Pediatric Probiotics: What You Need to Know
By Cris Pearlstein
As a mom I’m always thinking about how to keep my 4-year-old as healthy as possible. Oftentimes this centers around the food she eats, but lately I’ve been very curious about supplements—specifically probiotics. I have a handful of friends who swear by the brand Seed, and I was so intrigued I reached out to see what they’re all about. Seed is a company that is working to “develop research-backed probiotics for outcomes across gastrointestinal, dermatological, oral, pediatric and nutritional health”, and they just launched their first for kids and adolescents age 3-17.
I caught up with co-founder and co-CEO Ara Katz to get the scoop on pediatric probiotics and what parents need to know. She says, “There’s a heavy burden on the consumer to know what they are purchasing does what it claims to do…to personally confirm the claims can require a lot of time and attention, and often be overwhelming.” I couldn’t agree more, and I realized that’s probably why I’ve never landed on a probiotic for my daughter. Who has the time to comb through scientific research?
Read on for my conversation with Ara, where she breaks down everything you need to know about probiotics, along with some easy-to-digest information about gut health. No pun intended.
What are probiotics? What should parents know about them?
Navigating the world of probiotics can feel impossible—and that’s not an accident. The FDA classifies probiotics as a “dietary supplement” (a regulated yet very under-enforced category), which means the industry can take advantage of “gut mania” by slapping a “probiotic” label on, well, pretty much anything.
Scientifically speaking, probiotics are ‘live microorganisms that, when administered in adequate amounts, confer a health benefit on the host’ (as defined by a 2002 UN-WHO expert panel, chaired by Seed’s Scientific Board Member, Dr. Gregor Reid).
One of the biggest misconceptions about probiotics is that they can be obtained from fermented foods and beverages like yogurt, kombucha, and kimchi. While it’s certainly possible for some to meet the scientific criteria for a ‘probiotic’, most fall short. Just because something contains live microorganisms, doesn’t mean it satisfies the definition.
Don’t be fooled by products just because they have many strains or high CFU counts (with labels in the billions!). More bacteria doesn’t always mean more effective – the key is the research-derived dosage.
What should parents look for when choosing a probiotic for their children?
When choosing a probiotic for your kiddos look for:
- Strain-level specificity. For any probiotic product, it’s important to look at what strains (not just species) are present in the product. When it comes to probiotics, benefits are clinically-assessed on the strain level.
- Ensure there is scientific evidence behind the benefits being claimed. It’s important to know that what your kids are taking has been studied in a pediatric population to not only have a beneficial effect, but also to ensure its safety.
- The product should guarantee survivability and stability throughout manufacturing, shelf-life, and digestion. In other words, the product should survive the potential heat and humidity it may encounter during shipping and storage and the trip through your child’s GI tract.
And above all, when you’re shopping for probiotics, look for one that makes all that evidence visible—and actually understandable—to you as a parent. I believe the onus of accountability should be on the company, not the consumer. But as this isn’t yet the norm, my central guidance is this: find companies you believe in, with values aligned with yours, with science and products you trust.
Do kids need probiotics to be healthy?
Probiotics are not absolutely necessary for a child to be healthy. That said, the last decade of research has illuminated the significant role of the microbiome in a developing child. Factors like diet, exercise, environment, use of antibiotics, sleep, and hygiene can impact critical windows of development and inform their systemic health through adulthood. Probiotics (and prebiotics), alongside foundational lifestyle factors, can provide support for a healthy microbial ecosystem.
Some quick stats:
- approximately 11% of young children experience antibiotic-associated diarrhea
- up to 29% of the pediatric population worldwide are classified as clinically constipated
- 50% of children with constipation still having problems after 5 years of treatment
These, along with countless other children simply experiencing anxiety or strain related to pooping, mean there are millions of children globally who can benefit from the digestive and GI impact of clinically validated probiotics.
An additional consideration is that our modern living practices and daily choices—such as more time spent indoors, poor diet, lack of fiber, antibiotic overuse, and other environmental factors—can disrupt the microbiome, especially in critical windows of development for children. For these reasons, specific probiotics can be an impactful way to nurture and support a child’s microbiome and systemic health beyond digestion.
What is it about probiotics that can improve a child’s health, specifically as it pertains to their gut?
