FAQs in Pediatric Practice: Probiotics

Editor(s): Frequently Asked Questions Vol.1 / 1,  2014

Summary

In the recent years, probiotics have been the focus of both popular media and science. The ability to modulate the composition of the microbiota by probiotics has resulted in probiotics being used to prevent, manage or treat various health conditions such as diarrhoea, allergies, dental caries, NEC and gestational diabetes among others. Emerging science on probiotics has helped elucidate the mechanisms of action by which probiotics are able to modify the intestinal microbiota and defend the body against disease-causing pathogens. This publication also goes into detail on differences between probiotics and prebiotics.

The term ‘probiotic’ is derived from the Greek term “pro bios”, which means that “for or in favour of life”. According to the Food and Agriculture Organisation of the United Nations and the World Health Organisation, probiotics are defined as “Live microorganisms which, when administered in adequate amounts, confer a health benefit on the host.” Probiotic bacteria are also referred to as ‘friendly bacteria’ or ‘good bacteria’. They are regarded as the ‘medicine’ of 21st century. The history of probiotics is thought to be as old as the Greek and Roman times when cheese and fermented milk were often recommended for consumption especially for children and convalescents. Although foods containing probiotics strains, such as cheese and fermented milk have been used for thousands of years, it was only during the beginning of the last century that the concept of probiotics evolved. The Russian Nobel Prize laureate, Élie Metchnikoff and French paediatrician, Henry Tissier provided the first scientific suggestions regarding the beneficial aspects of some selected bacteria.

Probiotics are essential for good health as they are functional foods. In-fact, regular consumption of probiotic-supplemented foods is recommended to establish a positive balance of beneficial microbes in the intestinal flora. Probiotics protect against harmful microorganisms and strengthen the host’s immune system, and thus play an important role in maintaining the health and well-being. Probiotic microorganisms are capable of stimulating and regulating several aspects of natural as well as acquired immune responses, and thus they exert beneficial effects throughout the body of the host. Clinical trials have demonstrated that probiotics offer several beneficial health effects.

There are several published studies suggesting that probiotic supplementation reduces allergic manifestations such as atopic dermatitis, improves lactose digestion and symptoms of infantile colic, and modulates immune development in infants. Paediatric practice should recommend probiotic supplementation since it has also shown to confer protection against antibiotic-associated diarrhoea and reduce the incidence of acute diarrhoea and rota viral shedding. It also reduces the risk of acute infectious diarrhoea results in shorter and fewer episodes of diarrhoea and can reduce the incidence of NEC.

Probiotics are effective in the treatment of acute infectious diarrhoea and mildly active ulcerative colitis in children; prevent antibiotic-associated diarrhoea, nosocomial diarrhoea, common gastrointestinal infections acquired in the community and dental caries; alleviate some symptoms of functional bowel disorders; and serve as an adjuvant therapy for Helicobacter pylori eradication. Probiotics are useful in the prevention and treatment of bacterial vaginosis. They facilitate better glucose tolerance16 and improve constipation during pregnancy. Probiotics enhance immune protective potential of breast milk and prevent the risk of atopic eczema in children.