one.

There is stronger evidence to show probiotic supplements may shorten the length of time diarrhoea continues for after a course of antibiotics [7]

Probiotic for babies with colic and reflux
Probiotic for babies with colic and reflux

Are there probiotics for colic?

There is just one recommended probiotic strain called Lactobacillus Reuteri, which has evidence in relation to helping babies and young children suffering from colic [3] [16]. This probiotic is found in the supplement:

Research has shown that this probiotic may increase the effectiveness of colic treatments, decrease colic symptoms, reduce daily crying and unsettled times [2]. The evidence is strongest for breastfed babies and there needs to be more research for formula-fed babies. 

There is not strong enough evidence that probiotics can prevent colic before it starts. 

Do probiotics help reflux?

Researchers have also looked at the probiotic strain Lactobacillus Reuteri and how this could help with reflux. Some studies have shown that babies taking a probiotic with this strain, had fewer episodes of reflux [12]. The supplement containing this strain is:

  • BioGaia (suitable from birth).

     

Which probiotics are best for wind and bloating?

Probiotics may not be helpful for wind and bloating, as this can be a side effect of taking probiotics for some children.

However, for children with Irritable Bowel Syndrome (IBS), there is some evidence that probiotics could help with general IBS symptoms such as stomach pain but more research needs to be done.

Which probiotics are best for stomach pain?

The probiotic strain Lactobacillus Reuteri may help some children suffering with stomach pain, without an obvious cause [17]

The supplement containing this strain is:

  • BioGaia (suitable from birth).

     

Is there a way to test whether my child needs probiotics?

There is no test but probiotics should be tried for around 4 weeks to see if they have helped. If they are not improving your child’s symptoms by 4-5 weeks, the probiotics could be stopped. 

What probiotics can’t help with?

It has been suggested that probiotics could help respiratory tract infections or the immune system, but there is very little evidence to support this [11].

In fact, they are not recommended for children with a weakened immune system.

Eczema

Research has been carried out to see whether probiotics could help children with eczema [9], as some children with eczema have changes in their gut bacteria. However, unfortunately, there is little evidence that probiotics can help the skin condition. 

There has been some recent research into mothers taking probiotics during pregnancy and lactation and how this may help reduce incidences of eczema in their children [14], however much more research is needed to recommend probiotics for reducing eczema. 

Allergy

Probiotics and food allergies have also been studied. There is some evidence that probiotics could help children with symptoms of cow’s milk allergies but unfortunately not enough to recommend them [10]. There needs to be more research into other food allergies.

What form do probiotics come in? 

Probiotic supplements come in different forms. These include liquid drops, powders for mixing into food or drinks, chewable gummies or soft chews. They can be flavoured or flavourless. Different probiotics come in different forms. 

How does my child take probiotics?

Gummies or chews are usually taken once or twice daily. Powdered probiotics are normally taken as 1-2 sachets daily, mixed into cool food or drinks. Liquid drops are usually taken on a teaspoon or mixed into cool food or drinks, once daily. Heating probiotics by adding them to warm foods or drinks may reduce how effective they are. Always follow the directions given. 

Can my child take probiotics if they have special dietary requirements?

Some probiotics are suitable for vegetarians, gluten or lactose-free diets. Others are sugar or soy-free or kosher certified. You will need to check for allergens and ingredient lists.

Best Probiotics for Babies
Best Probiotics for Babies

Best Probiotics for Babies

Which are best for baby?

The best baby probiotic supplements for babies are liquid drops or powdered sachets. 

All are suitable from birth onwards.   

BioGaia and Bio-Kult Infantis can be mixed with formula or breast milk. Optibac can be mixed with food or drinks, including formula. All three contain Lactobacillus strains which may be helpful for colic or constipation. 

Best Probiotics for Toddlers
Best Probiotics for Toddlers

Best Probiotics for Toddlers

Which are best for toddlers? 

All are suitable but if you have a fussy eater the best option may be the gummies or chewable types. 

  • Alflorex is a chalky chewable tablet suitable from age 3

  • Up4 Probiotics Kids Cubes are gummies suitable for aged 3 plus  

  • Ultimate Flora Kids are chewable and are suitable for aged 2 plus. 

All three of these probiotics may help with constipation.

Probiotics for older children
Probiotics for older children

Which are best for older children?

Many children’s probiotics are suitable for up to 12 years. 

  • Digestive Advantage is a probiotic for children aged 3-12 years containing a bacteria called BC30. There isn’t a great deal of published research to support its use and so it can’t be recommended.

  • Optibac Probiotics for Babies and Children may aid constipation in children up to 12 years. 

  • Culturelle Kids daily chewable tablets are suitable for 3-12 years and may help both constipation and diarrhoea. 

  • Alflorex chewable tablets are suitable for children over 3 years and also could help aid constipation.  

  • Symprove is primarily aimed at adults but their website states it can be used with children at the discretion of the parent. It’s friendly bacteria are associated with improving diarrhoea, constipation and colic.

There are many other brands available and parents should decide which is best for their child. Seek the help of a Registered Dietitian if you are unsure.

Have you tried probiotics with your children and have they helped?

If you would like to see the full reference list for this blog, please contact me.

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6 Responses

  1. Really useful information, thank you. My LO was born prem was given antibiotics at birth and struggled with reflux and colic – this has continued. We are just starting first flavours and she seems uncomfortable after eating. I will definitely consider using probiotics.

    1. Hi Gemma, I’m so please to hear you have found this blog helpful, hopefully the probiotics will help your daughter.

  2. Hi, I used probiotics on my baby to help with reflux last year. (We has both been on antibiotics after my labour.) it got rid of his reflux. Now we are approaching autumn and he’s 14 months the age where they tend to get one illness after another, I’m considering starting us both (I’m still bf) on antibiotics. Is it recommended to take every day for a few months or not? Thanks in advance x

  3. Hi

    Thank you for sharing such an informative blog- this is great! Could I kindly request a copy of the reference list please? specifically regarding the limited evidence for any benefit in children with gas and bloating type symptoms. Much appreciated. What is the best way to contact you to access this?

  4. Thank you for the comparison.
    How do you suggest dosing Symprove for a 12.2 kg toddler? An adult dose is 70ml daily.
    Thank you.

    1. Ooh great question! This is where you’d need to work with a dietitian to calculate whats right for your child based on their weight, how effected they are with their constipation and what the rest of their diet consists of. You can book in with one of my team via my Consultations page or ask your GP for a referral to an NHS dietitian.

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meet Sarah

I’m Sarah, a Registered Dietitian, Children’s Nutritionist and mummy from East Sussex. My blog is to guide & inspire you with information about weaning, nutrition, food and toddler feeding. Learn more about me here.

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