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Vegan Baby Probiotics. Are They Worth It or a Waste of Money?

Alina Petre, MSc. RD.
Vegan baby probiotics - www.morethanjustveggies.com

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Someone recently asked me for my professional opinion on vegan baby probiotics.

Probiotics are thought to offer health benefits such as a stronger immune system, improved digestion, and a more robust resistance to allergies. Probiotics are even touted to help fight colic in babies.

Many adults take probiotics, so it’s only natural to wonder whether their baby may also benefit from taking them. But do probiotics offer the same benefits to babies? And are they actually safe for them?

In this article, I’ll cover everything you need to know about probiotics for babies, including which ones to buy, how to give them to your baby and when it may be most beneficial to do so.

What are probiotics?

Probiotics are usually defined as live microorganisms that provide a health benefit when taken in adequate amounts (1).

They are often referred to as “healthy bacteria,” although they technically also include yeasts. 

Probiotics are naturally found in fermented foods such as  tempeh, sauerkraut and kombucha. They can also be purchased as supplements, and are sometimes also added to packaged foods.

The most common types of probiotics for babies

The probiotics strains most commonly given to babies or added to products intended for them include: 

It’s important not to confuse probiotics with prebiotics. Prebiotics are a type of fiber that probiotics feed on. By providing them with a source of food, prebiotics help probiotics work more effectively.

Products containing both probiotics and prebiotics are typically referred to as “synbiotics”.

In sum – Probiotics are beneficial bacteria and yeasts that can provide a health benefit when taken in sufficient amounts. They are different from prebiotics, but function better with than without them. 

Where do you find probiotics?

Probiotics are naturally present in a variety of foods. 

Those who choose to eat a plant-based diet can get their probiotics from: 

Keep in mind that pasteurization kills microorganisms, including probiotics. So when looking for probiotic-rich foods, make sure to pick versions that have not been pasteurized. 

Practically, this may mean looking for the sauerkraut that’s found in the refrigerated aisle of your supermarket rather than on the shelf. Or, if you have the time, making it yourself!

Probiotics can also be added to plant milks and yogurts. The best way to tell whether a food is fortified with probiotics is to scan its label for Lactobacillus or other probiotic strains. 

Baby probiotics can also be purchased as supplements. These come in a variety of forms, including liquid drops, powders or pills.

Do babies get probiotics from breastmilk?

Human milk is naturally rich in both prebiotics and probiotics. 

Research suggests that the live bacteria found in breastmilk may come, in part, from the bacteria present in the breastfeeding parent’s own gut and breasts.

Breastfed babies are thought to receive between 104-106 bacteria per day. The most common bacterial strains found in breastmilk include Staphylococcus, Streptococcus, Lactobacillus and Bifidobacterium (2). 

In addition to probiotics, human milk also contains a category of prebiotics known as human milk oligosaccharides (HMOs). HMOs help promote the growth of beneficial Bifidobacteria in the baby’s gut. 

In turn, these Bifidobacteria offer protection against diseases and contribute to the healthy development of your baby’s immune system (2). 

Infant formula doesn’t contain HMOs, but non-HMO prebiotics may be added to some formulations (3).

In sum – Probiotics are naturally found in breastmilk and fermented, non-pasteurized foods. Probiotic strains may also be added to certain foods and are also available in supplement form. 

Are probiotics plant-based?

Probiotics are microorganisms such as bacteria and yeast. At their core, they aren’t derived from animals. Therefore, they can be suitable for a vegetarian or vegan diet.

That said, not all foods that contain probiotics are plant-based. For instance, both milk- and water-kefir are a source of probiotics. However, milk kefir is not considered plant-based while water kefir is. 

The same can be said about probiotic supplements.

At their core, probiotic supplements are plant-based. However, many of the most popular brands include animal-derived ingredients such as gelatin, lactose or other milk sugars into their formulations. 

The best way to confirm whether a probiotic supplement is plant-based is to check it’s ingredient’s list before purchase. 

Certain products may lack the official vegan seal but contain no animal products nonetheless. When in doubt, you can always contact the company directly to double-check. 

