What The Experts Say
“Probiotics are essential to the development of healthy gut microbiota – and that starts at birth. Supplemental probiotics are not necessary for breastfed babies as breastmilk contains both pre and probiotics. However, if you are looking to increase your baby’s probiotic intake and provide the 400 IU supplemental vitamin D recommended for breastfed babies, try Culturelle Baby Grow + Thrive Probiotics and Vitamin D drops.
If your baby is not breastfed, check your formula to see if it contains probiotics – if not, it may be beneficial to add one like Enfamil Infant Probiotics Dual Probiotics. As with any supplement, consult your pediatrician before adding a probiotic to your baby’s diet.” Anne Cook Carroll, MS, RDN
Cancer: Prevention And Treatment
Results of published studies have demonstrated the positive benefits of functional foods, such as yogurt, and the administration of probiotics to prevent carcinogenic processes in animal models. As yet, no published RCTs warrant recommendation of routine administration of probiotics to either treat or prevent cancer in adults or children.
Dna Isolation Amplicon Library Construction And Sequencing
DNA extraction was performed using the SDS lysate freeze-thaw method. Fecal bacterial genomic DNA was extracted using the PowerMax extraction kit , according to the manufacturers instructions, and stored at 80°C until further use. The amount of bacterial genomic DNA was analyzed using a NanoDrop ND-1000 spectrophotometer . The V4 region of bacterial 16 S rRNA gene was amplified by PCR using forward primer 515F and reverse primer 806R . PCR products were purified using AMPure XP Beads and were quantized using a PicoGreen dsDNA, Assay Kit . The purified amplicons were then pooled in equimolar concentrations, and the final concentration of the library was determined using Qubit . After quantification, an Illumina HiSeq 4000 pair-end 2 × 150 bp platform was used for sequencing.
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Intestinal Bacterial Colonization And Development Of The Intestinal Mucosal Defense System
Similar to the fetus, an infant at the time of birth has a sterile gastrointestinal tract, but bacterial colonization occurs rapidly.,, The newborn infant’s gestational age, mode of delivery, and diet seem to have significant effects on this process. Neonates who are born by Caesarian delivery, born preterm, and/or exposed to perinatal or postnatal antibiotics have a delay in intestinal commensal probiotic bacterial colonization. When delivered vaginally, breastfed infants and formula-fed infants have a similar pattern of bacterial colonization at 48 hours of age. However, by 7 days of age, approximately two-thirds of formula-fed infants have a predominance of Bacteroides fragilis, compared with only 22% of breastfed infants.
Toward the end of the first month of life in developing countries, breastfed infants are found to have Bifidobacteria-predominant colonization, whereas formula-fed infants have equal colonization with Bacteroides and Bifidobacteria species. In resource-rich countries, however, differences are less pronounced between breastfed and formula-fed infants.
Inferred Functional Changes Related To Infant Health
We analyzed the function of the intestinal microbes related to the health of infants and found that, in terms of the abundance of bacteria associated with pneumonia, both the supplemented formula and the standard formula were different from the breastfeeding groups . Interestingly, the supplemented formula group was very close to the breastfeeding group in terms of ureolysis . This suggests that prebiotics and OPO might improve parts of the function of the gut microbiota of formula-fed infants, bringing it closer to the effects of breast milk.
Figure 5 Analysis of the function of intestinal bacteria that affect newborns health. Relative abundance of intestinal bacteria related to septicemia in three groups. Relative abundance of intestinal bacteria related to ureolysis in three groups. fs, supplemented formula group f, standard formula group m, breastfeeding group . * ** ns, no significant.
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Benefits Of A Bifidobacterium
The decline of Bifidobacterium in infant gut microbiomes and the associated dysregulation of the microbial community, with more numerous potential pathogens, has been suggested as one possible contributor to the increased incidence of autoimmune diseases that plague residents of resource-rich nations. Conversely, observational studies have shown beneficial immune effects of having a fecal microbiome dominated by Bifidobacterium. In two studies in Bangladeshi infants and young children, fecal B. infantis and Bifidobacterium abundances at two months of age were strongly correlated with improved vaccine responses at six months and two years old compared with infants not colonized by B. infantis or with low relative abundances of Bifidobacterium.
In an effort to restore the Bifidobacterium-dominated infant gut microbiome that was typical of breastfed babies 100 years ago, we decided to conduct a randomized, controlled trial using the B. infantis EVC001 probiotic. Given that not all B. infantis strains consume all HMOs efficiently, we selected B. infantis EVC001 because we knew this strain had the full cassette of genes needed to fully digest all HMOs. Healthy, full-term, breastfed infants were randomized to consume B. infantis EVC001 for 21 consecutive days starting on day 7 postnatal or to not receive the probiotic.
Are Probiotics And Prebiotics Good For Babies
We know that naturally occurring breastmilk probiotics are both beneficial and safe for baby, but what about introducing probiotics to formula-fed little ones?
