Infant Probiotics: B. Lactis or L. Reuteri?

[coffeeclaw_1986]

Overwhelmed by options for probiotics. I had my daughter on Gerber “gentle” probiotics with Vitamin D. The strain in them is b lactis. I went to buy them again and see a different type, the “soothe” ones, popping up more and that uses the strain l reuteri.

“Gentle” says that’s b.lactis is the most studied infant probiotic and it’s beneficial for babies born by c section. I didn’t have a c section but I was GBS+ so on antibiotics for delivery. “Soothe” says it’s effective in reducing spit up chance of developing colic. My daughter never spits up and isnt colic.

I have a ton of gut issues and was really worried about my daughters gut health due to being on antibiotics during delivery. So anyone know much about these strains and if one is better? Or would there be a benefit in switching back and forth between the two?

 

[lisad65]

@coffeeclaw_1986 The evidence in the literature is not entirely clear. Here is the position statement from the Canadian Pediatric Society which was recently updated in Dec. 2022 based on review of the current literature. There seems to be different recommendations based on the indication.

Below are the summarized points. I’m including them all here in case others are interested. Based on the information you provided, I don’t think any of these directly applies to your daughter. I’ve bolded the two recommendations that are probably most relevant to you below.

“The use of probiotics in paediatric populations remains a challenge, as evidenced by contradictory recommendations in current published guidelines. Based on the literature reviewed for this statement, the following recommendations can be made (listed here, and in Table 1, from strongest to weakest).
- There is sufficient evidence to support the use of multi-strain probiotic combinations to lower mortality risk in preterm and low birth weight (LBW) infants with sepsis.
- Probiotics combinations may be of benefit in reducing the incidence of necrotizing enterocolitis (NEC) in preterm neonates >1000 g, but appears to have no impact on NEC mortality.
- Lactobacillus sp. can be considered to treat abdominal pain related to functional gastrointestinal disorders, especially irritable bowel syndrome.
- Lactobacillus rhamnosus and Saccharomyces boulardii can be considered for the prevention of antibiotics-associated diarrhea.
- Consideration of probiotics to reduce the incidence of Clostridium difficile-associated diarrhea (CDAD) in children on antibiotics is recommended, especially when they are at high risk (>5% baseline risk) of infection. Use of probiotics to treat established CDAD is not recommended.
- Consideration of probiotics in conjunction with standard therapy to increase Helciobacter pylori eradication and decrease the side effects of treatment is recommended.
- Lactobacillus reuteri supplementation can be considered for reducing colic symptoms.
- Consideration of probiotics to help prevent atopic dermatitis and eczema is recommended, but further research is needed to confirm optimal strains and timing of administration. Probiotics are not recommended for the prevention of other atopic diseases.”

 

[sharrylee]

@lisad65 Great information!

I'm a pharmacist and I'll add that I frequently use http://www.probioticchart.ca/ to match product/strain and indication.

 

[allart]

@sharrylee Thank you so much for sharing this! I did have a quick question about vaginal probiotics recommended to be taken orally. I'm not really understanding how those can have an effect on the vagina...I mean, how would they travel there? Lol. Just curious as I've read mixed things about it but I'm curious because I know there's one strain that is shown to prevent premature birth, which I'm at risk for. Thanks again!

 

[sharrylee]

@allart To be honest it doesn't seem super intuitive to me either, and I dont consider myself an expert on this particular topic. Seems like the theory is through ascension (similar to how e.coli from the anus would get into the urethra to cause a UTI).

this small study seems to show the probiotic bacteria colonizing in the vagina after oral intake, so there seems to be some merit to the theory.

Personally I think it makes more sense to go direct to the source instead of making the probiotic take the scenic route, but if oral is preferable and would get better compliance then I don't see a problem with it. I haven't looked into comparisons, or if there is any head-to-head trials to see if vaginal route has shown better results or not.

 

[andybrooks]

@coffeeclaw_1986 Fwiw, our pediatrician said for long term use (which we are doing), so switch between strands and types for different exposure. She said there is no need to always stay with the same one. We are switching between like four or five different ones, whatever I can find in store at the time.