Baby Probiotics: When and Whether to Use Them
Medically reviewed by Dr. Sarah Chen, MD, FAAP · Board-Certified Pediatrician
Content reviewed against published AAP, NIH, WHO guidelines
Last reviewed:
Digestive issues are common in infants and toddlers. If your baby is experiencing baby probiotics: when and whether to use them, here is what you need to know.
The short answer
Probiotics are live beneficial bacteria that may help with specific infant digestive issues, but the evidence is mixed and their use should generally be discussed with your pediatrician. The strongest evidence supports Lactobacillus reuteri DSM 17938 for reducing crying time in breastfed infants with colic — a 2018 meta-analysis in Pediatrics found it reduced crying by about 50 minutes per day compared to placebo. Evidence for constipation and diarrhea prevention is less robust. The AAP has not issued a blanket recommendation for routine probiotic use in healthy infants, citing the need for more research on strain-specific effects, optimal dosing, and long-term safety. Probiotics should not be given to premature infants or immunocompromised babies without medical supervision.
Key takeaways
- Probiotics are live beneficial bacteria that may help with specific infant digestive issues, but the evidence is mixed and their use should generally be discussed with your pediatrician. The strongest evidence supports Lactobacillus reuteri DSM 17938 for reducing crying time in breastfed infants with colic — a 2018 meta-analysis in Pediatrics found it reduced crying by about 50 minutes per day compared to placebo. Evidence for constipation and diarrhea prevention is less robust. The AAP has not issued a blanket recommendation for routine probiotic use in healthy infants, citing the need for more research on strain-specific effects, optimal dosing, and long-term safety. Probiotics should not be given to premature infants or immunocompromised babies without medical supervision.
- Usually normal when: Choosing not to give your baby probiotics — they are not required for healthy infants
- Call your doctor if: Baby develops a rash, hives, or breathing difficulty after taking a probiotic — this could indicate an allergic reaction
- Varies by age — see the age-by-age breakdown below
“The biggest concern with vomiting is dehydration. Young children can become dehydrated quickly, so it's important to replace fluids. Offer small amounts of an oral rehydration solution frequently.”
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What Parents Should Know
According to AAP, NIH, WHO guidelines, probiotics are live beneficial bacteria that may help with specific infant digestive issues, but the evidence is mixed and their use should generally be discussed with your pediatrician. The strongest evidence supports Lactobacillus reuteri DSM 17938 for reducing crying time in breastfed infants with colic — a 2018 meta-analysis in Pediatrics found it reduced crying by about 50 minutes per day compared to placebo. Evidence for constipation and diarrhea prevention is less robust. The AAP has not issued a blanket recommendation for routine probiotic use in healthy infants, citing the need for more research on strain-specific effects, optimal dosing, and long-term safety. Probiotics should not be given to premature infants or immunocompromised babies without medical supervision. At 0-3 months, this is the peak period for infant colic, and where probiotic research is strongest. Lactobacillus reuteri DSM 17938 has the best evidence for breastfed colicky infants, with multiple randomized controlled trials showing benefit. The typical dose studied is 10⁸ CFU (100 million colony-forming units) daily. Evidence in formula-fed colicky infants is less clear. Always consult your pediatrician before starting any probiotic in a young infant. It is generally considered normal when choosing not to give your baby probiotics — they are not required for healthy infants. However, you should contact your pediatrician promptly if baby develops a rash, hives, or breathing difficulty after taking a probiotic — this could indicate an allergic reaction.
Normal vs. Concerning
By Age
What to expect by age
0-3 months
This is the peak period for infant colic, and where probiotic research is strongest. Lactobacillus reuteri DSM 17938 has the best evidence for breastfed colicky infants, with multiple randomized controlled trials showing benefit. The typical dose studied is 10⁸ CFU (100 million colony-forming units) daily. Evidence in formula-fed colicky infants is less clear. Always consult your pediatrician before starting any probiotic in a young infant.
3-6 months
As colic typically resolves by 3-4 months, the primary reason to consider probiotics may shift. Some pediatricians recommend probiotics during or after antibiotic use to help restore gut flora, though evidence specifically in this age group is limited. If your baby had colic and benefited from probiotics, your doctor may suggest continuing or tapering off.
6-12 months
With the introduction of solid foods, the gut microbiome undergoes significant changes naturally. Some parents consider probiotics to ease the digestive transition. Limited evidence suggests certain strains may help with acute gastroenteritis (stomach bug) duration, reducing diarrheal illness by about 1 day according to a Cochrane review. Probiotic-containing foods like yogurt can be introduced around 6 months.
