Saturday, February 13, 2016

When stomach bugs are good for your kid

While the image of trillions of tiny bacteria swarming inside your body sounds like a science fiction nightmare, those bacteria actually may help control weight gain and prevent diabetes, among other good things. A dietitian offers advice on how to cultivate them.

When stomach bugs are good for your kid

A color-enhanced photo released by the Rowett Research Institute in Scotland shows Lactobacillus bacteria - or "friendly bacteria - observed in a scanning electron microscope. (AP Photo / Rowett Research Institute)
A color-enhanced photo released by the Rowett Research Institute in Scotland shows Lactobacillus bacteria - or "friendly bacteria - observed in a scanning electron microscope. (AP Photo / Rowett Research Institute)

It’s a creepy crawly scene any 9-year-old – and science nerds of all ages – would flip for: Trillions of tiny bacteria swimming, swarming inside a human body. But this isn’t science-fiction, a horror movie or a Saturday morning cartoon. The good bacteria that call the human digestive system home have gotten plenty of good press in recent years for everything from helping break down food to possibly controlling weight and preventing diabetes.

Recently, scientists from Children’s Hospital of Philadelphia found that these beneficial bugs also seem to help regulate the way the immune system responds to threats – and found evidence that killing off good bugs might reduce thaat effect. Does all the evidence in favor of good bugs mean parents should be feeding probiotic-enriched foods and probiotic supplements to their kids? I asked registered dietitian Beth Wallace of Children’s Hospital of Philadelphia, a regular contributor to the Healthy Kids expert panel, for advice.

Q: Do kids need probiotic supplements?

A: In the last five years, there has been impressive growth in the research done on both probiotics and prebiotics in children. There is some really promising evidence in both the gastrointestinal (GI) and allergy fields, but there are still a lot of questions left to be answered. There needs to be real confidence in the evidence that we know the best types of bacteria, the right dose, and probiotic source before we can provide both effective and safe recommendations.  

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Q: What foods provide probiotics?

A: The easiest way to add probiotics from foods is to look for “fermented foods” and it’s really not too difficult to find natural sources. Commonly we think of yogurt with live, active cultures (noted on the label), but also consider fermented beverages like kefir and buttermilk, and soft cheeses. Nondairy options include sourdough bread, sour pickles, sauerkraut, and soybean products like miso soup and tempeh. The best part of eating food sources instead of taking a supplement is that you can get a good variety of healthy bacteria instead of a single bacterial strain.

Q: Anything else we should do to keep our good bugs happy?

A: Focusing on probiotics alone is a waste! Prebiotics are equally as important because these nutrients are what your intestinal lining uses as fuel to flourish. Even better, you don’t need any specialty foods because a mix of whole grains, fruits in whole form (bananas, apples, berries), raw vegetables (asparagus, onions, garlic, artichokes) will do.

Q: What about foods like sauerkraut and kim chee? I’ve read that they’re packed with prebiotic fiber, but they’re also very high in sodium.

A: This brings up a really important point. The good parts of one food (probiotics or prebiotics) can’t really outweigh the negative.  If one of the products you choose to use is high in fat, sugar, or sodium, make it a weekly item instead of a daily staple.

Q: If a child has to take an antibiotic, should a parent also give them probiotics in some form?

A: There is some good data that starting a probiotic supplement is beneficial in preventing diarrhea when a child is started on antibiotics (mostly commonly for an acute respiratory infection). The studies with the most favorable outcomes used the yeast product Saccharomyces boulardii or the bacteria Lactobacillus GG (LGG). The studies used either a separate supplement, or a formula supplemented with probiotics. (Note: Always follow label instructions. And don’t give a supplement to a toddler or baby without talking with your healthcare practitioner first.)

Q: Are there kids who should not take or eat extra probiotics?

A: Yes. Any child who has a suppressed immune system or is chronically ill should avoid these products until we know what is safe. The other issue is that many of the premixed items are not pasteurized, so there is always a bigger concern for food borne illness. Even good bacteria can become dangerous for children in these situations.

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About this blog
The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Anna Nguyen Healthy Kids blog Editor
Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Magee DeFelice, M.D. Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Chief of Pediatric Emergency Services at Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Registered Dietitian at Children's Hospital of Philadelphia
Emiliano Tatar, M.D. Pediatrician at Einstein Healthcare Network Roxborough Plaza
Jeanette Trella, Pharm.D Managing Director at The Poison Control Center at CHOP
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D. Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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