Latching on to probiotics for kids
Parents find benefits in giving their infants gut-health supplements Marie-Claire Arrieta co-wrote
When Yael Baruch brought her infant daughter, Lacey, home from the hospital in early May, it was an especially momentous event for the Toronto mom of three and her husband, Ronnie Basch.
That’s because their newborn had made a surprise appearance eight weeks before her expected due date, extending their hospital stay to four weeks. As is common among babies born prematurely, Lacey began having a little extra trouble with her digestion.
“Lacey was showing signs of discomfort with lots of gas and tummy aches,” Baruch says. “When we were in the NICU (neonatal intensive care unit), lots of babies were taking Biogaia for digestion issues.”
So on the advice of their NICU nurse, says Baruch, they decided to begin giving the popular baby probiotic drops to their tiny girl.
“It’s been two weeks and we definitely see an improvement.”
As science begins to reveal more about the roles that good bacteria play in our lives — including in digestion as well as our broader immune systems — parents are cottoning on to the potential benefits of administering probiotics to their infants, supplements containing billions of good bacteria.
“Whether it’s going to improve the health of a baby that’s already healthy, I personally really doubt it,” says microbiologist Marie-Claire Arrieta, an assistant professor at the University of Calgary.
“With that said, we know that probiotics are safe,” says Arrieta, also a mother of two and co-author of Let Them Eat Dirt: Saving Our Children From an Oversanitized World.
While there’s no official rec- ommendation for broad use of pediatric probiotics, there are many conditions that can be improved by using them — colic and premature birth among them, she says.
“Preemies have it hard and part of the reason is their guts are really under developed and they’re not really ready to face the world,” she says.
But that doesn’t mean every parent of an infant should necessarily rush to the pharmacy or vitamin shop to get probiotics for their baby.
The Canadian Paediatric Society doesn’t have a current position on probiotics.
Its last statement on the subject was in 2015, and a spokesperson for the group says that’s not recent enough to still be referenced for this article. The upshot at the time, though, was that literature suggests there are benefits to using probiotics for treating some conditions, but that more research is needed.
During that time, though, use of probiotics has continued to become more mainstream.
Registered nutritionist Lianne Phillipson, author of Sproutright: Nutrition to Tummy to Toddler, says the interest from her clients and their confidence in giving probiotics to their children has increased in recent years. “When I was doing my Mommy Chef classes 10 years ago and I would recommend probiotics, parents would go to their doctors and many would come back and say ‘My doctor thinks you’re a quack’ and says ‘don’t waste your money.’”
Since that time, though, there’s been more research, and “the microbiome is talked about so much more,” she says.
In humans, the microbiome is the mini-ecosystem of microbes within our guts.
Babies are born without them and our early exposures to microbes is what kick-starts our immune system, Arrieta says.
In Let Them Eat Dirt, she and her co-author, esteemed microbiologist Brett Finlay, stressed the importance of rethinking the modern-day habit of blasting natural microbes away with overuse of antibacterial soaps, sanitizer and antibiotics. So, too, has knowledge changed in the past five years about how babies come into contact with crucial good bacteria right as they’re born, Arrieta says. “We now know that babies born via C-section, for a number of weeks have different microbiomes than babies that are born vaginally, and now we know it’s because of the passage through the vaginal canal.”
Having heard about this possible connection between the immune-boosting microbiome and mode of delivery, expectant parents of babies born through planned Caesarean sections have become interested in trying to make a C-section birth look a little more like vaginal deliveries, at least from a microbial perspective, perhaps heading off a need for oral probiotics.
This has given rise to a do-ityourself practice known as vaginal seeding, explains obstetrician Chelsea Ellwood, a Vancouver-based reproductive infectious disease specialist and spokesperson for the Society of Obstetricians and Gynecologists of Canada (SOGC).
“And that practice is where (parents) take some gauze, place it in the vagina, and they rub it all over the baby’s face and put it in the mouth and all over the baby after delivery, to try and mimic the process that would go on theoretically during a vaginal birth.”
Parents pack their own gauze for the procedure and hospitals don’t stand in the way, says Ellwood, but “this practice has come about with basically no evidence to support it.”
What research has shown is that an infant’s gut microbiome looks different if they were born vaginally or through Csection.
Additionally, Ellwood says, one retrospective study made a link between infant gut microbiome at 3 months potentially influencing a scoring system that might mean the infant has a higher risk of developing asthma at two to three years.
“And thus the leap was made that the way the baby comes out influences the infant’s gut microbiome at three months, that subsequently influences the inf ant’s long-term adverse health-outcome risk.”
Physicians cannot recommend a practice unless they know it does no harm, and Ellwood warns there’s no safety data on vaginal seeding.
Direct oral contact with a gauze soaked in bodily fluids could expose babies to an undiagnosed infection from the mother in a different, more adversarial way than they would have through vaginal delivery, she says.
Gabrielle Cassir, an obstetrician at Mount Sinai Hospital in Toronto, shares the same safety concerns.
“Patients that do deliver vaginally are usually screened for group B streptococcus,” she explains.
“People who have elective Csections are not necessarily screened for it.”
But it’s important to note that the moment of birth isn’t the only opportunity to give newborns a microbial good start.
“A very important aspect to discuss with patients is that breastfeeding may be the best way to have good microbes flourish,” Cassir says.