Know When to Recommend Probiotics in Children

Parents will ask you whether probiotics will help their child.

Point out that probiotics may be worth a try in some cases. But evidence is limited and study results are often conflicting. Plus data from one species or strain can’t be applied to another.

Consider these tips when educating parents about probiotics.

Colic. Some evidence suggests that giving infants probiotics for 2 to 3 weeks may help colic symptoms and reduce crying time.

If parents want to try a probiotic, suggest giving one with L. reuteri (BioGaia Protectis Baby Drops, etc) has the most evidence.

Diarrhea. Probiotics may prevent antibiotic-associated diarrhea in about 1 in 9 kids.

Recommend taking a probiotic with L. rhamnosus (Culturelle Kids Chewables, etc) or S. boulardii (Florastor Kids, etc) while on an antibiotic...and continuing for about 3 days after the course ends.

Suggest separating the dose of probiotic from the antibiotic by 2 the probiotic is more likely to survive in the gut.

Explain that it’s okay to try a Lactobacillus product for irritable bowel syndrome in kids. But don’t recommend one for infectious diarrhea or Crohn’s...evidence shows that Lactobacillus does NOT help.

Eczema. Weak evidence suggests a combo product of lactobacilli species may be worth a try for atopic dermatitis or eczema. But there’s not enough data to suggest an optimal strain or how early to start.

Educate that probiotics are generally safe. But advise against them in immunocompromised children...due to possible risk of infection.

Lean away from probiotics for allergies...or cystic fibrosis. There’s not good evidence they help.

Reinforce sticking to probiotics with a Natural Product Number (NPN)...since they’re reviewed by Health Canada for safety and quality.

Use our Natural Medicines resource to answer questions about probiotic dosing and possible interactions.

Key References

  • Paediatr Child Health. 2022 Dec 27;27(8):482-502
  • PLoS One. 2015 Oct 28;10(10):e0141445
  • Cochrane Database Syst Rev. 2019 Apr 30;4(4):CD004827
Pharmacist's Letter Canada. March 2023, No. 390314


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