While the benefits of probiotics and prebiotics for babies are still being studied, they can be a safe addition to your babys dietunless baby is immunocompromised, has cancer, or was born prematurely. Make sure to work with your little ones doctor to ensure youre choosing appropriate baby prebiotics and probiotics and dosing correctly.
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Bacterial Fermentation In The Large Intestine
The primary role of the colonic microbiota is to salvage energy from dietary material that has escaped digestion in the upper GI tract, through the process of fermentation. Approximately 810% of the total daily energy requirements of the host are derived from colonic bacterial fermentation . Most bacteria in the adult human colon are saccharolytic and so obtain their energy through the fermentation of carbohydrates. Diet is one of the principal factors that determine the type and amount of bacteria that colonise the bowel, as well as regulating metabolic processes. Principal substrates for colonic bacterial growth are dietary ingredients that have escaped digestion in the upper GI tract .
Infant Formula Supplemented With Probiotics
European Society for Pediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition published a systematic review of studies assessing the safety and health effects of probiotic-supplemented infant formulae. No conclusive data were obtained from ESPGHANs analysis of infant and follow-on formulae due to considerable variability in the type and dose of probiotics used and supplementation periods.
Formulae supplemented with probiotics do not raise safety concerns with regard to growth and adverse effects . There are sufficient data supporting the safety of probiotics for infants older than 6 months. However, data on the use of probiotic supplementation in infants younger than 4 months are more limited. Studies in breastfed infants younger than 6 months who received a formula supplemented with either Lactobacillus fermentum CECT5716 or Lactobacillus rhamnosus GG revealed that formulae were well tolerated and had no adverse effects on growth either during the study period or at 35 years of age . A recent study revealed that growth and food tolerance improved in premature infants > 30 weeks of gestational age fed with a formula supplemented with Saccharomyces boulardii, and no adverse effects were detected .
3.1.2 Prevention and treatment of infant disorders
. Thus, fecal Bifidobacterium breve concentrations in infants fed with a fortified formula have been documented to be similar to those found in breastfed infants.
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Search Method For Identification Of Studies
A literature search in all languages was conducted on electronic databases which included The Cochrane Central Register for Controlled Trials 2009, Scopus , EBSCO host , OVID , SPORT Discus , Web of Science , Science Direct , EMBASE , CINAHL , PUBMED / MEDLINE , Latin American Caribbean Health Sciences literature , , NLM Gateway . RCTs published in non-English language journals were translated by independent translators who were familiar with the subject matter. The search strategy used to search PUBMED is shown on Table . This search strategy was modified to search other electronic databases.
Table 1 Search strategy used in PUBMED
We conducted a hand search on abstracts of major conference proceedings such as the Pediatric Academic Society meetings , cross checked references cited in RCTs and in recent reviews for additional studies not identified by electronic searches and specialty journals which were not included in any database such as Pediatrika, Chinese Journal of Microecology and International Journal of Probiotics and Prebiotics.
Summary Of Main Findings
This review was under powered to detect clinically important differences in primary outcomes because of the few number of studies, small sample size and poor methodological quality of studies. This review found no significant effect on weight gain from use of probiotics added to infant formula. There was also no significant probiotic effect on linear and head growth from the one study measuring these two outcomes. Probiotic supplementation failed to significantly reduce the risk of complications such as NEC, sepsis and death compared to control group. Outcomes such as number of days on parenteral nutrition and other infections were not reported. There was no significant difference in the amount of feed volume and frequency of vomiting between study groups. Preterm infant formula with probiotics was well tolerated as no gastric aspirates, abdominal distension or diarrhea was reported. Effects of probiotics on stool characteristics were under reported. Results from one study showed probiotics supplementation did result in a larger number of stools per day.
Quality of the evidence and potential biases
Agreements and disagreements with other reviews
No significant difference was found in contrast with past reviews and that the potential reasons are lack of power, poor quality of studies or a lack of effect in formula fed infants. This review did agree with some aspects of past reviews. Prebiotics did have an impact on GI micro flora feed tolerance .
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Gut Microbial Diversity Analysis
We analyzed bacterial diversity to determine the effects of supplemented formula and standard formula on the gut microbiota. A Venn diagram showed that, compared with standard formula, supplemented formula produced bacteria similar to those of the breastfeeding group . The abundance grade curve showed that OTUs of the supplemented formula group and the breastfeeding group were both around 1200, and that the OTUs of the standard formula group were around 800, which shows the detection depth is sufficient in three groups. . The mean Chaos 1 index showed that there were no significant differences between the supplemented formula group and the breastfeeding group , while there were significant differences between the standard formula group and the breastfeeding group . These findings suggest that the supplemented formula group was closer to the breastfeeding group in terms of gut microbial richness . The Shannon and the Simpson indexes showed that both the supplemented formula group and the standard formula group had significant differences with the breastfeeding group in terms of diversity .
