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An update on probiotics in paediatrics

Maria Zemła1, Maja Kotowska-Bąbol, Hania Szajewska

  • 1Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland.

Current Opinion in Clinical Nutrition and Metabolic Care
|December 3, 2025
PubMed

Insights

Recent pediatric probiotic research confirms 2023 European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines for gut disorders. New evidence does not yet support changes to these strain-specific recommendations for probiotics.

Area of Science:

  • Pediatric Gastroenterology
  • Microbiome Research
  • Clinical Trials

Background:

  • Probiotics are frequently used in pediatric care, but their effectiveness differs based on specific strains and health conditions.
  • In 2023, the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) established strain-specific guidelines for pediatric gastrointestinal issues.

Purpose of the Study:

  • To review scientific literature published after 2024.
  • To determine if emerging evidence necessitates modifications to the existing ESPGHAN probiotic recommendations for pediatric gastrointestinal disorders.

Main Methods:

  • Systematic review of studies published since 2024.
  • Analysis of clinical trial data on probiotic efficacy in pediatric populations.
  • Comparison of new findings against 2023 ESPGHAN guidelines.

Main Results:

  • Lacticaseibacillus rhamnosus GG (LGG) and Saccharomyces boulardii are recommended for preventing antibiotic-associated diarrhea.
  • Specific probiotics like L. reuteri DSM 17938 and B. lactis BB-12 show potential for infant colic and functional abdominal pain.
  • No probiotics are currently recommended for constipation, and evidence for necrotizing enterocolitis prevention remains limited.

Conclusions:

  • Current research since 2024 has not provided sufficient data to alter the established ESPGHAN probiotic recommendations.
  • The efficacy of probiotics in pediatrics is limited to a select number of strains and specific indications.
  • Further large-scale, multicenter studies with standardized methodologies are required to strengthen the evidence base.
Abstract

Keywords:
microbiotapaediatricsprobioticsrandomised controlled trials

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