While it’s true that today, most parents and caregivers are looking for a probiotic to support (or optimize) gastrointestinal function and digestive health, it’s important to first identify that probiotics are a science and that specific strains are studied for specific outcomes. For example, certain strains have been studied in children to impact antibiotic-associated diarrhea, whereas others have been studied to support bowel movement frequency and ease of pooping. Others still have benefits for skin, cardiovascular, or respiratory health.
As generally transient microbes, probiotics travel through your child’s colon, interacting with immune cells, gut cells, dietary nutrients, and existing bacteria to, directly and indirectly, deliver specific benefits depending on the strains they contain.
Our PDS-08™ Pediatric Daily Synbiotic—a clinically studied 2-in-1 powdered synbiotic for kids and teens ages 3-17 with 9 probiotic strains and a fiber-based prebiotic—was formulated with strain-specific benefits in and beyond the gut, supporting digestive, gut immune, dermatological, and respiratory health. In a 12-week clinical study, PDS-08™ was even shown to support healthy regularity and help promote easy, frequent poops in children experiencing intermittent constipation.
What are some signs or red flags that your child has an “unhealthy” gut?
As the gut microbiome can impact many complex systems in our bodies, many different physical effects (both positive and negative) can stem from the gut. Everybody is physiologically unique and therefore, an “unhealthy gut” may manifest itself differently from child to child—anything from mild gastrointestinal symptoms to the severity of their allergies, and even more severe conditions due to inflammation and the production of toxins. There is also some evidence that the gut microbiome may play a role in children’s mood and behavior, with some studies showing that toddlers with more diverse microbes in the gut were more engaged, happy, and interactive. If your child is experiencing severe or prolonged gastrointestinal distress, then it’s likely a good idea to further explore with your pediatrician.
What is the difference between taking a probiotic supplement and eating whole foods that contain probiotics?
Fermented foods and beverages are sometimes characterized or labeled as ‘probiotic foods’ or ‘contains probiotics’. While it’s certainly possible for some to meet the scientific criteria for a ‘probiotic’, most fall short. As mentioned, just because something contains live microorganisms, doesn’t mean it satisfies the internationally recognized definition of a probiotic. And unlike some clinically studied probiotics (e.g. PDS-08™) they have not been subjected to controlled studies in humans (or in this case, specific pediatric populations) and demonstrated a health benefit beyond the food or beverage itself. The health benefit must, at least in part, be due to the live microorganisms and must extend beyond any nutritional benefit of the fermented food. For these reasons, the terms ‘fermented food’ and ‘probiotics’ cannot be used interchangeably.
The point I’m making is not to dissuade anyone from eating fermented foods. Many fermented foods and beverages are extremely nutritious (and delicious), and naturally contain antioxidants, organic acids, and polyphenols. The distinction is that they are not necessarily reliable sources of probiotics.
What are some of the best foods to eat for a healthy gut?
A diet with a wide (diverse) variety of plants—like fruits, vegetables, nuts, and seeds—are important for your microbes, and can support a healthy and diverse microbiome. They feed your microbes to help them do the important work in your body.
Microbiome research has demonstrated some clear and actionable dietary guidelines:
- High abundance of diverse sources of plant fibers and polyphenols (like vegetables, walnuts, pomegranates, and berries)
- High intake of fiber and microbiota-accessible carbohydrates (like broccoli, Brussels sprouts, beans, and sweet potatoes)
- High intake of Omega-3 fatty acids and monounsaturated fat (like salmon, sardines, avocados, and olive oil)
- Low intake of sugar, preservative agents, processed foods, food additives
- Low intake of saturated fat
What would you say to a parent who is hesitant to give their child supplements?
I get it. And I share this skepticism and hesitation.
In the noise of hyperbolic claims and misinformation, choosing the right supplements for your child (or deciding not to) can feel paralyzing—we see this especially in pediatric probiotics. It’s important to do your research and learn more about the products you purchase, as not all are created equal. This means we as parents have to do our homework on the companies, products, the “why” you are seeking supplementation for and if there are other avenues to try first (like diet). And of course, use our gut instinct (pun intended). All data and science aside, you know your child best, and the choice you make to give your child supplements depends on what you are most comfortable with.