The gut microbiome supports gut health which in turn supports overall health.
Disrupting the gut bioeme balance can result in dysbiosis, which means the balance of the gut bacteria favours bacteria which can cause issues in the gut.
Research suggests that if the healthy colonies of the millions and trillions of bacteria that live in our gut are disrupted, this can lead to greater chances of developing issues later in life.
This risk is even greater if this disruption or dysbiosis occurs early on in life.
Establishment of a ‘healthy’ relationship of gut bacteria early in life appears to be important for maintaining a healthy gut ecosystem of bacteria going forward.
Breast Fed Babies and Gut Bacteria
Breast-fed babies obtain 30% of their healthy gut bacteria directly from their mother's milk and 10% from the skin on the mother's breast.
This boost of healthy gut bacteria from breast milk continues even after solid food has started, as long as breast milk continues. A great start for baby's gut health.
A common practice for adults is to directly take probiotics to build up a healthy gut microbiome. How effective is this?
Studies have found that the benefits of this are often fleeting which means that unless you keep taking the probiotic, it is not really effective as no lasting changes to the gut bacteria balance occurs.
A small but interesting study (2019) has shown that breast fed babies who received a very short course of a probiotic (bifido Infantis) still had colonies of those beneficial gut microbes 30 days after the end of 3-week probiotic treatment (1). A follow up study showed that the probiotic had established in the gut at 12 months of age.
This is significant, as this shows lasting change once the particular prbiotic under study had been ceased, with beneficial bacteria not only thriving, but dominating.
It is not known if these findings can be generalised to other probiotic strains administrated to babies.
Current Evidence for Giving Babies Probiotics
Studies looking at probiotics given to babies in the first year tend to be varied in their results so reliable conclusions are difficult to draw, however there are some probiotcs that have been linked with particular issues, which you can read below.
ALLERGY PREVENTION & Probiotics in Babies
Early introduction to potential allergen foods for normal infants or probiotics for infants at high risk of allergies may protect against development of allergic disease later in life (2).
No individual probiotic strains recommended with regards to reducing allergy risk.
More studies are needed to explore the relationship between LGG and milk protein allergy (5).
COLIC RELIEF & Probiotics in Babies
The aetiology of infantile colic is not well understood; however, studies have suggested that changes in the intestinal microbiota can lead to symptoms of infantile colic.
For this reason, different strains of probiotics have been studied to help understand their effectiveness in the treatment of infantile colic.
According to a systemic review and analysis, All probiotic strains studied (15 in all) seem to have some positive effect in treating infantile colic.
Exclusively breastfed infants have demonstrated more significant reduction in crying time. However, the available evidence on the effectiveness of probiotics in formula-fed and caesarean-born infants is limited (3).
This is a meta-analysis so a review overall, and so while it would seem there is not one probiotioc that can be recommended over another until there is more research done, you will find some probiotics such as Lactobaccillus. reuteri and Lactobaccillus rhamnosus: GG (LGG) have been studied MORE so there is more evidence linking them to improving colic in babies.
Lactobaccillus reuteri and colic relief:
Lactobaccillus reuteri DSM 17938 is the most studied probiotic for infantile colic and is supported by the strongest evidence in the treatment of infantile colic and reduction of its symptoms (decrease in crying time and fussing) in predominantly breast fed babies (4).
Note: Insufficient evidence for formulae fed babies.
Study levels: 1 × 108 colony-forming units (CFU)/day
Lactobaccillus rhamnosus: GG (LGG)
A study and first meta-analysis concluded that LGG is effective in treating infantile colic, with their particular study showing that excessive crying was reduced on average by 32 minutes per day. Other studies included in the meta-analysis showed a variation in results.
The sudy concluded while LGG seemed to help with colic in babies, more studies are needed to explore the effects of LGG with different doses, administration time, and duration on infants with different feeding moods (5).
Bifidobacterium breve
Less studies done on Bifidobacterium breve with colic, but some show positive results for breast fed and formulae fed infants.
A study of infants bottle fed showed an improvement in colic in babies (4).
