Probiotics and Prebiotics in Pediatrics

Abstract

This clinical report reviews the currently known health benefits of probiotic and prebiotic products, including those added to commercially available infant formula and other food products for use in children. Probiotics are supplements or foods that contain viable microorganisms that cause alterations of the microflora of the host. Use of probiotics has been shown to be modestly effective in randomized clinical trials (RCTs) in (1) treating acute viral gastroenteritis in healthy children; and (2) preventing antibiotic-associated diarrhea in healthy children. There is some evidence that probiotics prevent necrotizing enterocolitis in very low birth weight infants (birth weight between 1000 and 1500 g), but more studies are needed. The results of RCTs in which probiotics were used to treat childhood Helicobacter pylori gastritis, irritable bowel syndrome, chronic ulcerative colitis, and infantile colic, as well as in preventing childhood atopy, although encouraging, are preliminary and require further confirmation. Probiotics have not been proven to be beneficial in treating or preventing human cancers or in treating children with Crohn disease. There are also safety concerns with the use of probiotics in infants and children who are immunocompromised, chronically debilitated, or seriously ill with indwelling medical devices. Prebiotics are supplements or foods that contain a nondigestible food ingredient that selectively stimulates the favorable growth and/or activity of indigenous probiotic bacteria. Human milk contains substantial quantities of prebiotics. There is a paucity of RCTs examining prebiotics in children, although there may be some long-term benefit of prebiotics for the prevention of atopic eczema and common infections in healthy infants. Confirmatory well-designed clinical research studies are necessary.

Tolerance and Efficacy of Infant Formula with High Sn-2 Palmitate in Formula-Fed Chinese Term Infants: an Open Label, Controlled Trial

“…Bonger et al tested the effect of beta palmitate combined with prebiotics (90% GOS, 10% FOS, 0.8 gr/dl), maltodextrine and starch on stool hardness and showed a significant effect. However the Oligosaccharides levels tested in this study as well as in other representative studies [25], were over 10 fold higher than in our study. Bar-Yoseph et al reported the benefit of sn-2 palmitate on top of galacto-oligosaccharides (GOS) on fatty acids excretion mainly in the form of saponified fatty acids [10].…”

Probiotics to prevent infantile colic

“…• Human milk naturally contains prebiotics; they are defined as indigestible oligosaccharides, which could selectively enhance the proliferation of certain probiotic bacteria in the colon, especially Bifidobacterium species (Thomas 2010). Some studies have failed to find a protective effect of breastfeeding on the development of colic in breastfed infants (Clifford 2002).…”

Acidified infant formula explained

“…Rotavirus was the most common cause of acute diarrhoea in randomised controlled trials. 17 The strains of probiotics used included Lactobacillus rhamnosus GG, Streptococcus thermophilus, L. casei, Bifidobacterium lactis or L. reuteri. These may be mixed with milk or infant formula, or given as an oral supplement.…”