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Probiotics show promise for a number of important health conditions in children.
Clinicians and parents often face tough choices when it comes to treating health issues in young children. As a part of growing up, kids often experience a broad range of common conditions. Yet, addressing children’s health is often challenging for a number of reasons.
For starters, clinicians and parents are often wary about recommending or administering medications that have potential side effects. A second common challenge is getting a child to take medications or supplements, as many children are averse to ingesting things with strong smells, tastes, or textures. Making dietary recommendations for young children has its own set of challenges. Many children have limited dietary preferences as it is. Restricting these choices further can significantly impact the ability to meet daily nutritional needs. Recommending that they eat more of a certain food group-such as increasing fruits and vegetables, or increasing water intake-is often a “no go,” as children are picky eaters and are not inclined to increase variety in their diets. Thus, treating common conditions that are amenable to simple interventions can often become a challenge.
These issues point to the need for simple therapeutic interventions that are safe and easy to administer, yet effective for a broad range of health conditions commonly experienced by children as they grow up. Natural medicines offer many of these benefits, although they are certainly not immune to some of these same challenges. However, within the paradigm of natural remedies, probiotics hold the promise of being effective for a number of common health conditions.
Probiotics have a high level of safety (when properly administered) and can be taken in a number of different types of preparations, presenting an opportunity for easy administration, with a relatively neutral taste and acceptable texture. Ongoing research into the value of probiotics for several common pediatric health issues shows that these healthy organisms hold significant promise.
According to the World Health Organization, probiotics are “live microorganisms which when administered in adequate amounts confer a health benefit on the host.” It is thought that probiotic organisms have such a broad impact on health primarily through their interaction with the body’s immune system. Immunologists believe that 70% or more of the immune system resides within the human gastrointestinal (GI) tract, offering probiotic organisms transiting through and colonizing the GI tract ample time to interact with immune cells.
As these interactions influence local and systemic processes throughout the body, it’s easy to see why a healthy, balanced GI microflora can have such a far-reaching impact on health. Research published recently highlights the potential benefits of probiotic organisms in children for several common allergic conditions and, of course, for influencing important parameters of digestive health-areas that are often frustrating to address for parents and clinicians.
Emerging evidence indicates that various strains of probiotics may be beneficial for preventing and treating childhood eczema, a skin condition often resulting from an allergic response.
Dr. Sung-Il Woo and colleagues from South Korea conducted a randomized placebo-controlled trial published in April 2010 in which children between the ages of 2 to 10 diagnosed with atopic eczema were administered a freeze-dried preparation of the probiotic organism Lactobacillus sakei (5 billion CFU-colony forming units-twice daily), or a placebo, for 12 weeks. Eighty-eight children were enrolled in the study, with 45 allocated to the probiotic group. The results showed a 31% average improvement in the treatment group after 12 weeks compared to a 13% improvement in the placebo group, with significantly more children in the probiotic group achieving a level of improvement in their skin condition, reaching 30 and 50%. Serum levels of inflammatory markers were also significantly lower in those children supplemented with the probiotic preparation.
Other preparations of probiotic bacteria have also been shown to be of benefit in atopic dermatitis. Dr. Sergei Gerasimov and colleagues conducted a study in the Ukraine in which 90 children, between ages 1 and 3 with moderate to severe atopic dermatitis, were administered a probiotic mixture containing L. acidophilus DDS-1, Bifidobacterium lactis UABLA-12 (total of 5 billion CFU twice daily), and prebiotics in the form of fructo-oligosaccharide, or a placebo, for eight weeks. An average improvement of 33.7% was noted in the group of children supplemented with the probiotic mixture versus an improvement of 19.4% in the placebo group, indicating a strong benefit for the probiotic supplement on skin health.
A review of the literature by Geun Eog Ji of Seoul National University published in 2009 advocates the administration of probiotic organisms as a primary intervention for preventing the development of atopic dermatitis in infants. The author details the results of several human and animal studies, including the administration of probiotics to expecting mothers and continuing with administration in infants in the first years of life, showing beneficial effects for the prevention of eczema and allergic skin conditions. Also detailed are potential mechanisms whereby the probiotics interact directly with the immune system to confer their benefits, including a reduction of immunoglobulin production (especially IgE), modulating effects on mast cells and eosinophils (cells commonly involved in the allergic immune response), and a shift in the balance of the Th1 and Th2 immune response towards a reduction of the overall allergic response. The review acknowledges that these effects are the likely result of what is termed the “cross-talk” between probiotic bacteria and the intestinal mucosa, indicating the importance of the GI tract as a primary immune organ.
While further research in the area of prevention and treatment of eczema and allergic skin conditions through the use of probiotic organisms is warranted, there seems to be a sound basis for their effect.
Proper bowel function is essential to health. Inconsistencies in bowel movements can cause a number of nonspecific symptoms that can contribute to behavioral issues in children. Constipation is a common bowel symptom that impacts young children. Effectively addressing constipation, however, can often be a challenge.
Recent evidence points to the ability of certain probiotic strains to confer benefits in this area. A study conducted in Taiwan compared the effects of Lactobacillus casei rhamnosus (Lcr35) administration to magnesium oxide or placebo in 45 children, under the age of ten years, with chronic constipation. Lcr35 administered daily in an amount of 8 × 108 CFU per day for four weeks was as effective as magnesium oxide and showed significantly better frequency of bowel movements, fewer use of enemas, and fewer hard stools than the placebo group. Children taking Lcr35 also experienced less abdominal pain than those consuming magnesium oxide.
Similarly, an Italian study published in 2010 in the Journal of Pediatrics compared daily administration of a strain of Lactobacillus reuteri (DSM 17938) to placebo in 44 infants, six months and older, diagnosed with functional constipation. Results from this eight-week study found that supplementation with the probiotic significantly improved frequency of bowel movements. Stool consistency in these children also improved over the eight-week period, indicating benefits of this probiotic in infants with constipation.
Moreover, a pilot study published this year investigated the effect of supplementation with the probiotic species Bifidobacterium breve in children 3 to 16 years of age with functional constipation. Twenty children were administered a sachet of powder daily containing between 108 and 1010 CFU of B. breve for four weeks. The frequency of bowel movements increased from an average of 0.9 bowel movements per week at the beginning of the study to 4.9 in week four. Stool consistency improved from baseline to week four, while episodes of abdominal pain also significantly decreased from an average of 4.2 episodes per week at the beginning of the study to 1.9 per week in week four. While researchers from Emma Children’s Hospital/Academic Medical Centre in Amsterdam where the study was conducted were impressed by the ability of B. breve to beneficially impact childhood constipation, they point out that additional research is needed to confirm the effects seen in the pilot study.
As research continues into the emerging field of the science of probiotics, it is clear that these beneficial organisms hold the potential for promoting health in diverse systems and organs. For children, probiotics offer promise in that they are relatively safe and they work with the body’s natural healing processes.
Preparations of these organisms offer the added advantages of relatively neutral taste and texture. Furthermore, probiotic organisms can be administered in several kid-friendly dosage forms, making it more likely that children will actually take them.
Of course, along with the potential benefits, there are still several challenges that exist. Further research is needed to determine which probiotic strains are best targeted to specific benefits. There is also the important question of efficacious dosing and how many CFUs are needed to confer a particular health effect. Along the same lines is the issue of viability and survivability of organisms through the acidic environment of the stomach and the often harsh conditions of the digestive tract. As scientists ponder these questions in future research, clear answers may emerge, allowing these friendly organisms tremendous potential to deliver on their immense promise.