By Nicolas Peters, MD
Many people have heard about using probiotics for stomach and intestine
problems and, in fact, several studies have shown them to be effective
in children for treating viral diarrhea and preventing diarrhea that occurs
during antibiotic treatment., Some experts are even recommending their use for infant colic. Recent research suggests probiotics may even help depression. One area where increasing evidence supports the use of probiotics in
children is for the common cold, also known as a viral upper respiratory
infection (URI). They have shown promise in not just preventing infections
but also in shortening duration of symptoms when children become ill.
What are probiotics?
Probiotics are known as “friendly bacteria,” that help maintain
the natural balance of organisms (microflora) in the human gastrointestinal
(GI) tract. A typical GI tract contains several hundred types of micro-organisms
that are able to promote healthy digestion and reduce the growth of harmful
bacteria. The most well- known probiotics are Lactobacillus acidophilus,
occurring naturally in yogurt, and Bifidobacterium, commonly found in
the gut of breast-fed infants.
From: Norton H. What Are Probiotics? The Huffington Post UK. April 12, 2014.
http://www.huffingtonpost.co.uk/henrietta-norton/what-are-probiotics_b_6261072.html Accessed 12/10/2015.
URIs are a significant burden to the healthcare system, filling Pediatricians’
offices during fall and winter. They are also an economic strain as family
members often have to take off work to care for a ill child. Since they are easily passed from person to person, preschool children
are three times more likely to get a URI an infection than those staying at home.
A group of researchers in Washington, DC found that giving a probiotic
drink to 3 to 6 year olds in a daycare/school for 90 days had a 20% decrease
in URIs compared with children who were not on probiotics.
During the 2010-2011 cold and flu season, 3 to 6 year olds were studied
in a preschool in Slovakia and were given a chewable probiotic tablet
with vitamin C, or placebo. After the 6 months the probiotic/vitamin C
group showed 33% reduction in URIs, an average of 21 days shorter duration
of symptoms, 30% decrease in school absences, and fewer days on cough
medicine, painkillers, or nasal sprays.
A review out of the UK of eight studies in children found fewer numbers
of days absent from day care / school in those who had taken probiotics
compared with those who took a placebo.
A study of children attending day care in Finland gave probiotics of placebo
for 28 weeks. The children given probiotics experienced cold symptoms
on 6 ½ days fewer per month compared to the control group.
In another Finnish study, 1-6 year olds attending day care were given milk
with a probiotic for 7 months over the winter. The children showed a 17%
decrease in the rate of URIs compared to those who got milk without the
probiotic. An unexpected and interesting finding came when the stool of
the children was tested for the presence of the probiotic strain. The
children who received the probiotic milk had a 79% increase in the probiotic
in their stool (as expected), but the control group, who did not receive
the probiotic, showed a 11% increase in their stool. This supports what
every parent of a preschool child knows: as much as you try to wash their
hands, they inevitably share germs with each other.
Recently, a Cochrane review was completed to assess the effectiveness probiotics
in preventing URIs. This meta-analysis concluded that in children given
probiotics, the odds of getting a URI was 43% less than children who did
not take probiotics. When the data was focused on children who experienced
3 URIs that season, the odds improved to a 56% decreased in those received
Often, when probiotics are studied in children, only one strain at a time
is used. Information suggests combinations of probiotic strains may have
an additive or even synergistic effect. One study so far has sought to determine if 2 strains were more effective
than one. Children between 3 and 5 years of age attending day care were
given probiotic powders 7 days a week for 6 months. The groups that received
probiotics had significantly fewer episodes of fever, cough, and runny
nose. The double probiotic group showed an improvement to a greater degree
than the single probiotic group. The double probiotic group also showed
shorter duration of symptoms when they did occur, compared to the control
group and compared with the single probiotic group.
As research has shown, a healthy GI tract supported with probiotics can
be beneficial in preventing colds and decreasing the duration of symptoms
in small children. Much more research is needed to determine the ideal
dose and strains of probiotics to use. But in the meantime, chances are
good that some probiotics are better than none.
Hao Q, Dong BR, Wu T. Probiotics for preventing acute upper respiratory
tract infections. Cochrane Database Syst Rev. 2015 Feb 3;2:CD006895.
 Timmerman HM, et al. Monostrain, multistrain and multispecies probiotics--A
comparison of functionality and efficacy. Int J Food Microbiol. 2004 Nov
 Leyer GJ, Li S, Mubasher ME, Reifer C, Ouwehand AC. Probiotic effects
on cold and influenza-like symptom incidence and duration in children.
Pediatrics. 2009 Aug;124(2):e172-9.