In recent years, probiotics have gained attention for their role in gastrointestinal health.
According to the World Health Organization (WHO), probiotics are live microorganisms that, when consumed in adequate amounts, provide health benefits. Often referred to as “friendly bacteria,” probiotics support digestive health, boost the immune system, and may even influence mood and behavior. They are naturally found in fermented foods, such as miso, yogurt, cultured milk, and pickled vegetables, and are also available in supplement form.
There are various types of probiotic supplements and products available in pharmacies, including chewable tablets, capsules, gummies, and powders. Some are specially formulated for women and children. This raises an important question for parents: Do children need probiotics?
Are Probiotics Necessary for Children?
Currently, probiotic supplements are not universally recommended for children. However, they are generally considered safe and may offer health benefits to children in various aspects.
Digestive Health
Probiotics play a crucial role in maintaining gut health. They help regulate bowel movements, improving both diarrhoea and constipation. In addition, probiotics aid in the fermentation of dietary fibres and prebiotics, producing short-chain fatty acids (SCFAs) that nourish intestinal cells and enhance the gut barrier. A healthy gut barrier is essential to prevent issues like leaky gut syndrome, which can contribute to various health problems.
Ishizeki et al. (2013) found that detection rates of Clostridium and Enterobacteriaceae were lower in the feces of infants who were administered Bifidobacteria. Clostridia (such as C. perfringens) are Gram-positive pathogens, while Enterobacteriaceae (including Salmonella and E. coli) are Gram-negative pathogens that may cause food poisoning.
Immune Support
Since a large portion of the immune system is located in the gut, probiotics contribute to immune health by modulating immune responses and inhibiting harmful pathogens. Some research suggests that early exposure to probiotics, particularly Bifidobacteria, may reduce the risk of infections, allergies, eczema, and asthma.
A 10-month randomized, double-blind, placebo-controlled study evaluated the effects of Bifidobacterium longum BB536 on diarrhoea and upper respiratory illnesses in 520 healthy Malaysian preschool children aged 2–6. Results showed a reduction in the duration of sore throat by 46.1%, fever by 27.8%, runny nose by 13.2%, and cough by 16.3% compared to the placebo group.
Gut Microbiota Development
Bifidobacteria are among the first bacteria to colonize the infant gut and are vital during early life. RNA gene sequence analysis showed that the abundance of Bifidobacteriaceae (B. longum, B. breve, and B. bifidum) was greater in the feces of breastfed infants than in those fed with formula.
Breast milk contains human milk oligosaccharides (HMOs), which support the growth of Bifidobacteria in the infant’s gut. As children grow, their gut microbiota becomes more diverse and complex, and the relative abundance of Bifidobacteria tends to decline. Therefore, introducing probiotics early in life may support the healthy development of gut microbiota.
Probiotics as a Treatment Option
Although probiotics are naturally present in certain foods, a healthy and varied diet rich in probiotic-containing foods like yogurt is often sufficient to maintain gut health. However, supplementation may be considered in specific situations.
Antibiotic Use
When antibiotics are prescribed to children, they can disrupt the balance of gut bacteria by killing both harmful and beneficial strains. This can lead to reduced levels of Bifidobacteria and other helpful microbes. Supplementing with probiotics during or after a course of antibiotics may help restore gut balance and reduce the risk of antibiotic-associated diarrhoea.
Gastrointestinal Disorders
Children experiencing digestive issues such as recurrent diarrhoea, constipation, or irritable bowel syndrome (IBS) may benefit from probiotic supplements. Studies have shown that supplementation with Bifidobacteria mixtures, including B. longum BB536, may improve abdominal pain and overall quality of life in children with IBS.
Allergies and Asthma
Probiotics may exert anti-inflammation and immune-modulation activity. A recent study in Italy suggests that probiotic mixtures containing Bifidobacteria may significantly improve symptoms and quality of life in children with allergic rhinitis and intermittent asthma triggered by pollen exposure.
The Role of Diet and Gut Microbiota in Children’s Long-Term Health
A child’s diet plays a key role in shaping their health throughout life. Early nutrition influences gut microbiota composition, which, in turn, impacts metabolic and immune function. Junk food and excess sugar consumption negatively impact the gut microbiota by reducing microbial diversity and potentially increasing harmful bacteria. Dysbiosis—or an imbalance of gut bacteria—during early life may increase the risk of obesity and other chronic health conditions.
Unlike adults, infants have a less diverse and less abundant microbiota. By the age of 3 to 5, the gut microbiota matures and resembles that of an adult. Diet and gut microbiota together regulate intestinal epithelial function.
A review published in the Journal of Microorganisms noted that early-life exposure to antibiotics and a high-fat diet can lead to long-term metabolic dysfunction. These factors can disrupt the activity of intestinal epithelial cells (IECs), which are responsible for regulating lipid metabolism, nutrient absorption, and gut hormone production. Disruption of IECs may contribute to obesity.
Childhood obesity has increased dramatically over the past three decades. In the U.S., about 20% of school-aged children are classified as obese. In Malaysia, a review published in 2025 indicates the prevalence of overweight, obesity, and excess weight among children is 13.9%, 11.8%, and 24.0%, respectively. Obesity is complex, influenced by both genetic and environmental factors, and often continues into adulthood. Studies suggest that gestational diabetes and maternal obesity can also increase the risk of diabetes and obesity in offspring by affecting fetal development.
In conclusion, probiotics may support digestive and immune health, especially during infancy and early childhood, and may help reduce health risks later in life. While not all children require probiotic supplements, maintaining a diet rich in fibre, prebiotics, and fermented foods like yogurt can promote the natural growth of beneficial bacteria in the gut.
Parents should consult healthcare professionals to determine the appropriate probiotic strains and dosages for their children, especially if there are specific health concerns. Ultimately, a balanced diet and a healthy lifestyle are essential for fostering a resilient gut microbiota in children.
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