What Are Probiotics & Are They Good For Infants?
Probiotics are typically good bacteria of the genera Bifidobacterium, Lactobacillus, Saccharomyces, and Streptococcus.
These probiotic strains include:
- Bifidobacterium lactis BI-07
- Bifidobacterium infantis EVC001 (B. infantis)
- Lactobacillus rhamnosus GG
- Lactobacillus reuteri NCIMB 11951 (L. reuteri)
- Lactobacillus plantarum DSM 9843
Clinical trials show that probiotic products can be beneficial for your baby’s gut health. They might also produce metabolic byproducts that help keep your baby’s developing immune system healthy. (1)
Studies and clinical trials have also shown that the use of probiotics can help prevent or treat certain gastrointestinal medical conditions, including the following: (1)
- Acute infectious diarrhea
- Antibiotic-associated diarrhea
- Constipation
- Atopic dermatitis or eczema – an inflammatory skin disease that leads to itching and risks of skin infection
- Gastritis – inflammation of the stomach lining by bad bacteria such as Helicobacter pylori
- NEC (necrotizing enterocolitis) – a serious inflammation experienced by premature infants, causing their intestinal tissues to atrophy and form holes
- CUC (chronic ulcerative colitis) – an autoimmune condition that makes the immune system attack the lining of the large intestine
Babies are naturally exposed to these good bacteria, particularly from breast milk and some formula, and through established gut bacteria colonies in the birth canal if you had a vaginal birth.
Probiotics In Breast Milk
Breast milk is a rich source of probiotics or good gut bacteria for your baby. So, breastfed infants might not need daily probiotic supplements as long as you’re regularly breastfeeding. (2)
Studies also show that human breast milk enriches probiotics and protects these live microorganisms as they’re transported to your baby’s lower intestinal tract through their acidic stomach environment. (2)
Plus, the milk appears to function as an incubator for these good bacteria, helping increase their dose and likelihood of successful colonization.
But don’t worry if you aren’t able to or choose not to breastfeed because dietary supplements and baby probiotics can help support your little one’s gut microbiome to keep their digestive system healthy.
Are Probiotic Supplements For Babies Safe?
Probiotics aren’t regulated by the FDA (Food and Drug Administration), so it’s best to choose a reputable brand to ensure your baby’s safety. (1)
The good news is that probiotics added to infant formulas are classified as GRAS (generally regarded as safe) under FDA regulations. (1)
Always consult your pediatrician before giving probiotics to your baby.
Our Top 5 Choices For Baby Probiotics
- LoveBug Baby Probiotic Drops (0.34 fl oz) – USDA-certified* organic probiotic with 15 billion CFU (colony forming units) per serving, six probiotic strains, and patented delivery technology (*USDA means United States Department of Agriculture)
- BioGaia Protectis Probiotic Drops (0.17 fl oz) – Tested in over 150 clinical trials and rated in a 2012 study among the best probiotic products with “A” ratings for effectiveness (3)
- Culturelle Baby Grow (0.30 fl oz) – GMO-free (without genetically modified organisms) and rated as one the best probiotic products with “A” ratings for effectiveness (3)
- Gerber Good Start Soothe Comforting Probiotic Drops (0.34 fl oz) – Clinically shown to reduce the crying time from colic by 50% in one week and reduce spit-up frequency by 50% in two weeks
- Garden of Life Baby Probiotics (1.9 fl oz) – Non-GMO Project Verified, certified USDA Organic, and the most affordable probiotics on our list
Continue reading to learn more about each baby probiotic product.
LoveBug Baby Probiotic Drops
What Makes It Special?
- Six probiotic strains, including L. rhamnosus GG, B. Infantis, and B. lactis
- Free from GMOs (genetically modified organisms), sugar, and common allergens
- 15 billion CFU (colony forming units) per serving (liquid formulation)
- Available in tasteless fine powder or liquid drops
- Contains 400 IU of vitamin D
- The brand claims that the product has patented BIO-tract delivery technology to consistently deliver at least 15 times the number of live, viable probiotic microorganisms through stomach acids compared to plain or standard capsules.
