Probiotic Evidence for Babies
The short answer
Evidence for probiotics in babies varies by condition. Lactobacillus reuteri has the strongest evidence for reducing colic in breastfed infants. Saccharomyces boulardii can help prevent antibiotic-associated diarrhea. For general "gut health," evidence is limited. Probiotics are generally safe for healthy term infants but should be discussed with your pediatrician before starting.
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By Age
What to expect by age
Lactobacillus reuteri DSM 17938 has shown benefit in reducing crying time in breastfed babies with colic when started early. Probiotics are generally safe for healthy full-term infants. Premature infants in the NICU may receive specific probiotics under medical supervision to reduce the risk of necrotizing enterocolitis.
If your baby is taking antibiotics, your pediatrician may recommend Saccharomyces boulardii or Lactobacillus GG to reduce antibiotic-associated diarrhea. Give the probiotic 2 hours apart from the antibiotic dose. Evidence for probiotics preventing eczema or allergies is mixed and not conclusive.
For acute viral gastroenteritis, Lactobacillus GG may slightly reduce the duration of diarrhea. Probiotics are not harmful but are not a substitute for oral rehydration. Fermented foods like yogurt with live cultures are natural sources of probiotics as solid foods expand.
Toddlers can get probiotics from yogurt, kefir, and other fermented foods. Supplemental probiotics may be considered during antibiotic courses or for recurrent digestive issues. The evidence for daily probiotic supplements in healthy toddlers is not strong enough to make a blanket recommendation.
What Should You Do?
When to take action
- Using a well-studied probiotic strain under your pediatrician's guidance for a specific condition
- Offering yogurt with live cultures as part of a balanced diet
- You want to discuss whether a probiotic would benefit your baby's specific condition
- Your baby has colic and you want to try Lactobacillus reuteri
- You need guidance on which probiotic strain and dose is appropriate
- Your baby develops a negative reaction (increased fussiness, rash, or worsening symptoms) after starting a probiotic
- An immunocompromised infant is being considered for probiotics, which requires careful medical guidance
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
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Related Digestive Concerns
Antibiotic-Associated Diarrhea in Baby
Diarrhea during or after antibiotic use is very common in babies because antibiotics kill beneficial gut bacteria along with the infection-causing ones. It typically resolves within a few days of completing the antibiotic course. Probiotics (particularly Saccharomyces boulardii or Lactobacillus) may help reduce antibiotic-associated diarrhea when given alongside the medication.
Gas Relief Drops (Simethicone) for Baby
Simethicone gas drops (brand names Mylicon, Little Remedies Gas Relief) are safe for babies and work by breaking up gas bubbles in the stomach, making them easier to pass. They are not absorbed into the body. While they are very safe, research shows mixed evidence on whether they significantly reduce gas symptoms compared to placebo. They are worth trying but do not work for all babies.
Colic Remedy Drops Effectiveness
Most over-the-counter colic drops and remedies have limited scientific evidence supporting their effectiveness. Simethicone has some safety data but mixed efficacy evidence. Lactobacillus reuteri probiotics have the strongest evidence for breastfed babies with colic. The most important thing to know is that colic resolves on its own by 3 to 4 months regardless of treatment.
My Baby's Belly Looks Swollen
A rounded, slightly protruding belly is completely normal in babies and toddlers due to immature abdominal muscles and their proportionally larger organs. However, if the belly becomes suddenly swollen, feels hard and tight, or is accompanied by pain, vomiting, or changes in bowel movements, it needs medical evaluation as it could signal gas buildup, constipation, or rarely, something more serious.
My Baby Has an Anal Fissure (Blood When Pooping)
A small streak of bright red blood on the surface of your baby's stool or on the diaper is most commonly caused by an anal fissure, which is a tiny tear in the skin around the anus from passing hard stool. Anal fissures are very common in babies and toddlers and usually heal on their own with simple measures like keeping stools soft. While this is rarely serious, any blood in your baby's stool should be mentioned to your pediatrician.
Tummy Massage for Baby Gas
Gentle abdominal massage can help relieve gas and discomfort in babies by encouraging gas to move through the intestines. The technique involves gentle clockwise circular motions on the belly (following the direction of the digestive tract), the "I Love U" stroke pattern, and gentle knee-to-tummy movements. Massage also provides comforting touch that can soothe a fussy baby.