Elsevier

Journal of Pediatric Health Care

Volume 17, Issue 6, November–December 2003, Pages 277-283
Journal of Pediatric Health Care

Original Article
Probiotic use in children

https://doi.org/10.1016/S0891-5245(03)00070-1Get rights and content

Abstract

Interest in nutritional supplements and functional foods has risen significantly in recent years. Many of the products that are marketed to consumers tout the benefits of probiotics for general good health and for a wide variety of conditions and situations. Although most of these products have been used safely for years, careful analysis of scientific research should be conducted before routinely recommending these products, especially for children. A basic understanding of intestinal flora, properties of probiotics, and clinical research findings is necessary for clinicians to delineate the role of probiotic agents in the pediatric population.

Section snippets

Intestinal flora

The intestinal tract of the human fetus is sterile but is exposed to many different species of microorganisms after birth. Primary portals of entry for these bacteria include the birth canal during delivery and contact with other humans and the surrounding environment. After birth, many factors influence the types and quantities of intestinal microflora of the infant. Besides extrinsic factors such as the mother's dietary intake or use of probiotics, type of birth (vaginal or surgical),

Definitions

A probiotic is a product with a sufficient number of viable microorganisms to alter the host's microflora to produce beneficial health effects (Schrezenmeir & de Vrese, 2001). Probiotics are ingested in an attempt to prevent or treat a specific pathologic condition. Although the desired effect is similar, prebiotics are different. Prebiotics are nondigestible food ingredients, such as inulin and oligosaccharides, that stimulate development or activity of beneficial intestinal bacteria (Gibson &

Proposed mechanisms of action

Several mechanisms of action are thought to influence the effectiveness of probiotics. Probiotics may stimulate production of compounds that inhibit or destroy pathogens. They also may act to lower intestinal pH by stimulating lactic acid, producing organisms that favor growth of more beneficial organisms. It is thought that the adhesion properties of the Lactobacillus species, as well as their production of bacteriocins, hydrogen peroxide, and biosurfactants, are particularly beneficial.

Some

Gastrointestinal system

The first intentional use of probiotics was in fermented foods as a way to prevent spoilage. Probiotic organisms are utilized today by the food industry to produce commonly consumed products such as cheese and yogurt. Traditional probiotic strains have been selected on the basis of these years of safe usage with no harmful adverse effects. Pre- and probiotics used in the food industry and in supplement form have positive effects on nutrient bioavailability, such as the ability to break down

Packaging and preparation

Most probiotics are stable only for limited periods when stored under cool and dry conditions. Most are freeze-dried microbial powders with dormant bacteria, and their viability is dependent on the unique properties of the bacteria, how they are produced (tablets, capsules, or loose powder), as well as how they are packaged (loose in a bottle or individually in foil/foil wraps) and stored (refrigerated versus shelf stable). When probiotics are exposed to moisture, oxygen, and heat, irreversible

Summary

Probiotics contain species of bacteria that are commonly found in the intestinal tract. Well-designed research studies suggest that supplementary consumption of certain probiotic strains, primarily Lactobacillus GG, may temporarily alter the intestinal microflora to produce a beneficial effect. Most commercially available strains of lactobacilli and bifidobacteria species are generally considered safe and may be especially helpful in treatment of pediatric diarrheal illnesses. However, clinical

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    1

    Rosemary J. Young is a Pediatric Gastroenterology Clinical Nurse Specialist at the University of Nebraska Medical Center, Omaha

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    Shari Huffman is a Pediatric Nurse Practitioner, Pediatric Gastroenterology and Nutrition, Nemours Children's Clinic, Jacksonville, Fla.

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