Probiotics may not work on baby’s diarrhea

Two large study, papers published in New England Journal of Medicine of 2018, have revealed that probiotics may not work on baby's diarrhea.

Probiotics may not work on baby’s diarrhea

In one study, from Massachusetts Medical Society, researchers conducted a prospective, randomized, double-blind trial involving children 3 months to 4 years of age with acute gastroenteritis who presented to one of 10 U.S. pediatric emergency departments. Participants received a 5-day course of Lactobacillus rhamnosus(L. rhamnosus) GG at a dose of 1×1010 colony-forming units twice daily or matching placebo. There were no significant differences between the L. rhamnosus GG group and the placebo group in the duration of diarrhea, duration of vomiting, or day-care absenteeism or in the rate of household transmission.

In another study, from the Canadian Institutes of Health Research, researchers conducted a randomized, double-blind trial involving 886 children 3 to 48 months of age with gastroenteritis who presented to six pediatric EDs in Canada. Participants received a 5-day course of a combination probiotic product containing Lactobacillus rhamnosus R0011 and L. helveticus R0052, at a dose of 4.0×109 colony-forming units twice daily or placebo. There were no significant differences between the probiotic group and the placebo group in the median duration of diarrhea, or vomiting

Probiotics treatment options reported previously improve outcomes in children with acute gastroenteritis may be limited to a small sample sizes. Incorporating the above mentioned two large study, perhaps we need to reconsider the effects of  probiotics on baby's diarrhea.

Are probiotics really useless on baby's healthy? But the fact is NOT.

1. Probiotics help extremely premature infants gain weight

In this study, Mohamad Al-Hosni, MD, and colleagues from three medical centers, in collaboration with Vermont Oxford Network, evaluated the effect of supplementing enteral (tube) feedings with probiotics in extremely premature infants who weighed 2 pounds, 2 ounces or less. They hypothesized that infants who received probiotic-supplemented feedings would tolerate larger volumes of feeding per day, grow faster and require fewer days of antimicrobial treatment than those in the control group.

2. Probiotic use may reduce antibiotic prescriptions

According to the Centers for Disease Control and Prevention (CDC), there are about two million cases of antibiotic resistant infections yearly in the U.S., resulting in 23,000 deaths. Reducing the use of antibiotics is one strategy in combatting resistance. 

Their study, supported in part by the International Scientific Association for Probiotics and Prebiotics and published in the European Journal of Public Health, found that when the results from twelve studies were pooled together, infants and children were 29% percent less likely to have been prescribed antibiotics if they received probiotics as a daily health supplement. When the analysis was repeated with only the highest quality studies, this percentage increased to 53%.

3. Probiotic use may prevent baby from food allergies

The finding, published in a research letter in JAMA Pediatrics, upends what scientists thought of human milk oligosaccharides (HMOs) -- the sugar molecules found exclusively in human breast milk -- and could lead to future studies on how the compounds can be potentially influenced by diet and other factors.

"Because HMOs may be linked to development of food allergies in an infant, manipulating HMO composition favorably could open up a new avenue for prevention of food allergies," said Kirsi Jarvinen-Seppo, M.D., Ph.D., chief of the Division of Pediatric Allergy/Immunology at URMC and senior co-author on the paper.

Warm Reminder: mom's milk may help probiotic gets a boost in babies, please breast-feed as long as possible.

Reference
[1]Schnadower D, Tarr P I, Casper T C, et al. Lactobacillus rhamnosus GG versus placebo for acute gastroenteritis in children[J]. New England Journal of Medicine, 2018, 379(21): 2002-2014.
[2]Freedman S B, Williamson-Urquhart S, Farion K J, et al. Multicenter trial of a combination probiotic for children with gastroenteritis[J]. New England Journal of Medicine, 2018, 379(21): 2015-2026.
[3]Source: Science Daily. Original title; Probiotics help extremely premature infants gain weight. Reference link: https://www.sciencedaily.com/releases/2010/05/100501013401.htm
[4]Source: Science Daily. Original title; Probiotic use may reduce antibiotic prescriptions. Reference link: https://www.sciencedaily.com/releases/2018/09/180914084840.htm
[5]Source: Science Daily. Original title; Probiotic gets a boost from breast milk. Reference link: https://www.sciencedaily.com/releases/2017/12/171206132149.htm
[6]Source: Science Daily. Original title; Breastmilk sugars differ in pregnant women on probiotics. Reference link: https://www.sciencedaily.com/releases/2019/01/190122125524.htm