- USDA-certified organic
Key Features
- Probiotic/Bacteria Strains: L. rhamnosus GG, B. infantis, L. reuteri, B. lactis, L. plantarum, and L. acidophilus
- How It’s Administered: 7 drops or one serving of the powder to be mixed with milk or water
- Safety Features: Sugar-free, GMO-free, and allergen-free
Product Recall
- None
Cons
- Some parents complained that the product made their colicky babies feel worse and caused either diarrhea or constipation.
- It doesn’t come with a dropper.
Other LoveBug Probiotic Products
- LoveBug Baby Probiotic Powder for 6-12 months old, one box (30 single-serve stick packs)
- LoveBug Infant Probiotics for 0-6 months old, one box (30 single-serve stick packs)
- LoveBug Toddler Probiotics, one box (30 single-serve stick packs)
- LoveBug Kids Probiotics, one bottle (30 chewable tablets)
BioGaia Protectis Probiotic Drops (Original)
What Makes It Special?
- Tested in over 150 clinical trials
- Trusted brand, with 74+ million sold bottles
- Gluten-free, milk-free, and lactose-free
- 100 million live L. reuteri Protectis per serving (5 drops)
- BioGaia is rated among the best probiotic products with “A” ratings for effectiveness against gastrointestinal disorders, including infectious diarrhea (3)
- The brand claims that this product is safe for long-term use.
Key Features
- Probiotic/Bacteria Strain: L. reuteri DSM 17938
- How It’s Administered: 5 drops per day or as recommended by your physician
- Safety Features: It’s free from milk, gluten, and lactose
Product Recall
- None
Cons
- Some parents complained that it worsened their baby’s colic, gas, spit-up, and diarrhea.
Other BioGaia Probiotic Products
- BioGaia Protectis Immune Active Probiotic Drops for 0-36 months, one bottle (0.34 fl oz)
- BioGaia Protectis Probiotic Drops with vitamin D, one bottle (0.34 fl oz)
Culturelle Baby Grow + Thrive Probiotic & Vitamin D Drops
What Makes It Special?
- Bottle with dropper
- Free from dairy, wheat, eggs, tree nuts, peanuts, and GMOs
- Contains 400 IU of vitamin D
- Culturelle (L. rhamnosus GG) is among the best probiotic products that received “A” ratings in a 2012 study for effectiveness against gastrointestinal disorders, including infectious diarrhea (3)
Key Features
- Probiotic/Bacteria Strains: Lactobacillus rhamnosus GG and Bifidobacterium animalis subsp. lactis (BB-12)
- How It’s Administered: 5 drops once a day or as directed by your physician
- Safety Features: Free from dairy, eggs, tree nuts, peanuts, wheat, and GMOs
Product Recall
- None
Cons
- Some parents complained that the product smelled gross and made their baby’s poop smell bad.
Other Culturelle Probiotic Products
- Culturelle Baby Calm & Comfort for 0-12 months, one bottle (0.30 fl oz)
- Culturelle Baby Grow + Thrive for 0-12 months, one box (30 stick packs)
Gerber Good Start Soothe Comforting Probiotic Drops
What Makes It Special?
- The brand claims that this product is clinically shown to reduce crying time by as much as 50% in one week, reduce the spit-up frequency by 50% in two weeks, and balance a baby’s gut microbiome. However, these statements haven’t been evaluated by the FDA.
- Contains L. reuteri DSM 17938, similar to those naturally found in breastmilk (and also used in Gerber formulas)
- 100 million CFU per serving
Key Features
- Probiotic/Bacteria Strain: L. reuteri DSM 17938
- How It’s Administered: 5 drops once a day
- Safety Features: Free from GMOs
Product Recall
- None
Cons
- Some parents complained that it doesn’t work as advertised because their colicky babies experienced worse gas and more crying.