In sum – At their core, probiotics contain no animal products. However, not all foods or supplements containing them are plant-based. So check the ingredients label or contact the manufacturer whenever possible. 

How do you give probiotics to a baby?

Baby probiotics can be purchased in pill-, powder-, spray- or liquid-form. Liquid probiotics are probably the easiest to give to babies. 

You can place drops directly into your baby’s mouth, mix them with baby formula, or drip them directly on the nipple before breastfeeding. For older babies, baby probiotics can also be mixed together with foods. In which case, powder forms may work as well.

For best effects, make sure that the food or beverage you mix them in is lukewarm. Mixing probiotics with overly hot liquids or solids may kill them, reducing their effectiveness (4). 

Which vegan probiotics are best for babies?

Probiotic supplements aren’t strongly regulated. This means that vegan baby probiotics may contain different ingredients or dosages than what’s listed on their label. They may also become tainted with harmful compounds, such as lead (5, 6).

This is why it’s best to pick a vegan probiotic supplement that is certified by a third party lab such as ConsumerLab, U.S. Pharmacopeia, or NSF international. 

At the time of publishing of this article, vegan probiotics for babies vetted by ConsumerLab include:

How should I store probiotics?

Probiotics need to be stored properly to retain their effectiveness. Some require refrigerators while others should be stored at room temperature. So make sure to check the storage instructions on your supplement’s label.

It’s also a good idea to look for products that list the number of CFUs per strain as well as a “use by” date on their label. 

Be cautious of products that only list the number of “CFUs at the time of manufacture”. This can be deceitful, as it doesn’t account for the decline in CFUs over the product’s lifespan. 

In sum – Probiotic drops are probably the most convenient to give to babies. For safety purposes, it’s best to pick a probiotic supplement vetted by an independent third party testing lab. 

When should I give my baby probiotics?

Based on the current research, probiotic supplements may be especially beneficial in a few specific situations. 

Are probiotics good for babies that are formula-fed? 

Breastmilk is naturally rich in probiotics, especially Lactobacillus and Bifidobacterium strains (2).

Research suggests that breastfed babies receive between ten thousand and one million (1×103-106)CFUs per day (2). 

In contrast, babies given infant formula don’t typically receive any probiotics. That’s because probiotics aren’t currently included on the list of mandatory ingredients in baby formula. Therefore, few formulations include them (7, 8).

Baby formula is formulated to resemble breastmilk as much as possible. Therefore, an argument can be made that formula-fed babies may benefit from receiving probiotics, simply because breastmilk contains them. 

That said, research on the long-term benefits or risks of probiotic supplementation in a baby’s first year of life is currently limited. 

This is why probiotics have yet to be included on the list of mandatory infant formula ingredients.  

If you’re feeding your baby with formula and wish for them to receive probiotics, you can opt for a baby formula with probiotics.

Alternatively, you can purchase a probiotic supplement and mix it with the baby formula yourself. Or give it directly to your baby.

Are probiotics good for babies born via C-section? 

During birth, a baby’s passage through the birth canal brings them in contact with various bacteria and yeasts. 

This is why babies born vaginally tend to have a larger amount and diversity of beneficial gut bacteria compared to babies born via C-section (9, 10).  

Antibiotics given during C-section delivery or to avoid a group B streptococcus (GBS) infection may also affect the composition of the bacteria present in the baby’s gut (10).

For the moment, the impact this has on a developing baby is not fully clear. 

Yet, some experts suggest that it may delay the maturation of the immune system. In turn, this is thought to possibly increase a baby’s risk of asthma, eczema and food sensitivities (10).

Interestingly, there is some evidence that the lesser probiotic quantity and diversity in babies born by C-section may be gradually offset during the baby’s first year of life by environmental factors including their diet (11).

For instance, one study showed that breastfeeding for 24 or more weeks significantly increased bacterial diversity in children born by C-section (12).

This suggests that babies born via C-section may benefit from receiving probiotics after birth, be it through breastmilk or supplements. 

If opting for a supplement, try choosing one that contains Bifidobacterium strains, as these are the main strain present in breastmilk and in the gut of infants born vaginally (10).

