What are probiotics and why are they important for children?
The human gut, especially that of a child, is home to trillions of microorganisms that collectively form the microbiota. This complex "organ" plays a key role in digestion, immune defense, and even influences mood and development. Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host [1]. In pediatrics, interest in probiotics is steadily growing as they can help in the prevention and treatment of various conditions associated with intestinal microbiota imbalance [1, 6].
However, it is important to understand that not all probiotics are the same. Their effect is strain-specific, meaning that the benefits shown for one bacterial strain cannot be automatically extrapolated to other strains or to probiotics in general [1, 6]. This means that when choosing a probiotic for a child, it is crucial to rely on scientifically proven data for a specific strain and a specific condition.
Probiotics in the fight against acute intestinal infections
One of the most studied areas of probiotic use in children is the treatment of acute infectious diarrhea. This is a common condition that can lead to dehydration and significant discomfort.
- The strains Lactobacillus rhamnosus GG and Saccharomyces boulardii I-745 have shown efficacy in treating acute infectious diarrhea in children, helping to reduce its duration and severity [1].
Alleviating functional digestive disorders
Functional digestive disorders, such as infant colic, irritable bowel syndrome (IBS), and functional abdominal pain, are frequent reasons for consulting a pediatrician.
- Infant colic: The strain Lactobacillus reuteri DSM 17938 has demonstrated efficacy in relieving the symptoms of infant colic [1].
- Irritable Bowel Syndrome (IBS): For children with IBS, encouraging results have been obtained using Lactobacillus rhamnosus GG and the probiotic mixture VSL#3 [1].
- IBS with predominant diarrhea (IBS-D): Studies have shown that Saccharomyces boulardii significantly improves IBS-D symptoms in children, normalizes stool morphology, regulates the diversity of the intestinal microbiota, and reduces inflammatory markers [4].
- Functional abdominal pain (AP-DGBIs): A systematic review and meta-analysis showed that probiotics provide moderate symptom relief in children with AP-DGBIs and can be considered as a safe adjunctive therapy rather than a standalone treatment. These findings are consistent with the 2025 ESPGHAN/NASPGHAN guidelines [3].
Support in Helicobacter pylori treatment
Helicobacter pylori infection is widespread and associated with chronic gastritis, peptic ulcer disease, and an increased risk of gastric cancer. Eradication therapy in children often faces the problem of growing antibiotic resistance and side effects [2, 5].
- Lactobacillus species have been proposed as adjuvants to improve treatment outcomes and reduce side effects of standard eradication therapy in children [2].
- Multi-strain probiotics can significantly alleviate gastrointestinal symptoms such as reflux, dyspepsia, and diarrhea associated with bismuth quadruple therapy without affecting the success of H. pylori eradication [7]. This highlights their value as a safe and well-tolerated addition to baseline therapy [7].
New horizons: probiotics and pediatric migraine
Migraine is a debilitating neurological disorder that often begins in childhood or adolescence and is frequently accompanied by gastrointestinal symptoms. Studies suggest there is a complex gut-brain axis that may play a role in the development of migraine.
- Preliminary studies are investigating the therapeutic potential of probiotics, such as Bifidobacterium longum, in modulating the microbiota and alleviating migraine symptoms in children, especially in the presence of comorbid gastrointestinal disorders [8]. This opens up new perspectives for the use of probiotics in pediatrics.
Important aspects of probiotic use in children
The use of probiotics in children requires a balanced approach and consultation with a doctor. Given the strain-specificity of effects, the choice of a specific probiotic strain should be based on proven efficacy for a particular condition [1, 6].
While probiotics are generally considered safe for children [1, 3], they often serve as an adjunctive therapy supplementing baseline treatment rather than replacing it [3]. Further standardized studies are needed to clarify optimal dosages, duration of administration, and long-term effects of various probiotic strains [3, 7].
Sources
- 1. The good bugs: the use of probiotics in pediatrics.
- 2. Lactobacillus supplementation for Helicobacter pylori eradication in children: A language-inclusive systematic review and meta-analysis of efficacy and safety.
- 3. Probiotics in pediatric functional abdominal pain disorders: a systematic review and meta-analysis.
- 4. Saccharomyces boulardii's impact on pediatric diarrhea-predominant irritable bowel syndrome: animal model findings.
- 5. Potassium-competitive acid blockers for Helicobacter pylori eradication in pediatrics: a narrative review of pharmacologic rationale, clinical evidence, and practical considerations.
- 6. What are the indications for using probiotics in children?
- 7. Traditional Chinese medicine alleviate gastrointestinal symptoms during bismuth quadruple therapy for Helicobacter pylori infection: A complementary perspective.
- 8. Targeting the microbiome in pediatric migraine: gastrointestinal manifestations and the therapeutic role of Bifidobacterium longum.
The information presented in this article is for informational purposes only and should not be used for self-diagnosis or self-treatment. Always consult a qualified medical professional for personalized advice and treatment.