Other Gerber Probiotic Products
- Gerber Good Start Soothe Vitamin D & Probiotic Drops, one bottle (0.34 fl oz)
- Gerber Good Start Gentle Everyday Probiotic & Vitamin D Drops, one bottle (0.34 fl oz)
- Gerber Good Protect Replenishing Probiotic Drops, one bottle (0.34 fl oz)
Garden of Life Baby Probiotics
What Makes It Special?
- Seven probiotic strains
- Non-GMO Project Verified
- Certified USDA Organic
- Certified gluten-free
- Certified vegan
- 4 billion CFU per serving
- Most affordable probiotics on our list
Key Features
- Probiotic/Bacteria Strains: Lactobacillus rhamnosus GG, L. acidophilus, L. reuteri, B. infantis, B. bifidum, B. longum, and B. lactis
- How It’s Administered: 2 ml or 0.07 fl oz (using the included syringe)
- Safety Features: Free from chemicals, artificial flavors, sweeteners, and dyes
Product Recall
- None
Cons
- Some parents complained that it smelled awful and tasted sour.
Other Garden Of Life Probiotic Products For Kids
The brand has dozens of probiotic products for all ages, but these are some of the other options for kids:
- Garden of Life Raw Probiotics for kids, one bottle (3.4 fl oz)
- Garden of Life Probiotics Organic Kids+, one bottle (30 chewable tablets)
Summary & Recommendations
USDA-certified Organic Probiotics With Six Probiotic Strains
- LoveBug Baby Probiotic Drops – 0.34 fl oz.
Tested In 150+ Clinical Trials & Rated “A” For Effectiveness
- BioGaia Protectis Probiotic Drops – 0.17 fl oz.
GMO-free & Rated “A” For Effectiveness
- Culturelle Baby Grow – 0.30 fl oz.
Clinically Shown To Reduce Crying Time & Spit-up Frequency
- Gerber Good Start Soothe Comforting Probiotic Drops – 0.34 fl oz.
Non-GMO Project Verified & Certified USDA Organic
- Garden of Life Baby Probiotics – 1.9 fl oz.
Research Results: Benefits Of Probiotic Supplements For Babies
Natural Exposure To Good Gut Bacteria For Infants
Numerous studies have shown that good bacteria benefits babies and adults, including reduced cancer risks. (1)(4)
Some of these studies also showed the benefits of probiotics, such as atopic eczema prevention, if given during the prenatal and lactation period. (1)
Helps Prevent Or Reduce Colic
A 2007 clinical trial with L. reuteri showed that probiotics could help colicky babies, including reduced crying times. The study was conducted with breastfed infants. (5)
Helps Prevent Or Reduce Acid Reflux
Some studies also showed that probiotics could be a non-invasive, cost-effective, safe, and preventative healthcare strategy for acid reflux and infant regurgitation. (6)(7)
Helps Alleviate Acute Gastroenteritis & Other Digestive System Issues
Studies show that probiotics can help prevent or alleviate some digestive problems and illnesses: (1)(8)
- Acute infectious diarrhea (particularly probiotic strains Lactobacillus casei, L. reuteri, Streptococcus thermophilus, Bifidobacterium lactis, and LGG or Lactobacillus rhamnosus GG)
- Antibiotic-associated diarrhea (particularly probiotic strains LGG, B. lactis, S. thermophilus, and Saccharomyces boulardii)
- Gastritis (inflammation of the stomach linings caused by bad bacteria Helicobacter pylori infection) – studies using fermented food with live microorganisms L. casei DN-114 001 showed positive results
- CUC (chronic ulcerative colitis, an autoimmune condition that makes the immune system attack the lining of the large intestine) – particularly probiotic strains S thermophilus, Bifidobacterium species, and Lactobacillus species
Helps Prevent Or Reduce Eczema (Atopic Dermatitis)
Although studies remain inconclusive on whether probiotics can be proven an effective treatment for eczema or atopic dermatitis (an inflammatory skin disease that leads to itching and risks of skin infection), some showed encouraging results. (1)
In a 2005 clinical trial, infants with moderate-to-severe eczema diagnosis were given Lactobacillus fermentum. They showed marked improvement in the extent and severity of their symptoms after receiving the probiotics for eight weeks. (1)(9)
Helps With Constipation & IBS (Irritable Bowel Syndrome)
Studies show that probiotics like LGG don’t appear to treat IBS (irritable bowel syndrome), a condition characterized by chronic problems in bowel movements, including diarrhea, constipation, and abdominal pain. (10)
However, probiotics might help relieve some symptoms, including perceived abdominal distention. (10)
Helps Prevent NEC
A newborn’s tummy is sterile at birth, and the gut microbiome is introduced from breast milk or formula.
