MIXED EVIDENCE FOR PROBIOTIC BENEFITS

Claims about the benefits of probiotics in both children and adults have been emerging for some years already, with the alleged benefits so numerous that it can be tricky to know just how much to believe.   In January of this year, there was a study from Italy published in  the AMA’s pediatrics journal which showed, as some previous one had,  benefit from lactobacillus reuteri in many infants with colic.   However, in April, there is another large study,  reported in the British Medical Journal.  In this report,  167 formula or breastfed infants between three weeks and three months of age enrolled,  with approximate half given lactobacillus reuteri and half given a placebo.  Using a pretty detailed protocol, these  investigators found no benefit in the treated babies.  The  conclusion was that this probiotic “did not reduce crying or fussing, nor was it effective in improving infant sleep, maternal mental health, family or infant functioning, or quality of life.”

In an article on use of probiotics for a different pediatric problem, the  April, 2014  issue of  Pediatrics (the AAP journal) contains  a study from Mexico,  looking into  the value of a probiotic for  preventing diarrhea in children attending day care.   As the article notes, there had  been previous investigations in Finland, India, Taiwan, and Indonesia which had suggested less diarrhea and respiratory infection in young children supplimented with probiotics.  Lead author Dr. Pedro Gutierrex-Castrellon and his co-investigators set out to design and carry out a  particularly well-controlled study to investigate these benefits   In a group of six to 36 month old children, 168  were  given a standardized amount of a type of lactobacillus reuteri  and and equal number were given a placebo.    The period of treatment was three months and then children were followed another three months.  There were  a number of specific measures by which benefit could be measured in a statistically reliable way

Without getting into the details of all this, the results of this research  demonstrated a lower risk of developing diarrheal illness or upper respiratory infection in those children who were given the daily dose of this bacterial supplement.  In addition, cost effectiveness was noted, as parents benefited from fewer missed school and work days as well as medical visits and antibiotic prescriptions.  The authors end the study by pointing out that their findings confirmed the results of early ones, but with an even better designed protocol, and concluded that  the preventive use of this agent can be recommended.

So?  Not helpful for colic, but helpful to prevent diarrhea and respiratory illness in daycare attendees? This is a very brief update on a big subject, we can expect to see more evaluation on probiotic use in the future.