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The good bugs: the use of probiotics in pediatrics
Naire Sansotta1, Diego G Peroni2, Simone Romano3
1Paediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII Bergamo.
Insights
Probiotics show strain-specific benefits for various childhood conditions like diarrhea and colic. Healthcare providers should consider specific strains and diseases when recommending probiotics for children.
Area of Science:
- Pediatric Gastroenterology
- Microbiome Research
- Clinical Nutrition
Background:
- Growing evidence supports probiotic use in pediatric conditions.
- Healthcare providers face uncertainty due to numerous probiotic options and conflicting data.
- Probiotics exhibit strain-specific effects, necessitating a focused approach.
Purpose of the Study:
- To review hypotheses on probiotic efficacy and safety in children.
- To evaluate data on probiotics for common pediatric diseases.
- To emphasize strain-specific effects over general probiotic use.
Main Methods:
- Literature review of current hypotheses and available data.
- Focus on individual probiotic strains and their documented effects.
- Analysis of studies related to common pediatric diseases.
Main Results:
- Strain-specific efficacy demonstrated for Lactobacillus rhamnosus GG and Saccharomyces boulardii I-745 in acute infectious diarrhea.
- Lactobacillus reuteri DSM 17938 effective for infantile colics; Lactobacillus rhamnosus GG and VSL#3 for irritable bowel syndrome.
- Encouraging results for probiotics in necrotizing enterocolitis, food allergy, and nonalcoholic fatty liver disease; equivocal data for constipation.
Conclusions:
- Probiotic efficacy is highly strain-specific and disease-specific.
- Healthcare providers must consider strain and disease when recommending probiotics.
- Personalized probiotic recommendations can optimize therapeutic outcomes in children.
Purpose Of Review:
There is growing evidence encouraging the use of probiotics in many conditions in children. However, given the wide number of probiotics available and contradictory data in the literature, the health-care provider is often faced with uncertainness about whether or not to use probiotics and which one(s) to choose. We here review current hypotheses regarding the efficacy and safety of probiotics and evaluate the available data on the use of probiotics in most common diseases in children. Considering that probiotics have strain-specific effects, we will focus on individual probiotic strains rather than on probiotics in general.
Recent Findings:
Strain-specific efficacy was clearly demonstrated with Lactobacillus rhamnosus GG and Saccharomyces boulardii I-745 in the treatment of acute infectious diarrhea, Lactobacillus reuteri DSM 17938 in infantile colics, Lactobacillus rhamnosus GG, and VSL#3 in irritable bowel syndrome. In addition, encouraging results are seen for use of probiotics in necrotizing enterocolitis, food allergy, and nonalcoholic fatty liver disease. However, the data available for constipation are to be considered somewhat equivocal.
Summary:
The clinical relevance of these findings indicates that healthcare providers need to take strain-specificity and disease specificity of probiotics into consideration when recommending probiotic for their patients.
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