Due to frequent antibiotic therapy and possible restricted feedings, premature babies have an increased risk for NEC (necrotizing enterocolitis), a serious inflammation that causes their intestinal tissues to die and form holes. (1)
Clinical trials showed that probiotic supplementation could help prevent severe NEC and reduce mortality rates in premature babies. (11)
Decreases Sickness Risks If Your Baby Is in Daycare Or Preschool
Children and infants are more likely to get sick with gastrointestinal and respiratory tract infections when attending preschool or daycare centers than those cared for at home. (12)
Clinical trials showed that probiotic supplementation could be a safe and effective tool to prevent gastrointestinal and respiratory infections in this population. (12)
How to Choose The Best Probiotics For Your Baby
Safety & Clinical Studies
Although the FDA doesn’t regulate probiotics, numerous studies have shown that they can be safe and effective as a remedy for various conditions. (1)(3)
BioGaia (L. reuteri protectis SD2112) and Culturelle (L. rhamnosus GG) are among the best probiotic products that received “A” ratings for effectiveness against gastrointestinal disorders, including infectious diarrhea, in a 2012 study. (3)
Ingredients & Formulation
Bifidobacterium and Lactobacillus are two of the most commonly used bacteria in baby probiotics. They’re also among the most studied ones.
CFU Count
There isn’t a standard number, but most probiotics contain millions or billions of CFUs (colony forming units) per serving. This number often refers to the product’s CFUs per milliliter, grams, or serving size.
The CFU refers to the estimated number of microorganisms in the probiotic supplement.
What Types Of Probiotics Are Available?
Most baby probiotics come as liquid drops or in powder form that you can add to milk, water, or soft food.
Several baby formulas also contain probiotics. Some examples are:
Chewable probiotics are available, but these are designed for older kids (2+ years old). Don’t give them to your baby because they pose a choking risk.
Other forms of probiotics are available, but most aren’t advisable for babies and young children:
- Fermented foods, such as sauerkraut
- Fermented drinks, such as some yogurt drinks
- Capsules
- Pills
Why Give Your Baby Additional Probiotics?
Breastfed babies are less likely to require additional probiotics because breast milk is rich in these live microorganisms.
However, your pediatrician might consider probiotic supplementation, particularly if your child is experiencing gastrointestinal issues.
Side Effects & Potential Risks Of Probiotic Supplements for Babies
Although these products may be helpful to address gastrointestinal issues, probiotic supplements can also cause the opposite effect and lead to the following side effects: (13)
- Stomach upset
- Gastric distress
- Bloating
- Gas
These symptoms usually appear for the first few days of taking probiotics but are likely to go away once your baby’s tummy becomes accustomed to the additional live microorganisms.
