EEH: The role of probiotics in gut health for babies and children

Probiotics and gut health have become a popular trend for adults, kids and even pets. Healthcare professionals recognize the importance of gut health as more than a fad, and the research and innovations surrounding probiotics for newborns and children are exciting.

Edward-Elmhurst Health uses hospital-specific products for certain high-risk infants in its Newborn Intensive Care Unit (NICU). Additionally, the advantages of over-the-counter probiotics can be seen at home with newborns, children and teens.

As always, before making any decisions about probiotics for a child, parents should talk to the child’s doctor first.

Probiotics in the NICU

Probiotics are bacteria that work by adding more “good bacteria” into the gastrointestinal (GI) system, improving the overall microbiome by reducing the amount of “bad bacteria.” Infants who receive probiotics have shown:

• Improved feeding tolerance
• Better growth rates
• More frequent stooling without the use of other medications
• Reduced feeding intolerance symptoms
• More restful sleep

Research is ongoing about the long-term benefits of probiotics, including better immune programming that might change allergic and autoimmune progression.

“While there is a lot of publicity about probiotics’ role in decreasing the occurrence of NEC (necrotizing enterocolitis) in extreme preemies, that effect is not yet proven. The real intention of a probiotic in extremely premature neonates is to alter negative gut imbalance and produce a more balanced gut,” says Bob Covert, MD, an independent neonatologist and Medical Director of the Edward Hospital NICU.

Neonatologists have always known that breast milk has significant advantages for premature newborns. Interestingly, 85% of the contents of breast milk feeds the infant, but 15% of breast milk’s makeup is undigestible.

Scientists now know that the other 15% of breast milk can only be completely digested by certain “good” bacteria. NICUs turn to probiotics to restore the good bacteria in the infant’s gut that potentially have benefits and functionality for the infant.

In June 2020, the Edward Hospital NICU started a probiotics program for babies born very prematurely, GI surgical infants and older patients with specific GI conditions. Not all babies in the NICU receive probiotics.

There are many probiotics on the market for newborns, including some with B. infantis strains. The Edward NICU selected the specific B. infantis strain known commercially as “Evivo,” or B. infantis EVC001, based on the most recent research.

Evivo is the only commercially available B. infantis strain that has the functionality to fully capture, consume and convert all human milk oligosaccharides (HMOs) in breast milk to ultimately lower the intestinal pH. Because of the complete capture, conversion and consumption of the HMOs by Evivo, the “bad” pathogenic bacteria are reduced by 80% and B. infantis and other good bacteria are increased.

This type of probiotic is suited for babies who are fed with breast milk, although Evivo still shows benefits for babies who only receive formula. The long-term effect may not be as significant for formula-fed babies compared to babies who receive breast milk.

Probiotics at home

Before starting probiotics, parents should talk to their child’s doctor about any health issues to ensure additional medical testing or screening is not needed. While there are no known side effects to probiotics, the doctor could describe potential side effects.

Once an infant is home from the hospital, single-strain probiotics are recommended for:

• C-section deliveries where the natural flora from the mom did not pass to the baby
• Deliveries where the mom received antibiotics
• Colic symptoms or general discomfort
• Diaper rash
• Watery stools

For older children, multi-strain probiotics can help with:

• GI discomfort
• Constipation
• Antibiotic use (as antibiotics can change the amount and type of bacteria in the gut)
• Immune response
• Urinary tract or yeast infections

Not all probiotics are the same, nor are they regulated by the Food and Drug Administration. It’s important to select a product manufactured by a company that is transparent and stands by its quality. Products that undergo third-party testing are recommended because the testing typically ensures the CFUs (colony forming units) in the product match what is specified on the label.

Some babies are born needing special care. At Edward-Elmhurst Health, we’re fully equipped to care for newborns who require special attention, such as premature infants, infants on ventilators and newborns with congenital conditions. Our transport team is available 24/7 with a dedicated ambulance to transfer high-risk mothers and newborns needing an advanced level of neonatal care to our hospitals.

Edward Hospital provides a Level III NICU—with the capabilities to treat the sickest and most fragile newborns of all gestational ages, including those with a variety of congenital and surgical conditions. Elmhurst Hospital provides a Level IIe Special Care Nursery with extended capabilities to care for low birth weight and premature infants, as well as infants on ventilators, at 30 or more weeks gestation.

Learn more at www.eehealth.org/services/pregnancy-baby/after-delivery/nicu.