Probiotics
Specifically for Colic
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Why it works for Colic:
Strain-specific effects on the gut–brain axis. The best-studied strain is Limosilactobacillus (Lactobacillus) reuteri DSM 17938. In breastfed infants with colic it has repeatedly reduced daily crying/fussing time versus placebo, with benefits evident by ~3–4 weeks. An individual participant data meta-analysis (IPD-MA) across RCTs found treated infants were ~1.7× more likely to achieve ≥50% crying reduction by day 21 than placebo; effects were clear in breastfed infants and uncertain in formula-fed infants. Pediatrics
Plausible mechanisms. Studies show L. reuteri DSM 17938 can colonize the infant gut, shift the microbiota (e.g., lower E. coli), and reduce intestinal inflammation (e.g., lower fecal calprotectin), changes that track with less crying. Some work also suggests immunomodulation (↑FOXP3⁺ regulatory T-cell markers). Nature
Guideline support (with nuance). The European paediatric GI society (ESPGHAN) says clinicians may recommend L. reuteri DSM 17938 at 1×10^8 CFU/day for ≥21 days for breastfed infants with colic (moderate certainty; weak recommendation). Evidence remains insufficient to recommend it for formula-fed infants. ESPGHAN also notes emerging (weaker) evidence for Bifidobacterium animalis subsp. lactis BB-12 in breastfed infants. ESPGHAN
How to use for Colic:
Choose the right strain & dose.
- L. reuteri DSM 17938: 1×10^8 CFU once daily for at least 21 days (used in most trials/guidelines). ESPGHAN
- Alternative (if advised by your clinician): B. lactis BB-12: 1×10^8 CFU once daily for 21–28 days (evidence moderate, recommendation weak, breastfed infants). ESPGHAN
Formulations. Infant formulations are typically oil-based drops. Match the exact strain name (e.g., “DSM 17938”) and CFU per daily dose on the product label to the above. (ESPGHAN stresses strain-specific recommendations.) ESPGHAN
Feeding type matters. Expect benefit primarily in exclusively or predominantly breastfed infants; trials show mixed/insufficient results in formula-fed infants. Pediatrics
Duration & reassessment. Trial for 3–4 weeks. If there’s no meaningful improvement, discontinue and re-evaluate other causes/strategies with your clinician (normalizing expectations, soothing techniques, cow’s-milk protein trial if indicated, etc.), per guideline tone. ESPGHAN
Scientific Evidence for Colic:
IPD meta-analysis (most decisive):
L. reuteri DSM 17938 reduced crying/fussing; clear effect in breastfed infants; not proven in formula-fed. Pediatrics
ESPGHAN 2023 position paper (guideline):
Recommends L. reuteri DSM 17938 1×10^8 CFU/day for ≥21 days for breastfed infants with colic (moderate certainty; weak). Also “may recommend” B. lactis BB-12 1×10^8 CFU/day for 21–28 days in breastfed infants. ESPGHAN
Representative RCTs (dose and effects):
- J Pediatr 2013: DSM 17938 1×10^8 CFU/day for 21 days in breastfed infants → ↓ crying vs placebo. MyCME
- BMJ 2014 community RCT (breast & formula-fed): mixed overall; supports “breastfed benefit/formula uncertain” pattern. BMJ
- Phase 1/II safety/biomarker trial: DSM 17938 5×10^8 CFU/day for 42 days—safety & inflammatory/microbiome outcomes reported. Journal of Pediatrics
Mechanistic/biomarker studies:
- Reduction in fecal calprotectin and immune modulation (↑FOXP3/↓RORγ) with DSM 17938 alongside symptom improvements. Journal of Pediatrics
- Microbiota shifts (e.g., reduced E. coli) associated with less crying. Nature
Prevention vs treatment:
Cochrane review on prevention: little/no effect on preventing colic, though crying time may be reduced; i.e., use is mainly for treatment, not prevention. Cochrane
Specific Warnings for Colic:
Use only in healthy, term infants unless your clinician says otherwise. Major pediatric bodies warn against routine probiotic use in preterm infants due to rare but real risks of invasive infection and product quality issues. The U.S. FDA has issued a safety communication about risk of invasive disease in preterm infants given probiotics. U.S. Food and Drug Administration
Immunocompromise/serious illness/indwelling lines: Avoid probiotics (or use only under specialist advice) in infants who are immunocompromised, critically ill, or have central venous catheters—case reports of probiotic-related sepsis exist (primarily in hospital/preterm settings). U.S. Food and Drug Administration
