I have previously written a little bit about prebiotics and probiotics in baby formula in the series about how to choose a baby formula. However, I get so many questions about this, and it’s such a hot topic these days that I wanted to make you all experts.
The microbiome is the hottest new thing in medicine. It is all the rage in the research world and is now thought to be responsible for practically everything. Yes, just like fashion, trends come and go in medical research as well. Right now, the microbiome is hotter than the lumberjack hipster look in Denver!
The intestinal microbiome is a term for all the bacteria that live in our intestine (mostly our colon). And this is a lot of bugs! Your colon is home to roughly 10 times more bacteria than you have cells in your entire body; Roughly 60% of your stool is actually made up of bacterial cells … that is cray! Your microbiome plays several major roles in the human body and new roles are being discovered every day. Currently we know that these good bugs are critical for our immune system and our weight regulation, and this is the case for infants too.
Babies are actively “growing” their microbiome which starts to develop even before birth. Whether your baby was born vaginally or via c-section plays an enormous role in what his/her microbiome will look like. But hey, the hell of delivery is behind you now so let’s not dwell on it! Let’s focus on what we can do with nutrition after birth to give baby the best chance of growing a healthy microbiome.
The infant microbiome of breastfed babies is very different than the microbiome of formula fed infants. There are lots of reasons for this. The first is that breast milk itself contains probiotic bacteria.
Probiotics are actual live bacteria that are considered “healthy”. These are the good guys.
The amount of probiotics in breast milk is very small, but is still thought to play a role in developing the infant
microbiome. Additionally, breast milk provides a large variety of probiotics that change over the course of lactation, and differ between moms. That makes it very hard to replicate.
Even more importantly, breast milk also contains a whopping load of prebiotics.
Prebiotics are food sources for healthy bacteria.
The prebiotics in breast milk are called human milk oligosaccharides (or HMO’s). These are chains of carbohydrate that baby is not capable of digesting, so they make it all the way to the large intestine where they serve as food for the good healthy bacteria there. The amount and variety of HMO’s in breast milk is literally astounding and is unique to every mom. All that prebiotic provides fuel for a very special kind of bacteria that we want to grow in baby’s gut. HMO’s also help protect the baby from infection, and help the immune system develop. These HMO’s, combined with the live bugs themselves creates a perfect recipe for the ideal infant microbiome.
The complexity of the prebiotics and probiotics in breast milk make it impossible to duplicate in formula. However, it is still worth trying to get our formula-fed babies’ microbiomes to look more like breastfed babies because of all the benefits we know this has! So far, the baby formula industry has thought of 2 ways to try to do this: 1) by adding prebiotics to formula, or 2) by adding probiotics to formula
What do probiotics look like in baby formula:
There are a few different types of probiotics that are added to some baby formulas. These good bacteria are chosen because they are either found in breastmilk and/or because they grow abundantly in breastfed babies’ guts. The two most common seem to be Lactobacillus Reuteri and Bifidobacterium Lactis (often just L. Reuteri or B. lactis on a label). Both of these probiotics have been researched to show that they are safe for even young infants to consume (1).
L. Reuteri is unique because there has been a lot of research done on this little bug, all focusing on infant colic. There are some pretty convincing studies that show that providing L. Reuteri to colicky babies results in less crying bouts and less total minutes of crying compared to either a placebo or gas drops (2)(3)(4). Hey now! If anyone reading this has ever had a truly colicky baby, we all agree that we have tried some much crazier things to get that baby to calm down (cue endless hours of swinging baby in the carseat, running the dryer with nothing in it, or walking up and down the stairs…). Providing a probiotic in a bottle that may help after just 7 days is one of the more logical things to try. If the colic is due to some underlying gastrointestinal discomfort, the probiotic may help to soothe this. However, the horrible thing about colic is we don’t know what causes it, so we can’t predict what babies will respond well to L. Reuteri. But it won’t hurt baby to try. Gerber makes a supplement that is pretty cheap, and ready for the correct dosages for babies.
L. Reuteri is also the probiotic in Gerber Good Start Soothe (see the chart below).
B. Lactis is one of the common bacteria found in breastfed babies’ intestines, and it is the one in Gerber Good Start Gentle. Gerber claims that it will help with babies’ immune development. Although, this is a bit funny to me, since one of the major roles of the microbiome as a whole is to aid in proper immune function…. But that’s marketing.
