Original ArticleProbiotic use in children
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
References (51)
- et al.
Protective nutrients and bacterial colonization in the immature human gut
Advances in Pediatrics
(1999) - et al.
Protective nutrients and functional foods for the gastrointestinal tract
American Journal of Clinical Nutrition
(2002) Prevention of diarrhea by the probiotic, Lactobacillus GG
Journal of Pediatrics
(1999)- et al.
Dietary modulation of the human colonic microbiota: Introducing the concept of prebiotics
Journal of Nutrition
(1995) - et al.
Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: A double-blind, placebo-controlled trial
Gastroenterology
(2000) Reduced incidence of necrotizing enterocolitis associated with enteral administration of Lactobacillus acidophilus and Bifidobacterium infantis to neonates in an intensive care unit
International Journal of Infectious Diseases
(1999)- et al.
Improved immunogenicity of oral D × RRV reassortant rotavirus vaccine by Lactobacillus casei GG
Vaccine
(1995) - et al.
Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial
Lancet
(2001) - et al.
Developmental microbial ecology of the neonatal gastrointestinal tract
American Journal of Clinical Nutrition
(1999) - et al.
Breaking the cycle: Treatment strategies for 163 cases of recurrent Clostridium difficile disease
American Journal of Gastroenterology
(2002)
The potential role of probiotics in pediatric urology
Journal of Urology
Gut bacteria and health foods—the European perspective
International Journal of Food Microbiology
Clinical applications of probiotic agents
American Journal of Clinical Nutrition
Feeding of Bifidobacterium bifidum and Streptococcus thermophilus to infants in hospital for prevention of diarrhoea and shedding of rotavirus
Lancet
Demonstration of safety of probiotics—a review
International Journal of Food Microbiology
Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children
Journal of Pediatrics
Practice parameter: The management of acute gastroenteritis in young children
Pediatrics
Prophylactic Lactobacillus GG reduces antibiotic-associated diarrhea in children with respiratory infections: A randomized study
Pediatrics
Treatment of recurrent Clostridium difficile colitis with Lactobacillus GG
Journal of Pediatric Gastroenterology and Nutrition
Prebiotics and human health: State-of-the-art and future perspectives
Scandinavian Journal of Nutrition
Limitations of probiotic therapy in acute, severe dehydrating diarrhea
Journal of Pediatric Gastroenterology and Nutrition
Probiotics in pediatric gastrointestinal disorders
Current Opinion in Pediatrics
Molecular monitoring of succession of bacterial communities in human neonates
Applied Environmental Microbiology
The metabolism of the intestinal microflora and its relationship to dietary fat, colon and breast cancer
Progress in Clinical and Biological Research
Probiotics and gastrointestinal health
American Journal of Gastroenterology
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Use of Probiotics in Pediatrics
2009, Journal of Pediatric Health CareCitation Excerpt :Some probiotic organisms, such as Bifidobacterium, Lactobacilli, Enterococci, and Streptococci, are components of natural human gut flora. In infancy, bacteria ingested during the birthing process or as a result of environmental contacts inhabit the gut and aid in establishing the gastrointestinal flora that will persist for the duration of an individual's life (Young & Huffman, 2003). In the United States, most probiotics are available as food product additives or as supplements in the form of loose powder, tablets, or capsules (Cabana et al., 2006).
Prescribing Probiotics
2007, Integrative Medicine, Second EditionIntestinal bacterial overgrowth syndrome and intestinal inflammation in cystic fibrosis
2007, Pediatria PolskaProbiotic Bifidobacterium bifidum G9-1 attenuates 5-fluorouracil-induced intestinal mucositis in mice via suppression of dysbiosis-related secondary inflammatory responses
2017, Clinical and Experimental Pharmacology and PhysiologyProbiotic Dahi containing Lactobacillus acidophilus and Bifidobacterium bifidum modulates immunoglobulin levels and cytokines expression in whey proteins sensitised mice
2016, Journal of the Science of Food and Agriculture
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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.