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Probiotics in Term Infants: Clinical Impact of Infant-Type Bifidobacteria: A Systematic Review and Meta-analyses
Mathias A Sjælland1, Marie T Philipsen2, Tine B Henriksen2
1Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Insights
Early use of infant-type bifidobacteria (ITB) probiotics may reduce eczema and respiratory infections in infants. More research is needed to confirm these benefits and establish optimal usage for infant gut health.
Area of Science:
- Microbiology and Immunology
- Pediatric Health
- Nutritional Science
Background:
- Infant-type bifidobacteria (ITB) probiotics, like B. longum subsp. infantis, are increasingly recognized for their potential to shape the infant gut microbiome and immune system.
- Despite growing interest, significant knowledge gaps persist regarding the clinical efficacy, optimal strains, dosages, and duration of ITB-probiotic use in infants.
- Understanding these factors is crucial for leveraging ITB-probiotics for improved infant health outcomes.
Purpose of the Study:
- To systematically review and evaluate the clinical effects of ITB-probiotic administration in healthy, term infants during their first year of life.
- To assess the impact of ITB-probiotics on various clinical outcomes, including atopic conditions, gastrointestinal health, growth, and infection rates.
- To synthesize current evidence and identify areas for future research in ITB-probiotic application for infants.
Main Methods:
- A comprehensive systematic search was conducted across major databases: PubMed, Embase, CENTRAL, and Scopus.
- Twenty-five studies were included and assessed for risk of bias using the revised Cochrane RoB 2 tool.
- Meta-analysis was performed where applicable to pool data for specific outcomes.
Main Results:
- Early ITB-probiotic administration was associated with a statistically significant reduction in eczema (RR = 0.78).
- A borderline significant reduction in respiratory tract infections was observed (RR = 0.74).
- Trends towards preventive effects were noted for antibiotic use, diarrhea, asthmatic bronchitis, and food allergy, but these did not reach statistical significance.
Conclusions:
- ITB-probiotics show potential clinical relevance, particularly in preventing eczema and respiratory tract infections in infants.
- Current evidence is limited by study heterogeneity and a lack of long-term follow-up data.
- High-quality, large-scale randomized controlled trials are necessary to confirm short- and long-term effects and standardize outcome measures for ITB-probiotic use in infants.
Abstract:
Probiotics labeled "infant-type bifidobacteria" (ITB), such as the B. longum subsp. infantis strains, have gained significant attention in recent years for their potential to positively influence the gut microbiome, early immune system development, and consequently future health. However, significant knowledge gaps remain regarding the actual clinical impact, the optimal strains, dosing regimens, and treatment duration-both in general and for ITB-probiotics specifically. This systematic review evaluates the clinical effects of administering ITB-probiotics to healthy, term infants within the first year of life. The aim was to address all categories of clinical outcomes. However, the included studies focused primarily on antibiotic use, atopic conditions, gastrointestinal health, and growth. We systematically and comprehensively searched PubMed, Embase, CENTRAL, and Scopus, followed by a meta-analysis where applicable. A total of 25 studies were included and assessed for risk of bias using the revised Cochrane tool (RoB 2). We found that early administration of ITB-probiotics was associated with a significant reduction in eczema [risk ratio (RR) = 0.78 (0.68, 0.90)] and a borderline significant reduction in respiratory tract infections [RR = 0.74 (0.54, 1.00)]. Other commonly reported outcomes, including antibiotic use, diarrhea, asthmatic bronchitis, and food allergy, also showed trends toward a preventive effect, though these findings did not reach statistical significance. This review underscores the potential clinical relevance of ITB-probiotics, particularly in the prevention of eczema and respiratory tract infections. However, the evidence is limited by study heterogeneity and a lack of long-term follow-up data. Further high-quality randomized controlled trials with larger sample sizes and standardized outcome measures are needed to clarify both short- and long-term effects of ITB probiotic administration in neonates and infants. This trial was registered at PROSPERO as CRD42024507608.
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