While I do think it is worthwhile to provide your formula fed baby with a probiotic (especially if you’ve got a colicky little angel on your hands), I want you to understand exactly what that means in biological terms. The microbiome is incredibly enormous in terms of the number and types of bacteria.
Here’s an analogy: Imagine your microbiome is like an outdoor in-ground swimming pool (deep-end and all) which is filled with colored balls from a playground ball pit. If this represents your baby’s microbiome, then each ball would be a different bacteria. There would be about 300 different colors of balls. Now roughly 80% of the balls would be 10 colors, but there would be 300 different colors represented. B. Lactis may be red. It’s one of those 10 common colors/bugs.
Providing a probiotic at the recommended dosage is like throwing ONE red ball into that swimming pool of balls. Wait, it’s not even that much. Some of the bugs will no longer be alive/active in the supplement, and some will not survive the acidity of stomach … so it’s more like throwing half of a red ball into the swimming pool. With this in mind, it seems insane that there are any studies at all that show benefit!
I give you this analogy to be sure you understand the context of what a probiotic may or may not do in the gut. If you understand this, you likely understand that you will see benefits only after prolonged (7 days at the very least!) and consistent (daily!) use. Still worth trying, especially since there’s no risk to your little one.
What do prebiotics look like in baby formula:
Adding a prebiotic to a baby formula is similar in context to adding a probiotic. There is an enormous variety of prebiotic glycans in breast milk. “Glycans” is just a super fancy science word for the chemical structure of the prebioitics – use it in order to show off to friends. Prebiotics in formula come in 2 general categories these days.
1 – Specialty formulas (like Similac PRO, and Gerber HMO) have a prebiotic that is actually found in breast milk: 2-fucosyl-lactose (or 2FL). This HMO helps the healthy bacteria grow and may have some immune benefits too (5)! However, remember that breast milk is full all kinds of different HMO’s. While 2FL is one of the most common, there is a large percentage of Moms that don’t put ANY 2FL into their breast milk (6). So, while having a breast milk-derived prebiotic is certainly appealing and likely helpful for many babies, I don’t think we haven enough research to universally recommend it. If you want to learn more about this HMO in formula, I’ve got this video for you!
2 – More traditional prebioitc fibers have been added to formulas for years. All of the breast milk prebiotic glycans (or HMO’s) are built off of the main sugar in breast milk – lactose. The alternative prebioitic glycans added to baby formula are built off of different sugars, either galactose or fructose. That’s why you see them on the list of ingredients as “galacto-oligosachharides” or “fructo-oligosaccharides”. Another one is “polydextrose” These different prebioicts are lab derived substitutes. While they DO serve as food for good bacteria, they don’t provide immune protection, and are not something that we find in breast milk.
You know what else in breast milk is a prebiotic? Lactose! Yup, some of that lactose in breast milk is not digested and makes it all the way down to the large intestine where it is “eaten” by good bacteria. The same thing will happen with baby formulas that contain lactose. This is another reason I recommend starting with a formula that has some lactose in it.
To summarize prebiotics, here’s an analogy. The prebiotics in breast milk are like providing the bacteria with every dish imaginable on tables that fill a banquet hall. A single galacto- or fructo-oligosaccharide offers the bacteria a single cup of broccoli. Like the probiotics, I still think it’s worthwhile to provide prebiotics to formula fed babies! Better to give broccoli than nothing! I just want you to know what you’re giving, and why you are giving it.
So how do I translate this new knowledge into real life purchasing decisions?
Now that you have all this rockstar scientist knowledge, how does it affect your purchasing decisions? First, you now know what you are looking for on the label, and how to not fall victim to simple marketing. To help you out, I have provided a list below of all the main name-brand formulas for healthy term infants that contain either pre- or pro-biotics. Plenty of other generic brands will have some of these ingredients as well, you just have to look on the list of ingredients to find them.