Treatment: 108 CFU/dau, for 21-28 days
REFLUX & Probiotics in Babies
There is insufficient evidence to recommend a specific strain in the management of regurgitation, although there are some promising data for Lactobaccillus reuteri DSM 17938.
Treatment: 108 CFU/dau, for 21-28 days
ECZEMA & Probiotics in Babies
Several studies have been conducted for Atopic Dermatitis prevention in children with probiotics, administering them both to their mother in pregnancy and to the child in the first months of life. In protecting eczema, the most efficacious strains of probiotics were Bifidobacterium, but strains of Lactobacillus also showed a protective effect. Potentially having a mixture of these probiotics rather than alone may have a better protective effect (6).
MASTITIS & Probiotics in Breast Feeding Mothers
Lactobaccillus fermentum CECT5716 during the breastfeeding period in a couple of studies was found to reduce the incidence rate of mastitis (7, 8).
Safety of Probiotics in Babies
It has been established that probiotics are safe and well tolerated in normal healthy infants and children.
Choosing Probiotics when your Baby has Food Issues
If you decide to take a supplement for your self as a breast feeding mother and/or give directly to your baby- just check that there are no other ingredients (called excipients) that may be an issue, such as dairy, soy, wheat or ingredients high in natural chemicals such as herbs or stevia (if avoiding these).
This is even more important if giving the supplement directly to your baby.
Once you are satisfied that the probiotic is free from problem ingredients, then it is a matter of trialling the probiotic and seeing how it works for you and your baby.
If it does not seem to help then a different probiotic could be trialled.
Probiotics and Histamines or Amines
Probiotics contain amines as a result of the fermentation process so not recommended if your baby seems to be sensitive to amines or hstamines through your breast milk, unless has already demonstrated tyo be useful, then may consider continuing.
See my blog on amine or histamine sensitivity and babies if you think your baby is histamine/amine sensitive.
Tips Starting Probiotics in Babies
The accepted wisdom if giving probiotics to infants is to start with very, very small amounts of the probiotic if been given directly, for example 1/8 of the suggested dose and very, very slowly build up to the recommended baby dose. While there may be an evident improvement in colic or bowel motions, there also maybe no noticable difference.
After trialing a probiotic for a month and seeing no imporvement, a different one couod be trialled.
Overall, there is patchy scientific evidence to guide choce of probiotics for babies, so indiviual trialling is best, using the issue as a guide as to which probiotic to choose.
We are only at the beginning of the gut microbiome journey- one can only guess what will be uncovered in the next 5 years! REFERENCES
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Huazi Liu, Qiang Fei, Tianming Yua (2024), The effectiveness of Lactobacillus rhamnosus GG in the treatment of infantile colic: a systematic review and meta-analysis.
Anania, C.; Brindisi, G.; Martinelli, I.; Bonucci, E.; D’Orsi, M.; Ialongo, S.; Nyffenegger, A.; Raso, T.; Spatuzzo, M.; De Castro, G.; et al. Probiotics Function in Preventing Atopic Dermatitis in Children. Int. J. Mol. Sci. 2022, 23, 5409. https://doi.org/10.3390/ijms23105409
Hurtado JA, Maldonado-Lobón JA, Díaz-Ropero MP, Flores-Rojas K, Uberos J, Leante JL, Affumicato L, Couce ML, Garrido JM, Olivares M, Fonollá J. Oral Administration to Nursing Women of Lactobacillus fermentum CECT5716 Prevents Lactational Mastitis Development: A Randomized Controlled Trial. Breastfeed Med. 2017 May 1;12(4):202–9. doi: 10.1089/bfm.2016.0173. Epub 2017 May 1. PMCID: PMC5444431.
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GENERAL
Pia S. Pannaraj, Fan Li, Chiara Cerini, Jeffrey M. Bender, Shangxin Yang, Adrienne Rollie, Helty Adisetiyo, Sara Zabih, Pamela J. Lincez, Kyle Bittinger, Aubrey Bailey, Frederic D. Bushman, John W. Sleasman, Grace M. Aldrovandi. Association Between Breast Milk Bacterial Communities and Establishment and Development of the Infant Gut Microbiome. JAMA Pediatrics, 2017; DOI: 10.1001/jamapediatrics.2017.0378
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