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Diarrhea…perhaps one of those things that I, as a parent, dread the most. Well, vomiting may come in first place, but they are pretty close. In children, diarrhea is most often seen with viral infections, but can also be a common side effect of antibiotics. Medications that stop diarrhea are not recommended in children since we want them to “get rid of” the virus that is usually causing this most unpleasant symptom. But what if there was something that could safely improve diarrhea or shorten just how many days you will be held up at home fearing an outing could bring the next “blowout?” Well, you are in luck - say hello to pre- and probiotics.

 “When infants are born, their intestines are sterile or basically like a blank canvas waiting to be “painted” by the nutrients they ingest.”

So, first, a quick biology primer. While the word “bacteria” typically conjures up thoughts of infection and illness, there are certain places in our body where we need beneficial bacteria, and the gut happens to be one of those places. When infants are born, their intestines are sterile or basically like a blank canvas waiting to be “painted” by the nutrients they ingest. Within the first few hours to days of their life, an infant’s gut becomes colonized with various forms of healthy bacteria that will aid in digestion, absorption and overall gut health.

Now, this is probably not the first time you have heard of the “biotics” as they have become quite popular not only in the medicine aisle, but also down the main grocery aisles. Prebiotics are a nondigestable food ingredient (usually a carbohydrate) that can “feed” or stimulate the growth of the good bacteria in your gut. Prebiotics are found in several forms in human milk (yet another reason to give breast feeding a try especially in the first few days of an infant’s life) and several formula companies are now adding prebiotics to infant formula. Probiotics, on the other hand, are supplements that contain viable microorganisms for the gut and can be found as powders or capsules or in certain cultured foods such as yogurts or drinks like Kefir.

A clinical report reviewing the current data on pre- and probiotics was published in the journal Pediatrics and found several cases where these products proved beneficial. Studies have found that starting a probiotic early in the course of viral acute gastroenteritis (i.e. the stomach bug) could shorten the duration of diarrhea by about one day. These probiotics were also shown to be helpful in preventing antibiotic associated diarrhea if the probiotic supplement was started on the same day as the antibiotic. There is also some evidence that probiotics could help to prevent severe intestinal infections in very premature infants.

 “The probiotics serve to basically put the good bacteria back where it belongs almost like restocking store shelves after a Black Friday sale.”

So why are probiotics beneficial in these cases? When you come down with the “stomach bug,” the diarrhea that is caused by the virus “washes” all of the good bacteria from your gut. A similar thing happens with antibiotic associated diarrhea as the antibiotic doesn’t know the difference between the good bacteria in your gut vs the bad bacteria causing your child’s ear infection, for example. The probiotics serve to basically put the good bacteria back where it belongs almost like restocking store shelves after a Black Friday sale.

The jury is still out on the benefit of adding pre- and probiotics to infant formula. There is no evidence that these additives are harmful to otherwise healthy infants. However, while the addition of prebiotics may certainly help to get formula even closer to breast milk, there is no evidence at this time to recommend routine use of infant formula fortified with these additives.

There is still a lot of ongoing research about other possible benefits of pre and probiotics in conditions such as infantile colic, colds, eczema, allergic conditions, ulcerative colitis and irritable bowel syndrome. It is important to note that probiotics should never be given to children with underlying medical conditions such as low-functioning immune systems or those that have indwelling medical devices such as catheters. Stay tuned for an upcoming “favorite things” post about my most recommended probiotics, but until then, make sure and discuss this topic with your child’s doctor to determine if your kiddo could benefit from those “biotics.”