| Formula | Pre or Probiotic | What Type | Marketing Claim |
|---|---|---|---|
| Gerber Gentle | Prebiotic & Probiotic | 2′-Fucosyllactose (2FL) & B. Lactis | Closest to breast milk |
| Gerber Soothe | Prebiotic & Probiotic | 2′-Fucosyllactose (2FL) & L. Reuteri | For excessive crying, colic, fussiness, and gas |
| Gerber Gentle for Supplementing | Probiotic | B. Lactis | Nutrition to complement breast milk |
| Gerber Natura | Prebiotic | Galactooligosaccharides | Organic |
| Enfamil Infant (Original, Premium & NeuroPro) | Prebiotic | Galacto-Oligosaccharides, Polydextrose | Supports older milestones like grasping |
| Enfamil Newborn | Prebiotic | Galacto-Oligosaccharides, Polydextrose | Tailored for early milestones like focus |
| Enfamil Gentlease (Original, Premium & NeuroPro) | None | Eases Fussiness, Gas and Crying | |
| Enfamil Reguline | Prebiotic | Polydextrose, Galacto-Oligosaccharides | Support digestive health and promote soft stools |
| Enfamil Enspire | Prebiotic | Galacto-Oligosaccharides, Polydextrose | Cognitive and Immune Benefits |
| Enfamil AR | Prebiotic | Galacto-Oligosaccharides, Polydextrose | #1 selling brand for spit up |
| Similac Advance | Prebiotic | Galacto-oligosaccharides | Closer than ever to breast milk |
| Similac Pro-Advance | Prebiotic | 2′-Fucosyllactose (2FL) & Fructooligosaccharides | Immune Support |
| Similac Pro-Total Comfort | Prebiotic | 2′-Fucosyllactose (2FL) & Fructooligosaccharides | Easy to digest and Immune Support |
| Similac Sensitive | Prebiotic | Galacto-oligosaccharides | For fussiness and gas due to lactose insensitivity |
| Similac Organic | Prebiotic | Fructo-oligosaccharides | Organic |
| Similac Pure Bliss | Prebiotic | Galacto-oligosaccharides | Starts with fresh milk from grass fed cows |
| Similac for Supplementing | Prebiotic | Galacto-oligosaccharides | For Breastfeeding moms |
| Similac for Spit Up | Prebiotic | Galacto-oligosaccharides | Help Reduce Frequent Spit Up |
If you are interested in my professional opinion, I am going to dedicate the entire next article to tell you how I recommend integrating pre- and probiotics into your baby’s diet. Please note: I am not your pediatrician! ALWAYS check with your doctor before adding any supplement to your infant’s diet. However, I will give you my professional opinion and step-by-step instructions that you can easily share with your doctor before trying it out for yourself.
Did you find it helpful to add a pre- or probiotic to your infant’s diet? Or have you found a baby formula you love with a pre- or probiotic that isn’t listed above? I’d love to hear about it! We all learn from each other’s experiences. Tell us all about it in the comments below.
xo, Bridget
References:
- Weizman, Z., and Alsheikh, A. (2006) Safety and tolerance of a probiotic formula in early infancy comparing two probiotic agents: a pilot study. J. Am. Coll. Nutr. 25, 415-419
- Savino, F., Cordisco, L., Tarasco, V., Palumeri, E., Calabrese, R., Oggero, R., Roos, S., and Matteuzzi, D. (2010) Lactobacillus reuteri DSM 17938 in infantile colic: a randomized, double-blind, placebo-controlled trial. Pediatrics 126, e526-533
- Savino, F., Pelle, E., Palumeri, E., Oggero, R., and Miniero, R. (2007) Lactobacillus reuteri (American Type Culture Collection Strain 55730) versus simethicone in the treatment of infantile colic: a prospective randomized study. Pediatrics 119, e124-130
- Szajewska, H., Gyrczuk, E., and Horvath, A. (2013) Lactobacillus reuteri DSM 17938 for the management of infantile colic in breastfed infants: a randomized, double-blind, placebo-controlled trial. J. Pediatr. 162, 257-262.
- Goehring, K., Marriage, B., Oliver, J., Wilder, J., Barrett, E. and Buck, R. (2016) Similar to Those Who Are Breastfed, Infants Fed a Formula Containing 2′-Fucosullactose Have Lower INflammatory Cytokines in a Randomized Controlled Trial. J. Nutrition. 146, 2559-2566.
- McGuire, M., Meehan, C., McGuire M., Williams J., Foster J., Sellen D., et al. (2017) What’s Normal? Oligosaccharide concentrations and profiles in milk produced by healthy women vary geographically. Am J Clin Nutr. 105 (5), 1086-1100.
I have decided to try European formula for my little one, which is the Hipp Dutch stage 1 because of the added pre plus probiotic in the formula. But after reading this article I then found that the probiotic in the Hipp is neither L.Reuteri nor B.Lactis. Instead it’s said to be LACTOBACILLUS FERMENTUM HEREDITUM®2. Is it as safe and good for infant like the other two bacterias would do?