Are probiotics good for preterm babies? 

Preterm babies weighing less than 3 pounds (1.5 kg) are especially at risk of developing necrotizing enterocolitis (NEC) and late-onset sepsis (LOS). 

NEC is a serious condition in which the large intestine becomes inflamed, and dies. NEC can also create a hole in the baby’s gut. This can cause bacteria to leak out from the gut into other parts of the baby’s body, leading to severe infection. 

LOS is a life-threatening infection that usually occurs in the first 72 hours to 120 days of life. All babies can develop LOS. However, pre-term babies have an immature immune system which increases their LOS risk (13).

Some studies suggest that preterm babies weighing less than 3 pounds (1.5 kg) may have a lower risk of complications or death, including from NEC or LOS, when given probiotics after birth. That said, not all studies agree (10, 14, 15, 16, 17).  

Currently, the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) recommends that, whenever possible, babies with NEC stage 2 or 3 be given either (18):

or

Bifidobacterium strains feed on prebiotics found in human milk. These prebiotics help the bifidobacteria get established in the baby’s gut. In turn, this enhances the gut’s ability to absorb nutrients and function properly (10).

Bifidobacteria are also thought to stimulate the development and function of the immune system. In turn, this may help protect preterm babies against NEC and LOS (19).  

Currently, supplements containing Bifidobacterium strains alone or mixed with Lactobacillus and other probiotic strains appear to be the most effective at preventing NEC in very preterm babies  (20, 21, 22).     

Moreover, supplements containing a mix of probiotics and prebiotics may be even more beneficial (23).  

Are probiotics good for gassy or colicky babies?

A colicky baby is usually defined as one that cries inconsolably for longer than 3 hours per day, on more than 3 days per week, and for a period longer than 3 weeks (24).  

The term colic is derived from kolikos, which is the Greek term for colon – the last part of the gut. Colicky babies appear to have fewer beneficial bacteria in their gut than non-colicky babies. They also often clench their fists or flex their hips, while crying.

Taken together, this has caused some to suggest that colicky babies possibly experience more discomfort due to gas, causing them to cry more frequently as a result of it (25, 26, 27).  

Because of this, probiotics have been proposed as a way to help reduce baby colic. They’re thought to do so by possibly restoring the balance of healthy bacteria in a baby’s gut (27).  

Older research suggests that Lactobacillus reuteri, a probiotic strain originally isolated from a Peruvian mother’s breastmilk, may help reduce colic in breastfed babies (24).

This probiotic strain has been available for purchase as “colic drops” for more than 20 years, with each dose of 5 drops providing more than 20 million (20 x 106) CFUs (24).

Yet, despite their long history of use, more recent studies suggest that probiotics do little to prevent baby colic.  

For instance, a recent Cochrane review that included relevant studies published up to three years ago reports that, at best, probiotics may reduce crying time by 33-44 minutes per day at best.

Moreover, the babies given probiotics appear no less likely to develop colic than those given a placebo (27).

Therefore, so far, the evidence doesn’t show probiotics to be that effective at reducing colic. However, studies on this topic remain limited. So more research is likely needed before strong conclusions can be made. 

Are probiotics good for infants with diarrhea?

Acute infectious diarrhea is usually defined as having at least three loose or liquid stools within a 24-hour period. Babies with infections diarrhea may develop a fever or vomiting.

A large review looked at the effects of probiotics on infectious diarrhea. Most of the studies it included int his review were done included primarily infants and children. 

The review found that supplements containing either one or multiple strains of probiotics reduced the duration of diarrhea by around 25 hours (28).

Participants given probiotics were also 59% more likely to have diarrhea lasting for fewer than 4 days compared to those given no probiotics (28).

According to the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), Lactobacillus rhamnosus GG (LGG) and Saccharomyces boulardii may be the most effective strains at treating infectious diarrhea. 

To be effective, the dosage should be of at least ten billion (1×1010) CFUs per day, and be taken for 5-7 days (29).

Are probiotics good for babies with constipation?

