Probiotics for Babies: Do They Help With Colic and Gut Health?

Probiotics are live microbes that may help the body when taken in the right amount.

For babies, they usually come as drops.

They are meant to support the gut microbiota, the community of bacteria living in the intestines.

A baby's gut microbiota starts forming at birth and keeps changing during the first years of life.

This early microbiota plays a big role in digestion and in training the immune system.

A newborn's gut is not fully mature.

It is still learning how to digest food and fight off harmful microbes.

When the balance of gut bacteria is off, doctors call this dysbiosis.

Dysbiosis has been linked to infantile colic, which is long, unexplained crying in an otherwise healthy baby.

Dysbiosis has also been linked to problems in premature babies, such as feeding intolerance and necrotizing enterocolitis, a serious bowel injury^[1].

Because of this, researchers have studied whether adding helpful bacteria back into the gut could prevent or ease these problems.

Colic is usually defined as crying for more than three hours a day, more than three days a week, for at least three weeks.

It often starts around two to three weeks of age and fades by three to four months.

The exact cause is not fully known.

Possible causes include gut immaturity, gas, a sensitive nervous system, and an imbalance in gut bacteria.

Colic is exhausting for parents, so any safe tool that helps is worth understanding.

One well studied strain is Lactobacillus reuteri DSM 17938.

This strain is thought to calm gut inflammation and change how the gut and brain communicate through the gut-brain axis.

It may also help crowd out gas producing bacteria in the intestine.

A recent meta-analysis pooled data from 11 randomized, placebo-controlled trials with 555 colicky infants^[1].

Babies given L. reuteri DSM 17938 were much more likely to have a treatment response, meaning at least a 50 percent drop in crying time, compared to placebo^[1].

The odds of responding were nearly seven times higher with the probiotic than with placebo^[1].

Daily crying time was also reduced by more than two and a half hours on average^[1].

These are large effects for a simple daily supplement, though the authors note more well designed trials are still needed^[1].

Premature babies have extra risks because their gut and immune systems are less developed.

Feeding intolerance, when a baby cannot digest milk feeds well, is common in this group.

Necrotizing enterocolitis is rarer but far more serious, since it involves injury to the bowel tissue.

The same meta-analysis reviewed eight trials in preterm newborns, covering 1,704 infants^[1].

Probiotic supplementation lowered the risk of feeding intolerance compared to placebo^[1].

It also lowered the risk of necrotizing enterocolitis^[1].

Babies given the probiotic reached full enteral feeding, meaning full feeding by mouth or tube without IV nutrition, sooner^[1].

They also had shorter hospital stays on average^[1].

There was no significant effect on sepsis, a serious blood infection, in either direction^[1].

Importantly, no safety concerns were reported in these trials^[1].

No, and this is one of the most important points about probiotics in general.

Effects are strain specific, meaning a benefit shown for one strain cannot be assumed for another.

Lactobacillus reuteri DSM 17938 has the most consistent infant research behind it so far^[1].

Other strains studied in infants include various Bifidobacterium and Lactobacillus species, often used alone or in combination.

Dose, the exact bacterial strain, and how long it is given can all change the outcome.

This is why picking a random probiotic off a shelf is not the same as using one studied in trials.

• Talk with a pediatrician before starting any probiotic for a baby.
• Ask specifically about Lactobacillus reuteri DSM 17938 if colic is the concern, since this strain has the strongest evidence^[1].
• For premature infants, probiotic use should only happen under medical supervision in a hospital setting^[1].
• Keep track of crying time and feeding patterns to share with the doctor.
• Continue breastfeeding or formula feeding as recommended, since probiotics are a support, not a replacement for normal feeding.
• Watch for reassurance that no unusual side effects appeared in the studies, but still report any concerns to a doctor^[1].

Otherwise healthy infants with frequent, unexplained crying may be reasonable candidates for a trial of L. reuteri DSM 17938, based on current evidence^[1].

Premature infants at risk for feeding problems or necrotizing enterocolitis are another group where research shows possible benefit^[1].

Babies with diagnosed medical conditions, immune problems, or complex health needs should only use probiotics under close medical guidance.

Full term, healthy babies without colic symptoms do not have strong evidence supporting routine probiotic use.

In the trials reviewed, no safety concerns emerged with L. reuteri DSM 17938 in either colicky infants or preterm newborns^[1].

Still, preterm infants are medically fragile, so any supplement should go through a hospital care team.

Long term effects of early probiotic exposure on the developing microbiota are still being studied.

As with any infant health decision, individual medical history matters.