It’s safe to say that health and wellness have been at the forefront of everyone’s minds this year. But with so much information readily available on the internet, it can be hard to discern fact from fiction. This month, we spoke with Dr. Will Bulsiewicz of Lowcountry Gastroenterology and author of New York Times bestseller Fiber Fueled, who shared research-based insights on the rising popularity of probiotics and their use in children.
Q: What are probiotics, and why are they important?
Probiotics are live microorganisms that have been shown in clinical studies to have benefits to humans. By microorganisms, I’m referring to bacteria and fungi. They are a part of our microbiome, which is the community of invisible, microscopic creatures that live on our skin and in our mouth but are most concentrated in our gut. I know this is going to sound crazy, but we actually have more of these microbes than we have human cells. Yes, you are less than 50% human. There are literally 40 trillion of these microbes as a part of your body. When we take probiotics, we are trying to boost the levels of the good microbes that go out of their way to help us be healthy humans. We can find probiotics in a supplement, but the tried and true way to get your probiotics is in your diet.
Q: What are the benefits of probiotics for kids?
First off, I just want to say that the hype is outpacing the science when it comes to probiotics. The industry is generating literally billions of dollars, and as a gastroenterologist, I definitely don’t see probiotics as being worth that much money to my patients. It’s important that we require our probiotics be proven by science. Otherwise, we could be wasting our money or, even worse, may be hurting ourselves. This becomes even more imperative when we are discussing a developing child. But there are definitely scientifically proven indications for probiotics in children, including treatment of a stomach bug, as a treatment for eczema or colic in infants, and in the treatment of abdominal pain related to irritable bowel syndrome.
Q: What are some of the best probiotic food sources that families can incorporate into their diet?
One of my favorite recent studies showed that apples have probiotics. Let me break this down a little bit ... Basically, the apple has a microbiome just like we as humans have a microbiome. The apple microbiome helps it to grow and thrive as it develops from flower to fruit. When we pick up and eat an apple, we are consuming the invisible microbes that are a part of that apple’s microbiome—100 million strong and literally thousands of species. We now see that many of those microbes are beneficial to humans (they certainly aren’t hurting us!) and that they mix and interact with our microbes. In other words, you can get probiotics by eating an apple. Yet another reason why they keep the doctor away. But here’s my main point, all living food—fruits and vegetables—have a microbiome. You don’t need a capsule; you just need to eat more real food.
Q: Are probiotic supplements safe for children? And what are some reasons families should consider using probiotic supplements?
Probiotics are generally considered safe, but we still have a long way to better understand the role of probiotics. To give you an example ... for years, I would treat my patients with a probiotic after taking an antibiotic. The idea was that the antibiotic destroys the microbiome, so let me bring it back by sprinkling the probiotics in there. It makes sense, right? Well, in 2018, a study came out that showed that when you treat a person with probiotics after antibiotics, you actually SLOW the recovery of the microbiome. In other words, you have the opposite effect of what you were hoping to accomplish. And this is the reason why we need clinical research because things don’t always work the way we assume they will. So when it comes to probiotics in our kiddos, we should be discussing it with our pediatrician and sticking to only using them when we have research studies to support them.
Q: When choosing a probiotic supplement, what should parents look for?
The most important thing is that you select a probiotic that’s actually been demonstrated in a clinical study to be beneficial for that specific indication. Generally, we consider multiple different strains (the different species in the probiotic) and higher numbers of probiotic microbes (labeled on the packaging as colony-forming units, or CFU’s) to be better. But above all else, I trust the one that’s actually been demonstrated in a research study to work. This is why it’s best to discuss it with your pediatrician, who can give you guidance on which probiotic may be best for your child.
Q: Can you give a child too many probiotics?
It’s always possible to have too much of a good thing. We need oxygen to live, but believe it or not, 100% oxygen (which we administer in the hospital sometimes) can actually be toxic if given for too long. And too much kale can cause kidney stones! But you should still eat your kale and regularly breathe oxygenated air. There aren’t many studies to show probiotics causing harm, which is somewhat reassuring. But if you notice that your child has a reaction that you worry is attributable to the probiotics, then you should stop the probiotic immediately and discuss it with your pediatrician.
For more on the connection between the foods we eat and our immune system, follow Dr. B on Instagram @TheGutHealthMD