Should You Feed "Friendly Bacteria" to Your Infant and Child?

Here's an unidentified flying fact for your consideration: There are 100 trillion (100,000,000,000,000) bacteria - weighing 4 pounds - happily living in your intestines. That's ten times more bacteria than there are cells in your body, more bacteria than the number of stars in our galaxy, more bacteria than the number of humans who have ever lived (estimated, by the way, at 100 billion) ... You get the picture. There are a lot.

Now that I've completely grossed you out, know this: without these guys, you'd be dead. Some scientists even consider our bacterial inhabitants to be an essential body organ because without them your intestines couldn't properly absorb nutrients, the tissues would be thin and easily torn, your immune system would be compromised, you would become vitamin K deficient, you would be unable to digest certain foods. No wonder, then, that most are called "friendly" (probiotic) bacteria.

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Probiotic bacteria and your infant
When your baby was born her intestines were was completely free of bacteria. Over the first weeks, as she swallowed milk and saliva, various germs entered her gut and took up residence.

Interestingly, these bacteria are different whether a breast- or bottle-feeder, and whether born by C-section or not. Breast-fed and vaginally-born infants are colonized by more of the friendliest guys of all: bifidobacteria, while bottle-fed, C-section delivered infants have far fewer. These bifidobacteria seem especially good in promoting intestinal growth and function, helping the immune system to develop, and playing a role in preventing allergies.

By 12-18 months of age, the bacterial flora (as they are picturesquely called) look pretty much the same no matter what the manner of birth or feeding.

Formulas with friendly bacteria?
Perhaps another reason "breast is best" is because of this effect. That's why you are now reading about infant formulas containing these "friendly" bacteria. Is it a good idea? Should you buy it?

Although the evidence is pretty thin at this point, I'm saying yes to supplementation (much like a vitamin) in the first year of life with bifidobateria and lactobacillus in formula-fed and/or C-section delivered infants. Here's my reasoning:

• Since your infant's intestines are going to become home to lots of bacteria anyway, why not try to duplicate what generally happens in nature (i.e., in a breast-fed, vaginally-born infant).


• Bifidobacteria seem to be very safe; there have been no reports of significant medical problems in infants who ingest them. And there seems to be increasing evidence of their positive role in early infant health.

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Other uses of probiotic bacteria in children?
The best evidence for the therapeutic use of probiotic bacteria is during a diarrheal illness (especially rotovirus), where they seem to cut down on the severity and duration of the symptoms. Probiotic bacteria have also have been shown to cut down GI disease in sick, premature infants. Other, less proven, uses have included to prevent infections of the genitourinary tract, to treat irritable bowel syndrome, and to help with preventing and treating eczema in infants.

Again, based on their safety and that it seems to make sense (at least to me), I often recommend using supplements of probiotic bacteria for kids during and after:

• Infectious diarrhea.


• Taking antibiotics for any reason.


• In the care of sick, premature infants (to prevent necrotizing enterocolitis).


• Symptoms of irritable bowel syndrome.


• Cases of severe eczema


• Recurrent urinary tract infections

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Look for supplements containing bifidobacteria and lactobacillus. (There is some debate if yogurt alone can do the trick. Personally I'd count more on the supplements you can buy at your drugstore or health food store).

But beware the exorbitant claims made that these bacteria can prevent cancer and cure other illnesses, which seem pretty dubious to me. Here's what the Harvard Health Letter had to say about this issue (2002):

"Probiotics have been oversold. The claims are that seductive pills, powders, and solutions containing 'friendly' bacteria will boost the immune system, prevent cancer and perform other assorted health miracles...But that doesn't mean it's based on total fiction...The evidence suggests that probiotic therapy could be useful some day as a form of preventive medicine - and not just for diseases affecting the gut."

And since preventive medicine is often best started in infants and children, I'm cautiously coming down on the side of their use, even though the scientific evidence is by no means well established (this is about as "fringey" as I get).

I'm curious: are any of you going down this road? What do your pediatric providers think about this controversial area?

Related Topics:

• WebMD Video: Good Bacteria
• Food for Thought: Breastfeeding and Bottle-Feeding

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