Are Probiotics Safe for Kids (and If So, Which Ones)?

When we think of probiotics, our first thought might be the thing that helps you poop. And you wouldn’t be wrong! But probiotics can offer so much more to your health than regular bowel movements (although that’s a plus). You might be wondering if probiotics are good for adults, they must be good for kids, too, right?

Let’s find out.

What are probiotics?

To understand what a probiotic is, we need to think about the intestinal environment. Believe it or not, there are more bacteria living in your intestine than there are human cells in your entire body. We know that some diseases can result from unhealthy changes to these bacteria.

Probiotics are living microorganisms (good bacteria and yeast) that can improve—and even restore—your gut’s microbiome, or environment. Sometimes our healthy stomach can become disrupted after the stomach flu, food poisoning or if we’re eating foods that make us sick or that we’re allergic to, like milk.

Scientists who study intestinal bacteria say that the environment of the intestine is so complex it is difficult to understand how the bacteria in the gut interact with each other, our intestinal function and the rest of our body. Understanding the relationship between intestinal bacteria and various diseases is even more complex.

We know that some bacteria can be “healthy,” while other bacteria can cause disease. Probiotic supplements are intended to be a supplement of these “healthy” bacteria. Most pediatricians would prefer children receive probiotics through natural sources, these include yogurt, sauerkraut, kimchi, kombucha, sourdough, and pickles. Some over the counter probiotic supplements are living bacteria but most of them have been killed and freeze-dried to process into capsules, powders and gummies in order to make them easier for a child (or adult!) to take.

What are some foods high in probiotics?

• Yogurt and kefir
• Sauerkraut
• Kimchi
• Kombucha
• Pickles
• Sourdough

Should my child take a probiotic?

To keep it short, no, probiotic supplements are not recommended for children. There have been many studies on probiotics. Although most of them suggest that probiotics are safe and may improve symptoms of various diseases, there are also studies that show probiotics may not help, may lead to unhealthy changes in the intestine or even cause infection. A paper released this year in the Journal of Pediatric Gastroenterology and Nutrition reviewed the recent recommendations for the use of probiotics for the management of selected pediatric gastrointestinal disorders from The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Special Interest Group on Gut Microbiota and Modifications. Recommendations for the use of specific probiotic strains were made for the management of acute gastroenteritis, prevention of antibiotic-associated diarrhea, nosocomial (hospital acquired) diarrhea and necrotizing enterocolitis, management of Helicobacter pylori infection, and management of functional abdominal pain disorders and infant colic. Despite evidence to support the use of specific probiotics in some clinical situations, further studies confirming the effect(s) and defining the type, dose and timing of probiotics are still often required. The use of probiotics with no documented health benefits should be discouraged.

Rather than focusing on probiotics, it seems better to focus on healthy dietary changes that include “prebiotics.” Think of prebiotics as food for healthy intestinal bacteria. Fiber is the best prebiotic and the best sources of fiber come from fruits, vegetables, and whole grains.

What are prebiotics?

A prebiotic is a food that is “non-digestible,” like fiber, that increases healthy intestinal bacteria. Some of the best sources of fiber come from foods like:

• Fruit
• Vegetables
• Whole grains, like wheat bread and oatmeal

The bottom line is that probiotics are not recommended for children, but probiotics and prebiotics found in whole foods are recommended for a well-rounded diet that is nutrient-dense and aids in the natural production of healthy gut bacteria in kids.

If you are thinking of trying a probiotic for you or your child, talk with your doctor first to make sure it is something they would recommend. In situations where a probiotic is used, consider doing a brief trial for 2-4 weeks to help decide if it is helping.