Hey Truc
This is Emily, Dr. Young’s assistant. Thank you for your question. I wanted to direct you to a video Dr. Young did where she compares HiPP vs Holle vs. Lebenswert. She includes this update in the description just fyi: **update!*** I got my hands on a German label. HiPP German, stage 1 and stage 2 DO contain a probiotic: Lactobacillus Fermentum. Just so you know there is also an update.
As always, check with your baby’s doctor, take any changes slowly and keep loving on that little one for us!
Emily
Hi! Love you videos and blog!
My daughter is 3 months old and just made the switch to Gerber HA due to reflux and a suspected milk protein allergy. She previously was on the Gerber soothe drops probiotic with parents choice sensitive formula. Now that she is on the Gerber HA formula should I continue the probiotics added with the ones that are already in it? Or stop the drops? Any help or advice is appreciated!
Hey Jamie
This is Emily, Dr. Young’s assistant. I am so glad you are loving the blog and videos. I know they were a huge help to me as well when I was feeding my youngest formula!
I am not sure if you have already seen this video about switching formulas when you are using a probiotic, but I am going to link it here as a reference for your question. I hope this helps guide you!
As always, check with your child’s doctor, take any changes slowly and you are an awesome mom! Snuggle that baby for us.
Emily
Hi, so i actually am fostering a baby, ive had him since about 1mo. Hes always been very gassy and hard to burp. Ive noticed all the signs of silent reflux. I took him to his ped. And she did nothing told me to give him more food. Hes 5 months now and on gerber soothe. He cries all day we have read & done everything except probiotics. We have even changed bottles 15x and finally found one that he dont choke down. We bounce him, rock him, burp him. Sometimes you can hear the gas gurgling around in his belly. I know hes a c-section baby. What are your suggestions?
Hey Kelly,
This is Emily, Dr. Young’s assistant. I am so sorry to hear your little one is suffering from gas and crying all day. I know that can be so trying. First of all you are doing a great job and thank you so much for being a foster mom! That is a huge roll as a caregiver. I am going to direct you to a few videos that I hope can help you and your little guy. Dr. Young has a video all about Baby Gas that may be helpful She also has a video on Gripe Water vs. Gas Drops that could be of service to you and a blog post here as well. And even a video on New Colic Tips that may help.
I hope these videos give you a bit more advice and direction for your little guy. As always check with your pediatrician, take any changes in formula slowly and keep loving that little guy.
Emily
My 2 month old bb was on gentlease at birth. Bug had baby acne, so we switched him to soy, acne cleared up. By week three he tested positive for covid. Recovered well. At some point in time he started arching his back and neck and cries mainly with feedings but sometimes not even during feedings. We try burping every 2oz, he cries and tightens up, and rarely burps. We have tried burping after the whole bottle which seems to work better for the crying and stiffness. But then his belly is bloated and hard. He only fussed when he arches. He’s not really a crier. Pediatrician told us to try physical therapy. I thought it was gas and formula. So I switched him to Gerber soother. I would say he is 75% better. Still arches sometimes and belly still bloats. And rash is back all over body. Figuring it’s a milk allergy. I was thinking about switching him to the Gerber Extensive HA. When I called Gerber they said Soothe has Reuteri and Extensive HA has B Lactobacillus. Unsure what to do from here. Should I switch to the Ext Ha or try Nutramigen
Hey Tina,
This is Dr. Young’s assistant, Emily. I was able to check with Dr. Young to provide you some guidance for your little one! I am so very sorry your baby had COVID, how scary! The virus is still so new, we don’t know much about any long term effects so it’s best to keep talking with your doctor. Here is what Dr. Young said in regards to your formula questions:
“Yes, Gerber HA has a different probiotic than Gerber SoothePro, but the difference in protein is much bigger than the difference in probiotic. If you switch slowly, then then he should be able to handle the switch in probiotic super easily. It does sound like a trial of Gerber HA might help. If he does not improve, then you know the rash and arching are not from the protein source. You would always check with your doctor before changing formula, but especially before trying a hypoallergenic formula, so be sure to call them as well.”
You are doing great mama! I know this is a hard season but keep loving on that precious baby!
