Does Your Baby Need Probiotics?

Parent giving their infant probiotics from a spoon

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Caring for a baby involves a lot of thinking about food and nutrients—is your little one eating the right things? Are they getting enough nutrients? And what shouldn’t they be eating? 

There’s something of a question mark around probiotics for babies, which are available via beverages, foods, and supplements marketed as having immunity-boosting powers and even helping with the symptoms of conditions like colic, eczema, and antibiotic-associated diarrhea. With all the hype surrounding supplements, you might be wondering if your baby should also hop on the probiotic train.

First, what exactly are probiotics? “They’re living microscopic organisms (like bacteria and yeast) that have benefits to us when we consume them,” says Willow Jarosh, RDN, co-author of the "Healthy, Happy Pregnancy Cookbook," and founder of Willow Jarosh Nutrition, a New York City-based culinary nutrition company and private practice.

Many probiotics are similar to the microorganisms that naturally reside in our bodies, Jarosh explains. “Probiotics are transient—meaning they don't stick around our digestive systems for long—instead, they interact with our systems and then leave.” 

The theory behind probiotics for babies is that they balance out the potentially harmful microbes living in infants’ digestive tracts.

First of all, there’s no denying that a healthy gut and balanced microbiome are essential. “This helps to support your child's immune system to help fight future infections,” says pediatrician Florencia Segura, MD, FAAP. “Our gut contains about 70% of the immune system, so a healthy microbiome can play a lifelong role in preventing illness and decreasing the risk of allergies, asthma, and other chronic diseases.”

It's important for our gut and brain to be in sync, which is precisely what the gut-brain axis is for, Jarosh says. This helps to regulate brain chemistry, which in turn is believed to have a positive impact on the stress response, cognitive function, and mental health in general.

However, there is little evidence to show that supplementing babies with probiotics provides any health benefits.

What the Research Says

Parents should make educated decisions about their infant's health, and whether or not to give them probiotics is no exception. In one observational study, 35 of 86 mothers took probiotics while breastfeeding and also gave them directly to their infants. After analyzing the infants’ fecal microbiome during their first six months, scientists found that probiotics were only associated with higher levels of Bifidobacterium (“good” bacteria) at week one.

A research review published in 2021 emphasized the need for further research, specifically strain-specific and dedicated-dose response studies. 

“The strongest evidence right now is for use of probiotics to prevent antibiotic-associated diarrhea, C. difficile-associated diarrhea, and diarrhea associated with being in the hospital," says Jarosh. If a baby’s microbial balance is thrown out of whack by taking antibiotics, which wipe out the good bacteria in the gut as well as the bad, supplemental probiotics may help to restore that balance and reduce the intensity of sickness. 

There’s also evidence that probiotics may be effective for colic prevention and treatment, although Jarosh points out that it appears to be more effective in babies receiving human milk, rather than formula.

Should Your Baby Take a Probiotic?

The American Academy of Pediatrics (AAP) has never recommended probiotics for babies, so it may be best to avoid them during the first few months.

“Because we are still lacking in the research needed to make wider recommendations, there are only certain instances where I'd recommend a probiotic to a little one,” says Jarosh. "This should be decided on a case-by-case basis. If a baby isn't experiencing symptoms that probiotics might help, then I don't see a reason to take them.” 

Dr. Segura points out that most baby formulas now have added probiotics, so your baby is going to be getting probiotics whether they’re breast or bottle-fed.

“In some cases in colicky babies, it may be reasonable to offer a specific probiotic, Lactobacillus reuteri,” she says. “There is some evidence from randomized trials that treatment with this specific probiotic L reuteri in breastfed infants is associated with decreased crying time; however, the evidence must be weighed against the natural history of improvement over time.”

Whatever your situation, always talk to your pediatrician before supplementing your baby’s diet with probiotics, says Dr. Segura. 

Gut-Friendly Alternatives

For a newborn, breastfeeding is the easiest way to support good gut health because breast milk has many "probiotic" factors, says Dr. Segura. And because many formulas are also adding probiotic factors, your infant won’t miss out if they’re not breastfed. 

Jarosh recommends a multifaceted approach, including offering a variety of foods and minimizing stress around the entire food and eating experience. “Include fermented foods if your baby enjoys them,” she adds. You might try things like fruit (e.g. coconut), kefir, fermented sweet potatoes, applesauce, and sauerkraut. 

Don’t forget that many things create stress, which in turn affects gut health. For instance, it’s important to create a space where your baby can get adequate sleep, says Jarosh, as well as minimize other stressors they might experience. It's also important to note using probiotics with kids who are "immunocompromised, chronically debilitated, or seriously ill and who have indwelling medical devices," could pose safety concerns, per the AAP.

A Word From Verywell

There isn’t great evidence to support giving your baby probiotics, and lack of regulation makes it more challenging to know what you are getting—something to consider more seriously when a baby is involved. The bottom line is that if you want to give your baby probiotics, it's best to discuss the decision with your infant's pediatrician.

9 Sources
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