The probiotic L rhamnosus
cuts babies' diarrhea duration by nearly two days, according
to an Italian study in the August 18 British Medical
Journal. Looking at kids between the ages of three
and 36 months, the study found probiotics — good
bacteria — successfully reduced the time infants
suffered from acute diarrhea.
At first glance, the number seems
small but it represents as much as half the length of
the affliction, says Dr Sunita Vohra, the director of
the University of Alberta's Complementary and Alternative
Research and Education Program. "That's two days less
suffering and losing fluid for the child, and a two-day
earlier return to work for the parents."
Besides, dealing with runny stool
and cranky babies are not the only hazards of this illness
— diarrhea can lead to serious dehydration and
kills more than 400 babies a year in the US and Canada.
ANTI-ANTIBIOTICS
Diarrhea can be caused by a virus or a bacteria but
in kids the real culprit is often an antibiotic prescription.
The drugs kill off the good bacteria in the kid's gut
along with the bad ones, leaving the patient vulnerable
to other harmful organisms.
Treatment for diarrhea has traditionally
been to keep the child hydrated. Docs rely mostly on
an oral, glucose-based rehydration solution to replace
the kid's body fluids. But that helps neither the symptoms
nor the duration of the diarrhea.
Enter probiotics. They include
the many good bacteria from the ones in yogurt to the
ones that help digest dairy products. The friendly living
organisms help by staging a sort of sit-in — they
colonize the gut and prevent harmful bacteria from setting
up shop until the colon's supply of normal bacteria
is replenished.
As research proliferates, probiotics
are becoming more and more popular with pediatricians
in the fight against infants' diarrhea. "The evidence
on probiotics is exciting and very promising," says
Dr Vohra. "They have a reassuring safety profile in
a normal host."
THE
CONS TO CONSIDER
But there is a catch. The new study's authors, from
the University of Naples, point out that not all probiotics
are created equal. "In most countries, micro-organisms
purported to have probiotic properties are considered
food additives rather than drugs," study authors write.
Therefore, only safety is closely examined before marketing
— not efficacy. Parents can buy them over the counter
and most don't bother checking with the pediatrician
to see which one works best.
"There are multiple sources for
those probiotic recommendations," Dr Vohra agrees. "Not
the least of which is the internet. Parents google medications
and treatments they think would help their kids." Sometimes
kids even end up in the emergency room because they've
used natural health products without the advice of a
physician, Dr Vohra notes. Other times, these products
are harmless but entirely useless. Some don't work at
all against diarrhea, while others work extremely well.
The study showed that the L
rhamnosus GG strain not only lopped off almost two
days of diarrhea, it reduced the number of stools per
day and improved their consistency. Another preparation
that proved equally effective was a cocktail of four
bacterial strains — L debrueckii, S thermophilus,
L acidophilus and Bifidobacterium bifidum. Neither
treatment had any side effects.
MDs'
ADVICE
Patients should be cautioned not to take probiotics
(or give them to their children) unless a doctor recommends
they do so, Dr Vohra warns. "You're giving a living
organism, so there's always a fear of infection," she
says. Chances of infection are slim, she concedes, but
a kid whose immune system is down because of illness
or another infection might not be able to handle even
a friendly bacteria. "You have to consider how much
potential benefit versus how much risk. That's what
parents should discuss with the doctor," she explains.
Although many physicians are unfamiliar
with probiotics, with mounting evidence to support their
use and increasing patient interest Dr Vohra says they'll
have to get more comfortable answering probiotics questions.
"It's about familiarity with usage and knowing what
side effects to watch out for, among other things,"
she says. "Once family physicians undertake learning
more about this, it'll become part of their routine
practice."
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