They rarely happen, but these are the possible risks of probiotic supplement use: (13)(14)
- Developing resistance to antibiotics
- Developing an infection
- Developing harmful metabolic byproducts
FDA Warns Against Probiotic Use For Premature Babies Following Infant Death
Update: November 15, 2023
The FDA issued a safety warning on September 29, 2023, against using probiotics for premature babies following the death of an infant in an undisclosed hospital. (15)
According to the FDA’s safety warning, Infinant Health’s Evivo probiotic with MCT Oil was administered to the preemie (birthweight <1000 g) as part of their in-hospital care. The baby developed sepsis due to Bifidobacterium longum and died. (15)
Genome sequencing done as part of the investigation showed that the bacterium that caused the baby’s death was a genetic match with the microorganism in the probiotic product. (15)
However, the FDA’s safety warning isn’t just limited to Evivo but also extends to all types of probiotics, particularly for preemies with a birth weight of under 1000 g. (15)
Note that even before this safety warning, the FDA and the AAP cautioned against probiotic use, especially in premature infants, due to the lack of FDA-regulated and pharmaceutical-grade products in the US. (15)(16)
So, why are probiotics used in hospitals if they can be dangerous?
That’s because studies, such as the 2023 JAMA Pediatrics literature review of 106 clinical trials involving 25,840 preemies, have also shown that probiotics can have positive effects on premature babies, especially in preventing: (17)
- All-cause mortality
- Severe necrotizing enterocolitis
- Sepsis
- Feeding intolerance
The review also found that both single-strain and multistrain probiotics can be effective in reducing the duration of a preemie’s hospitalization. (17)
Abbott Stops Sale Of Similac Probiotic Tri-Blend After Receiving FDA Safety Warning
On October 24, 2023, the FDA issued a warning to Abbott Laboratories regarding their Similac Probiotic Tri-Blend product. According to the FDA, “the probiotic is an unapproved new drug and an unlicensed biological product” whose availability on the market violates the FDA Cosmetic Act and the Public Health Service Act. (18)
The probiotic is marketed especially for use with preterm infants. According to its label, the product contains the following probiotics among its ingredients: (18)
- Bifidobacterium infantis or B. infantis (Bb-02)
- Streptococcus thermophilus or S. thermophilus (TH-4)
According to the FDA’s warning letter, these products violated the law because of the following: (18)
- B. infantis (Bb-02) is considered an unsafe food additive under the FDA Cosmetic Act
- S. thermophilus (TH-4) is a new dietary ingredient with inadequate information or proof that it can’t cause a significant or unreasonable illness or injury risk, especially when used in preterm infants
The FDA explains that the safety warning was issued because Abbott Laboratories is marketing Similac Probiotic Tri-Blend as a product that can treat, prevent, or mitigate disease. (18)
The federal agency adds that Similac Probiotic Tri-Blend is also considered a biological product under the law because of its application in the supposed treatment or prevention of human beings’ disease or condition. However, the probiotic doesn’t have a valid biologics license application and, thus, shouldn’t be lawfully marketed as a drug. (18)
Further, the FDA declares Abbott’s probiotic product as ‘adultered’ because it contains B. infantis (Bb-02), which hasn’t been approved as a food additive. (18)
The FDA also slams Abbott’s conflicting statements about the product: (18)
- Abbott’s Pediatric Product Nutrition Guide and the product label state that this probiotic is “not intended for infants with compromised intestinal permeability.”
- However, the company’s infographic recommends the product’s use to “increase the number of good bacteria in the gut, promoting a healthy microbiome” despite acknowledging that the gut of preterm infants “isn’t fully developed.”
In response, Abbott has stopped sales of the Similac Probiotic Tri-Blend, and the product is no longer available on their website. (19)
According to a Reuters report, an Abbott spokesperson clarified that the issue only affects Similac Probiotic Tri-Blend, a product used by less than 200 hospitals. The Abbott spokesperson added that the company’s infant formula products aren’t affected and are still available in retail stores. (19)
What Should I Know Before Giving Probiotics To My Child?
Probiotics shouldn’t be given to seriously or chronically ill babies unless your pediatrician determines that their benefits outweigh the risks.