Some studies suggest that probiotics may also help relieve constipation in babies. 

For instance, a recent review reports that children between the ages of 3 and 7 given probiotics over 3-12 weeks had close to one additional bowel movement per week compared to those given a placebo (30).   

However, not all studies were able to replicate these findings. What’s more, probiotics didn’t appear to help soften the children’s stools (31, 32, 33, 34).  

So far, I couldn’t find any studies done specifically on babies. Therefore, more research is needed on this topic before strong conclusions can be made.

Do probiotics protect against eczema?

Several studies have examined the effects of probiotics on atopic dermatitis – a common type of eczema that affects about 15-20% of children and 1-3% of adults (1).

A review of these studies suggests that babies may have a 6% lower risk of developing atopic dermatitis if exposed to probiotic strains such as Lactobacillus, Bifidobacterium and Propionibacterium in utero and up to 6 months after birth (35).

That said, probiotics taken either before or after birth, rather than during both time periods, don’t appear to have the same positive effect. Moreover, other probiotic strains didn’t appear to be as effective (36).   

Another recent review suggests that children with eczema may experience less severe symptoms after taking probiotics for 4-8 weeks. These results were strongest in children over one year old, but not all probiotic strains were equally effective (37).  

This is confirmed by another review, which notes that single-strain probiotics rather than a mixture of strains appear to have no effect at all (38).

This same review further suggests that although statistically significant, the reduction in eczema symptoms seen after taking probiotics may be too small to make a true real-life difference (38).  

Because of this, the authors conclude that there’s currently not enough evidence to recommend using probiotics to treat eczema (38).

Do probiotics protect against allergies?

Food allergies affect around 6% of babies under two and 9% of children aged three to five years. The most common are allergies to eggs, milk, and peanuts (10, 39).

Probiotics can act both on the gut and immune system. Because of this, they are thought to offer some protection against allergies (10).

Yet, although plausible, there’s currently limited evidence to support this idea. 

For instance, a recent review examined studies who exposed babies to probiotics during pregnancy and after birth. 

Five of the studies looked at babies given probiotics only after birth. Only one of them found that the babies given probiotics had a significantly lower risk of food allergies. The other four found no significant effect (10).

Another five studies looked at babies exposed to probiotics in the last few weeks of pregnancy as well as in the first 6-12 months of life.  

Two of the five studies reported a 8%-16% lower risk of allergies or food sensitivities in babies exposed to probiotics. In one of the two studies, results were only apparent in babies born via C-section. The other three studies found no significant effect (10, 40, 41). 

It’s worth mentioning that most of these studies included newborns with known allergies, or a high risk of developing allergies. Therefore, findings may not be applicable to all babies (10).

So probiotics may help reduce allergies in some babies. However, more research is needed to understand which babies may truly benefit most.

Do probiotics protect against asthma?

Historically, there’s been some evidence suggesting that babies given probiotics may have a lower risk of developing asthma later in life (42, 43, 44, 45, 46).  

However, more recent studies suggest that giving your baby probiotics in the first 6-9 months of life is unlikely to reduce their risk of asthma (10).   

Asthma tends to develop in the later preschool years. Therefore, a common criticism is that many studies may be too short to truly catch any effects. 

Moreover, some studies were unable to follow-up with up to 70% of their original participants. So this may have also influenced their results.

For all these reasons, more studies are needed before any conclusions can be made.

In sum – Probiotics may protect against NEC and LOS. They may also be beneficial against diarrhea, constipation, asthma, eczema and colic. However, more research is needed. 

Can probiotics be harmful to babies?

Probiotics are generally considered safe (47, 48, 49).

Some fear that probiotics may increase the risk of generalized infection – also known as sepsis.  However, studies to date do not generally find this to be the case (10). 

I found one report suggesting that preterm infants given probiotics together with antibiotics were more likely to experience an antibiotic-resistant bacterial infection than those given antibiotics without probiotics.

That said, all babies in this study were born before 32 weeks, and weighed less than 3.3 pounds (1.5 kg). Therefore, it’s not clear whether this finding applies to all preterm babies. 

