Although causality remains to be
confirmed, current evidence supports
the view that the gut microbiota play role
in human health and disease. If so, it is
logical to assume that manipulation of
the gut microbiota, such as through the
administration of probiotics could potentially
be a preventive and/or therapeutic measure
in the evolution of disease states. Here,
some examples of current research related
to probiotics are described.
Certain probiotics prevent NEC.
Controversy exists whether current evidence
is sufficient to change practice and start
the routine use of probiotics in preterm
infants to prevent NEC. Lactobacillus reuteri
DSM 17938 is likely to reduce crying times
in breast-fed infants with infantile colic.
More studies, especially in formula-fed
infants, are needed. Recently, for the first
time, it was documented that L reuteri was
effective for preventing infantile colic in
both breast-fed and formula-fed infants.
A number of randomized controlled trials
found that probiotics (e.g. Lactobacillus GG
and L reuteri DSM 17938) reduced the risk
of gastrointestinal and/or respiratory tract
infections. The use of probiotics with proven
clinical efficacy [e.g., Lactobacillus GG, S.
boulardii, L reuteri DSM 17938] is in line
with current European recommendations for
the management of acute gastroenteritis.
There are studies that show a protective
effect, no effect, or even a predisposing
effect of using probiotics for preventing the
allergic condition. In 2015, the World Allergy
Organization (WAO) published evidencebased
recommendations about the use
of probiotics in the prevention of allergy.
According to these recommendations (all
are conditional and supported by very low
quality evidence), current evidence does
not indicate that probiotic supplementation
reduces the risk of developing allergy in
children. However, the WAO considers
that there is a likely net benefit from
using probiotics resulting primarily from
prevention of eczema. The use of probiotics
was suggested in pregnant women at high
risk for having an allergic child; in women
who breastfeed infants at high risk of
developing allergy; and in infants at high risk
of developing allergy. For healthy infants,
the administration of currently evaluated
probiotic-supplemented formula to infants
is safe with regards to growth and adverse