Product quality matters. Probiotic effects are strain-specific and many supplements lack pharmaceutical-grade oversight; mislabeling/contamination have been reported. Choose reputable products that clearly list strain (e.g., DSM 17938) and CFU/dose; discuss with your clinician. (AAP commentary and report emphasize these concerns.) Pediatrics
Expected side effects. Usually mild (temporary gas/bloating). Stop and seek medical care if your baby develops fever, poor feeding, lethargy, or appears ill. (General safety stance reflected in guideline/report language.) ESPGHAN
General Information (All Ailments)
What It Is
Probiotics are live microorganisms—primarily bacteria and some yeasts—that provide health benefits when consumed in adequate amounts. They are often called “good” or “friendly” bacteria because they help maintain a healthy balance of microorganisms in the gut microbiome. Common probiotic strains include Lactobacillus, Bifidobacterium, and Saccharomyces boulardii. These beneficial microbes are naturally found in fermented foods like yogurt, kefir, sauerkraut, kimchi, miso, and some cheeses, as well as in dietary supplements.
How It Works
Probiotics support the body’s natural microbial balance, primarily within the gastrointestinal (GI) tract. They work through several mechanisms:
- Restoring Gut Flora Balance: When the gut microbiota becomes imbalanced due to factors such as antibiotics, poor diet, or illness, probiotics help repopulate it with beneficial bacteria, crowding out harmful microbes.
- Enhancing Digestive Function: Probiotics aid in breaking down food, fermenting dietary fiber, and producing essential nutrients such as short-chain fatty acids and certain vitamins (e.g., B12 and K2).
- Supporting the Immune System: A large portion of the immune system resides in the gut. Probiotics interact with intestinal cells to strengthen the gut barrier, modulate immune responses, and reduce inflammation.
- Producing Antimicrobial Substances: Some probiotic strains produce natural compounds that inhibit or kill harmful bacteria, including Clostridium difficile and E. coli.
- Communication with the Gut-Brain Axis: Emerging research shows that probiotics may influence mood and cognitive function by interacting with the gut-brain axis, affecting neurotransmitters such as serotonin.
Why It’s Important
Maintaining a balanced gut microbiome is crucial for overall health. Probiotics contribute to several key areas:
- Digestive Health: They can help prevent or alleviate diarrhea (especially antibiotic-associated), reduce symptoms of irritable bowel syndrome (IBS), and support recovery from inflammatory bowel diseases like Crohn’s disease and ulcerative colitis.
- Immune Defense: Regular intake of probiotics may lower susceptibility to respiratory and gastrointestinal infections by improving immune response and reducing inflammation.
- Metabolic Health: Certain strains are linked to improved metabolism, better weight management, and enhanced insulin sensitivity.
- Mental and Emotional Well-being: By supporting the gut-brain axis, probiotics may help alleviate anxiety, depression, and stress-related symptoms in some individuals.
- Allergy and Skin Support: Probiotics can reduce the risk or severity of eczema and other allergic reactions by modulating immune tolerance.
Considerations
While probiotics are generally safe for most people, several factors should be considered:
- Strain-Specific Effects: Not all probiotics are the same. Each strain has unique effects, so choosing the right one for a specific condition is important. For instance, Lactobacillus rhamnosus GG is effective for diarrhea, while Bifidobacterium longum may help with IBS.
- Quality and Viability: Probiotic products vary in quality. The number of live organisms (measured in CFUs—colony-forming units) and storage conditions affect their efficacy. Look for products tested for stability and verified for potency through expiration.
- Possible Side Effects: Some individuals may experience mild bloating, gas, or digestive discomfort initially. These symptoms usually subside as the body adjusts.