Moreover, this was an observational study, which makes it impossible to determine whether the probiotics are what actually caused the antibiotic resistance (50).

Another study suggests that children given probiotics in the first 2 months of life may be more likely to experience oral, respiratory or gut infections in the first 2 years of life. 

However, this study was also observational. Therefore, stronger studies are needed to confirm these findings (51).

There have also been two reported cases of sepsis in newborns given Bifidobacterium. One infant had a rare abdominal wall defect and the other weighed less than 600 grams at birth. Neither case was life-threatening (52, 53).

What about high-risk babies?

Keep in mind that so far, probiotics have been given to thousands of newborn infants, including premature ones. Side-effects are generally minor, with gas being the most common  (32, 54, 55).

Therefore, although important to be aware of, the reports above appear to be the exception rather than the norm.

Nonetheless, safety studies in at-risk groups such as severely ill or immunocompromised babies are limited (56).

Currently, the World Gastroenterology Organisation (WGO) advises to only give babies the specific type of probiotic strains in the dosages that have a proven efficacy for the condition you’re trying to prevent or treat.

You can read more about the type and dosage of recommended probiotics for each condition in table 9 of the WGO’s 2017 Global Guidelines on Probiotics and Prebiotics. 

In sum – Probiotics are generally considered safe for babies. Caution should be used with severely ill, immunocompromised or very preterm babies with birth weights below 3.3 lbs (1.5 kg). 

A quick word about prebiotics

Although they may sound similar, prebiotics are different from probiotics.

Probiotics are healthy bacteria and yeasts, while prebiotics are the food they feast on. Prebiotics can also be referred to as prebiotic fiber.

Prebiotic fiber releases short-chain fatty acids (SCFAs) when broken down by the bacteria in your gut. SCFAs provide fuel for the cells in your gut. SCFAs also help improve your gut’s ability to absorb nutrients and move digested food along more easily (57).  

In addition, SCFAs can help lower the gut’s pH, which prevents the growth of harmful bacteria. They also prevent these bad bacteria from sticking to the inside of your gut. As a result, SCFAs can help improve the balance of bacteria in your gut (57).

There are more than 1,000 different types of probiotics we know of. Despite this, only a select few can be purchased as supplements.

For this reason, some experts suggest that focussing on prebiotics when trying to improve the balance or diversity of gut bacteria may be a more effective strategy than focussing on probiotics alone (57).

Studies thus far suggest that prebiotics may directly help soften stools, reduce constipation and increase the ratio of good to bad bacteria in the gut. They may also possibly reduce the risk of allergies, inflammation, infections, and certain gut disorders (57).

However, more focussed studies on prebiotic are needed before strong conclusions can be made. 

Which foods are richest in prebiotics?

Prebiotics are naturally found in a variety of plant-based foods. The plant foods richest in prebiotic fiber include: 

Everyone can benefit from eating a diet rich in prebiotics. However, pregnant or breastfeeding individiuals may especially benefit from doing so.

That’s because a diet rich in prebiotics can help improve the balance of bacteria in your gut. In the case of pregnant or breastfeeding parents, this can in turn improve the balance of bacteria in your baby’s gut.

Once your baby begins solids, try gradually including prebiotic-rich foods to their diet in age-appropriate textures and amounts. 

In sum – A prebiotic-rich diet can help probiotics thrive and work more effectively. A combination of both a is likely more beneficial than probiotics alone. 

To sum it all up

Probiotics are helpful bacteria that can improve the balance of bacteria in your baby’s gut. Because of this, they may offer many health benefits.

For instance, they may offer some protection against constipation, diarrhea, asthma, eczema and colic. However, more research is needed to confirm these benefits.

In addition, probiotics may help prevent necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) in babies born prematurely. 

Baby probiotics are generally considered safe. However, as with all supplements, they risk being contaminated with unwanted compounds. That’s why it’s best to purchase from brands that allow third-party testing, whenever possible. 

A vegan diet tends to be naturally rich in prebiotics. This is great, because prebiotics, alone or in combination with probiotics, are likely more effective than probiotics alone.  

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