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Moderate evidenceGut health

Children's Probiotics

Kid-dosed probiotic drops and powders, mostly Lactobacillus reuteri or Saccharomyces boulardii. The evidence is strain-specific and situation-specific: useful for colic in breastfed infants and for shortening acute diarrhoea, weak for everything else.

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What the science says

  • Colic in breastfed infants Moderate evidence

    An individual-participant-data meta-analysis of four double-blind trials (345 infants) found L. reuteri DSM 17938 cut crying and fussing by about 25 minutes a day at 21 days, with a number needed to treat of roughly 3 in breastfed infants. The effect was not significant in formula-fed infants.

  • Preventing colic in healthy newborns Limited evidence

    A Cochrane review of six trials in 1886 newborns found the evidence for prophylactic probiotics to prevent colic inconsistent and of low certainty, so giving probiotics to a well baby to avoid colic is not supported.

  • Acute gastroenteritis Moderate evidence

    A network meta-analysis of 174 trials in over 32,000 children ranked Saccharomyces boulardii plus zinc among the more effective options for shortening diarrhoea, by roughly 35–40 hours. However, two large trials in high-income emergency departments found no benefit for Lactobacillus rhamnosus GG, so the effect appears to depend on setting and strain.

Dosage & safety

Studied doseL. reuteri DSM 17938: 5 drops (about 10^8 CFU) once daily for 21–28 days in the colic trials. S. boulardii: 250–500 mg per day for the duration of acute diarrhoea. Doses are strain-specific; a product's CFU count says little without the strain code.
SafetyGenerally well tolerated in healthy children. Live probiotics should be avoided in premature or immunocompromised infants, children with central venous lines, and those who are critically ill, where bloodstream infections have been reported. Check for milk or soy carriers in flavoured powders.

How to take it

TimingL. reuteri drops once daily; S. boulardii for the duration of the diarrhoea episode.
With food?With a feed or meal, but never stirred into hot food or drink, which kills the organisms.
Worth knowingS. boulardii is a yeast, so it keeps working through an antibiotic course while bacterial probiotics do not.

Interactions

With medications

  • antibiotics

    Antibiotics kill bacterial probiotics such as L. reuteri. separate by at least 2 hours and continue for a week or two after the course

  • antifungal medication (fluconazole, nystatin)

    S. boulardii is a yeast, so antifungals kill it and cancel the benefit. do not give the two together

  • immunosuppressants and chemotherapy

    Bloodstream infections have been reported in immunocompromised and critically ill children. do not give without the treating doctor's approval

Well-established interactions only — this is not a complete list. Always tell your doctor and pharmacist what you take.

Frequently asked questions

Do probiotics help colic in babies?

For breastfed infants, yes, with moderate evidence: L. reuteri DSM 17938 cut crying by about 25 minutes a day at 21 days in a pooled analysis. The effect was not significant in formula-fed infants, and preventive use in well newborns is not supported.

Do probiotics help children with diarrhea?

Some do: Saccharomyces boulardii plus zinc ranked among the more effective options, shortening diarrhoea by roughly 35–40 hours, with moderate evidence. Two large trials found no benefit for Lactobacillus rhamnosus GG, so strain and setting matter.

What dose of children's probiotic should I give?

In colic trials, L. reuteri DSM 17938 was given as 5 drops once daily for 21–28 days; S. boulardii was given at 250–500 mg per day for the duration of acute diarrhoea. Children's probiotic doses are strain-specific.

Are probiotics safe for children?

Children's probiotics are generally well tolerated in healthy children, but avoid them in premature or immunocompromised infants, children with central lines and those critically ill. Do not give S. boulardii with antifungals such as fluconazole or nystatin.

Scientific references

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