Should we treat every infant with a probiotic?

Area of Science:

• Microbiology
• Pediatrics
• Gastroenterology

Background:

• Intestinal dysbiosis is increasingly prevalent in developed nations, linked to modern lifestyle factors and associated with numerous inflammatory diseases.
• Probiotic administration has demonstrated significant benefits in specific infant populations, particularly for preventing severe conditions.

Purpose of the Study:

• To review the current evidence on probiotic use in infants for various conditions.
• To address the unanswered question of whether routine probiotic administration can reverse infant intestinal dysbiosis and associated diseases.

Main Methods:

• Systematic review of existing literature on probiotic efficacy in infants.
• Analysis of evidence for conditions including necrotizing enterocolitis, late-onset sepsis, death, infantile colic, and atopic dermatitis.
• Identification of research gaps regarding the long-term impact of probiotics on infant gut microbiota.

Main Results:

• Strong evidence supports prophylactic probiotics for very preterm infants to prevent necrotizing enterocolitis, late-onset sepsis, and death.
• Probiotics, specifically L. reuteri DSM 17938, show strong benefits for infantile colic in breast-fed infants.
• Evidence for preventing atopic dermatitis is mixed, with benefits observed when initiated during pregnancy.

Conclusions:

• Probiotics are effective for specific, severe conditions in vulnerable infant populations.
• The potential for routine probiotic use to broadly impact infant intestinal dysbiosis and related diseases requires further investigation.
• Large-scale, long-term studies are warranted to determine the paradigm-shifting potential of probiotics in infant health.