Should I Choose An Infant Formula With Prebiotics
While the prebiotics found in breast milk may be beneficial in reducing common infections in healthy children, many health experts continue to question whether prebiotic additives in infant formula deliver on claims of benefitting digestion and an infants immune system. According to the American Academy of Pediatrics , prebiotics added to infant formula do not appear to be harmful to healthy infants, but there is currently not enough evidence to support the routine use of prebiotics in formula.
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Mechanisms Of Probiotic Activity
Although there is good evidence for the effect of probiotic preparations in GI health, little is known about the manner in which these changes occur. Several different mechanisms by which probiotics may protect the host from intestinal disorders have been suggested:
production of anti-microbial substances: lactic acid bacteria produce a wide variety of anti-bacterial substances, as well as inhibitory metabolites such as organic acids, diacetyl and H2O2. They also produce bacteriocins and antibiotic-like substances with activity against both Gram-positive and Gram-negative bacteria
competition for adhesion receptors or sites: the presence of some bacteria in the intestinal tract is dependent on their ability to adhere to the gut epithelium, such that they become immobilised on the gut wall and resist being flushed out by peristalsis, as well as occupying a niche at the expense of potentially-harmful organisms
competition for nutrients
stimulation of immunity: the underlying mechanisms of immune stimulation are not well understood, but specific cell-wall components or cell layers may act as an adjuvant and increase humoral immune response
degradation of toxin receptors.
Prevention And Treatment Of Allergy
A 2007 Cochrane review concluded that there was inconclusive evidence for giving prebiotics to prevent allergic disorders in infants. However, in 2008, Arslanoglu et al reported on a 2-year follow-up of an RCT in 132 infants at risk of atopy because of parental atopy. Infants were fed a partially hydrolyzed formula with either an added mixture of FOS and GOS or maltodextrin placebo in the first 6 months of life. Those given the prebiotic mixture of FOS and GOS had a reduced incidence of atopic disease. Cumulative incidences of atopic eczema, recurrent wheezing, and allergic urticaria were higher in the maltodextrin placebo group than in the intervention group . In a 2009 review, van der Aa et al analyzed relevant publications to date and concluded that there is presently not enough evidence to support the use of probiotics, prebiotics, or synbiotics for the prevention or treatment of allergic dermatitis in children. Confirmatory studies of the benefits of prebiotics, especially for children fed formula that is not partially hydrolyzed or infants fed partially hydrolyzed formula, which are already being promoted to reduce the incidence of atopic disease, are needed before any recommendations can be made for the use of prebiotics in infants and toddlers to prevent infection or atopic disease.
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How Much Do Formula Fed Babies Poop
Formula-fed babies typically poop three to four times a day, but some go as long as three or four days without a bowel movement. As long as your babys poops are soft and passed without a struggle, you dont have to be concerned. But call your pediatrician if your little one doesnt poop for more than five days.
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Probiotics And Prebiotics In Pediatrics
This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have filed conflict of interest statements with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.
Dan W. Thomas, Frank R. Greer, Committee on Nutrition Section on Gastroenterology, Hepatology, and Nutrition Probiotics and Prebiotics in Pediatrics. Pediatrics December 2010 126 : 12171231. 10.1542/peds.2010-2548
Prebiotics are supplements or foods that contain a nondigestible food ingredient that selectively stimulates the favorable growth and/or activity of indigenous probiotic bacteria. Human milk contains substantial quantities of prebiotics. There is a paucity of RCTs examining prebiotics in children, although there may be some long-term benefit of prebiotics for the prevention of atopic eczema and common infections in healthy infants. Confirmatory well-designed clinical research studies are necessary.
What Do You Mean By Probiotics In Infant Formula
Probiotics is a word that you may run across when shopping for infant formula for your baby. Some formulas are fortified with these probiotics, which are types of live bacteria. They are good or friendly bacteria that are already present at high levels in the digestive system of breastfed babies.
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Irritable Bowel Syndrome And Constipation: Treatment
There has been a single published RCT of the treatment of irritable bowel syndrome in children. LGG reduced abdominal distension and discomfort in a group of 50 pediatric patients over a 6-week study period. Response to therapy was recorded and collected on a weekly basis by using the Digestive Symptom Rating Scale. Various probiotics were shown to be helpful in several other RCTs of treatment of IBS in adults.,, One published RCT addressed the use of probiotics or a placebo as adjunct therapy to a stool softener to treat functional constipation in 84 children. LGG was not an effective adjunct to lactulose in treating constipation in children. Thus, probiotics may be of benefit in children with IBS on the basis of a single RCT, but a recommendation for them use cannot be made without further confirmatory studies. Probiotics cannot be recommended at this time for treatment of constipation.