12-24 months
Toddlers develop a more diverse gut microbiome through varied diet. Probiotic supplementation is generally unnecessary for healthy toddlers eating a balanced diet. Situations where a pediatrician might recommend probiotics include recurrent diarrheal illness, during antibiotic courses, or specific GI conditions like irritable bowel symptoms.
What to Tell Your Pediatrician
- Describe when you first noticed baby probiotics: when and whether to use them and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you are considering starting a probiotic and want guidance on appropriate strains and dosing.
- Mention if baby has colic (crying more than 3 hours/day, 3 days/week) and you want to discuss probiotic options.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Choosing not to give your baby probiotics — they are not required for healthy infants
- Baby having gas, occasional fussiness, or stool changes without probiotics
- Your pediatrician suggesting a wait-and-see approach rather than recommending probiotics
- Mild gas or temporary stool changes when first starting a probiotic
- You are considering starting a probiotic and want guidance on appropriate strains and dosing
- Baby has colic (crying more than 3 hours/day, 3 days/week) and you want to discuss probiotic options
- Baby is on antibiotics and you want to discuss whether probiotics might help prevent diarrhea
- Baby has recurrent digestive issues like constipation or loose stools
- Baby develops a rash, hives, or breathing difficulty after taking a probiotic — this could indicate an allergic reaction
- Premature or immunocompromised baby develops fever, bloating, or feeding intolerance while on probiotics
- Baby has bloody stools, high fever, or signs of serious infection while taking any supplement
What You Can Do at Home
- Keep track of when you notice baby probiotics: when and whether to use them — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that choosing not to give your baby probiotics — they are not required for healthy infants — this is generally within the range of normal.
- At 0-3 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Keep your baby upright for 20-30 minutes after feeding. Note any patterns between feeds and symptoms.
- While monitoring at home, seek immediate care if baby develops a rash, hives, or breathing difficulty after taking a probiotic — this could indicate an allergic reaction.
Related Conditions
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.
Baby Constipation
Constipation in babies is defined by hard, dry, difficult-to-pass stools rather than by how often your baby poops. Breastfed babies can go several days without a bowel movement and still be perfectly normal. If your baby is passing soft stools comfortably, even if infrequently, they are likely not constipated.
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.
Related Resources
Diarrhea Decision Tree
Evaluate diarrhea severity, dehydration risk, and when to act.
Poop Color & Texture Guide
What your baby's poop color and consistency mean, and when to worry.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is baby probiotics: when and whether to use them normal?
When should I call the doctor about baby probiotics: when and whether to use them?
When is baby probiotics: when and whether to use them normal?
What causes baby probiotics: when and whether to use them?
What should I mention to my pediatrician about baby probiotics: when and whether to use them?
Is baby probiotics: when and whether to use them normal at 0-3 months?
Is baby probiotics: when and whether to use them normal at 3-6 months?
Should I go to the ER for baby probiotics: when and whether to use them?
Does baby probiotics: when and whether to use them go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Baby Probiotics: When and Whether to Use Them.
Things to mention
- Describe when you first noticed baby probiotics: when and whether to use them and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you are considering starting a probiotic and want guidance on appropriate strains and dosing.
- Mention if baby has colic (crying more than 3 hours/day, 3 days/week) and you want to discuss probiotic options.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- You are considering starting a probiotic and want guidance on appropriate strains and dosing
- Baby has colic (crying more than 3 hours/day, 3 days/week) and you want to discuss probiotic options
- Baby is on antibiotics and you want to discuss whether probiotics might help prevent diarrhea
Urgent signs to report immediately
- Baby develops a rash, hives, or breathing difficulty after taking a probiotic — this could indicate an allergic reaction
- Premature or immunocompromised baby develops fever, bloating, or feeding intolerance while on probiotics
- Baby has bloody stools, high fever, or signs of serious infection while taking any supplement
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of baby probiotics: when and whether to use them are normal. Talk to your pediatrician if baby develops a rash, hives, or breathing difficulty after taking a probiotic — this could indicate an allergic reaction.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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Related Digestive Concerns
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.
Baby Constipation
Constipation in babies is defined by hard, dry, difficult-to-pass stools rather than by how often your baby poops. Breastfed babies can go several days without a bowel movement and still be perfectly normal. If your baby is passing soft stools comfortably, even if infrequently, they are likely not constipated.
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.
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.
Can Antibiotics Damage My Baby's Gut?
Antibiotics can temporarily disrupt your baby's gut microbiome, which may cause loose stools, fussiness, or diaper rash during and shortly after treatment. However, when antibiotics are medically necessary, the benefits of treating the infection far outweigh the temporary gut disruption. Most babies' microbiomes recover within weeks to months, especially with breastfeeding and a gradual return to normal feeding patterns.