- Health Conditions: People with compromised immune systems (e.g., those undergoing chemotherapy, critically ill, or with central venous catheters) should consult a healthcare provider before using probiotics, as infections, though rare, can occur.
- Regulation and Evidence: Probiotics are classified as dietary supplements in many regions, meaning they are not as strictly regulated as medications. Scientific evidence varies depending on strain, dosage, and condition studied, so results are not universally guaranteed.
Helps with these conditions
Probiotics is most effective for general wellness support with emerging research . The effectiveness varies by condition based on clinical evidence and user experiences.
Detailed Information by Condition
Acid Reflux (GERD)
Microbiome angle: Long-term acid suppression (PPIs) can disturb gut microbiota and is linked with small-intestinal bacterial overgrowth (SIBO). Probio...
IBS
Probiotics are live microorganisms that confer health benefits to the host when administered in adequate amounts. In the context of IBS, probiotics ma...
Constipation
Probiotics may relieve constipation by:Modulating the gut microbiota and enhancing fermentation, which increases production of short-chain fatty acids...
Crohn's Disease
The effectiveness of probiotics in treating Crohn's disease is a subject of ongoing research and is not as clearly established as it is for other infl...
Stomach Ulcers
Probiotics have garnered attention as a complementary approach in the treatment of stomach ulcers. These live microorganisms, when administered in ade...
Acne
Tame inflammation & rebalance microbes (gut–skin axis). Oral probiotics can reduce inflammatory signaling and shift microbial patterns associated...
Eczema
Gut–skin & skin microbiome effects. People with eczema often show gut dysbiosis and Staph aureus overgrowth on skin; certain probiotic strains may...
UTI
Restore protective vaginal flora. In many women with recurrent UTI (rUTI), protective vaginal Lactobacillus species are depleted and uropathogens (oft...
Leaky Gut Syndrome
They can strengthen the intestinal barrier. Multiple mechanistic reviews show specific probiotic strains up-regulate tight-junction proteins (e.g., oc...
SIBO
Competitive exclusion & ecological replacement: some probiotic strains compete with overgrown bacteria, reduce pathogen adhesion, or secrete subst...
Allergies (Hay Fever)
Immune re-balancing (Th1/Th2 & Tregs): Several reviews and a 28-trial meta-analysis suggest certain probiotic strains can modestly reduce nasal/ey...
H. Pylori Infection
Multiple mechanisms of action: Probiotics work through competitive inhibition, co-aggregation ability, enhancing mucus production, production of bacte...
Gastritis
Improve microbial balance & reduce dysbiosis. Probiotics can help restore a healthier stomach/intestine microbial community after infection or ant...
Interstitial Cystitis
IC/BPS shows microbiome differences (urinary, vaginal and gut) versus controls, suggesting dysbiosis could contribute to symptoms; this motivates inte...
Celiac Disease
Restore a healthier gut microbiota / correct dysbiosis. People with CeD often show altered intestinal microbiota (lower bifidobacteria, altered lactob...
Food Allergies
Probiotics show promise — especially certain strains (eg. Lactobacillus rhamnosus GG and some multi-strain mixes) — for helping induce tolerance in so...
Gastroparesis
Alter gut microbiota and reduce SIBO. Slow gastric/small-bowel motility in gastroparesis predisposes to small intestinal bacterial overgrowth (SIBO)....
Mold Exposure
1) Dietary mycotoxins (e.g., aflatoxin) from moldy foodsCertain probiotic strains can bind or metabolize mycotoxins in the gut, potentially reducing a...
Colic
Strain-specific effects on the gut–brain axis. The best-studied strain is Limosilactobacillus (Lactobacillus) reuteri DSM 17938. In breastfed infants...
Ear Infections
Microbiome “interference” in the nose/throat (nasopharynx): Some commensal strains (e.g., Streptococcus salivarius 24SMB/K12) can compete with common...
Colorectal Cancer
Microbiome modulation & barrier support. CRC is associated with dysbiosis; select probiotics can shift microbial composition, strengthen epithelia...
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Helps With These Conditions
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