When Should Babies Take Probiotics?
It depends on your baby’s needs. Your healthcare provider might recommend probiotics after your baby took antibiotics, especially if they experienced diarrhea due to the medications.
Follow your pediatrician’s advice if they recommend daily or just a few days a week.
Remember that probiotics, including fermented food such as sauerkraut or dietary supplements, contain live microorganisms that could affect your baby’s gut microbiome. Only give them to your child with your doctor’s advice.
Can You Give Babies Probiotics Every Day?
Your pediatrician might advise daily supplementation if you’re dealing with a colicky baby. However, depending on different factors, they might also choose a less frequent schedule.
Minimum Age Limit: Are Probiotic Drops Safe For Newborns?
There isn’t a specific minimum age limit for using probiotics because they’re actually an essential part of your baby’s gut microbiome. They’re naturally found abundantly in breast milk.
However, it’s best to ask your healthcare provider whether your baby needs probiotics and their recommendations on which ones to use, especially if your baby was born prematurely or has metabolic, digestive, or immune conditions.
FAQs
Do Infant Probiotics Help With Gas?
Yes. Probiotics can help alleviate colic, gas, and flatulence. However, they might also cause these symptoms when they’re first taken. (13)
Do Probiotics Cause Gastric Distress?
Most of the time, probiotics don’t cause gastric distress. They’re even used to alleviate gastrointestinal issues.
However, they could trigger stomach upset, gastric distress, bloating, and gas for the first few days of taking them. (13)
Is Gripe Water A Probiotic?
No. Gripe water isn’t a probiotic, but some formulations, such as Wellements Organic Probiotic Gripe Water, contain strains of good gut bacteria.
REFERENCES:
(1) https://publications.aap.org/pediatrics/article/126/6/1217/65014/Probiotics-and-Prebiotics-in-Pediatrics
(2) https://www.researchgate.net/publication/326579046_The_Prebiotic_and_Probiotic_Properties_of_Human_Milk_Implications_for_Infant_Immune_Development_and_Pediatric_Asthma
(3) Ciorba M. A. (2012). A gastroenterologist’s guide to probiotics. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 10(9), 960–968. https://doi.org/10.1016/j.cgh.2012.03.024
(4) http://www.caister.com/backlist/ciim/v/v1/02.pdf
(5) https://publications.aap.org/pediatrics/article-abstract/119/1/e124/70744/Lactobacillus-reuteri-American-Type-Culture
(6) https://onlinelibrary.wiley.com/doi/full/10.1111/mcn.13290
(7) https://ijponline.biomedcentral.com/articles/10.1186/s13052-020-00862-z
(8) https://journals.lww.com/jcge/Abstract/2005/09000/Effects_of_a_Specially_Designed_Fermented_Milk.9.aspx
(9) https://adc.bmj.com/content/90/9/892
(10) https://www.sciencedirect.com/science/article/abs/pii/S0022347605004154
(11) https://onlinelibrary.wiley.com/doi/abs/10.1002/ebch.1976
(12) https://www.wageningenacademic.com/doi/10.3920/BM2014.0101
(13) https://my.clevelandclinic.org/health/articles/14598-probiotics
(14) https://www.researchgate.net/publication/325426510_Probiotic_supplementation_and_associated_infant_gut_microbiome_and_health_A_cautionary_retrospective_clinical_comparison
(15) https://www.fda.gov/media/172606/download
(16) https://publications.aap.org/pediatrics/article/147/6/e2021051485/180282/Use-of-Probiotics-in-Preterm-Infants?autologincheck=redirected
(17) https://jamanetwork.com/journals/jamapediatrics/article-abstract/2810095
(18) https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/abbott-laboratories-669353-10242023
(19) https://www.reuters.com/business/healthcare-pharmaceuticals/fda-issues-warning-letter-abbott-probiotic-products-infants-2023-10-26/