Emily
I’m wondering what the beneficial age range is for probiotics. For example, if my baby is on probiotics regularly for the first few months, do I then need to keep going or has the gut biome been established? When do I stop, assuming there aren’t particular issues like eczema or colic?
Sorry if this has been asked but I can’t seem to find an answer to this! If my baby is on Gerber Good Start gentle formula, can I still add a probiotic to it even though it contains one? I can’t find info on how much it contains. Just that it is B.Lactis. I have both Gerber soothe probiotics and mommy’s bliss. Gerber soothe seemed to help with his reflux and mommy’s bliss helped with keeping him regular. Any suggestion on what to do? Didn’t know if he can have too many probiotics? Thanks!
Hi Stephanie, definitely check to be sure your pediatrician is OK with it – but I think it should be fine! No one has asked about the Gerber before and its a great question! The Gerber Gentle (powder) when made will provide about 120 million CFU (which stands for colony forming units) in about 28 oz of formula when made. The drops will provide roughly 100 million CFU of a different strain. The Mommy’s Bliss provides 1 BILLION of a third strain. So altogether, he’s getting less than 2 billion CFU combined of 3 different strains. For comparison, some multi-strain infant probiotics provide up to 3 or 5 billion CFU. So, if he’s tolerating it, then I think its fine – but absolutely check with your doctor.
I am currently vacillating between choosing Gerber Goodstart Gentle and Plum Organics Gentle for my 3 month old who we will need to start supplementing very soon. My only reservation with Plum is that it does not contain pre or probiotics. Our pediatrician is ambivalent. Are the pro/ probiotics less important if the baby is also getting some breastmilk? Should it be our deciding factor (it seems like the two formulas are otherwise very comparable)?
Thank you for your site!
Hi Lindsay!
In my opinion, EVERYTHING is less important if baby is getting breast milk. You can always add probiotic drops if you’d like. The main differences between the 2 are: Plum is organic and provides 100% lactose as carb. Gentle provides a PRE and PRObitoic (which she is getting a better version of in her breast milk), and the carb is 70% lactose, and 30% maltodextrin.
So, I’d suggest you start with the Plum. If she develops signs of having a hard time with all that lactose (usually gas), then you have something ready to switch to. That is just my opinion – trust your intuition here Mama!
My son is on Nutramigen formula and is very sensitive to dairy. Do you think
1. A pro biotic would be beneficial to him?
2. If you do recommend him taking a probiotic which one would work without causing issues due to his dairy issue?
Thank you for your help.
Hi Shannon, well – check with your doc first. A probiotic is not going to help him with his allergy, but it may help his intestines heal. Just be careful. I have observed that some infants whose intestines are “raw” (for lack of a better word) sometimes don’t respond well to probiotics until they are healed. Every baby is different! If he is doing well on the Nutramigen, then I would start him on a single strain bifidobacterium probiotic. Make sure your doc thinks it’s also a good idea.
Thank you so much for posting this! What is the difference between the probiotic B Lactis and L Reuteri? I have been trying to research it and I’m not finding anything. I currently have my baby on Geber soothe who is colic and this has helped him a lot! The only problem is it makes him constipated. I wanted to try Gerber gentle since it does not seem to much different than soothe but maybe hoping the different probiotics in gentle could help him.
Hi Chelsea! These are 2 different bacteria: one Bifidobacteria, and one Lactabacillus. L Reuteri has actually been shown in clinical trials to reduce symptoms of colic. B. Lactis has been shown to provide other benefits, but not helpful for colic.
Even bigger – Soothe is 30{d3431cee00683dd1c43a4eb0fdbd2aadf61cae39541cb3bcdd241b07539079d2} Lactose and Gentle is 70{d3431cee00683dd1c43a4eb0fdbd2aadf61cae39541cb3bcdd241b07539079d2} Lactose. So if he needs a low lactose formula then Gentle won’t be a good fit for him. Ask your Dr about tips to help with constipation. Adding another probiotic might help. There are also baby constipation supplements (Mommy’s Bliss makes one). Ask your Dr if you can try one of these when he is blocked up. And when he’s old enough, there’s lots you can do with solid food to help with constipation.
Probiotics are really good not just for babies but also for moms. I actually used a probiotic all throughout my pregnancy and breastfeeding stage. Qiara probiotics really helped me a lot. I suffered form mastitis on my first born and my probiotic supplement stopped it. At the same time, during my pregnancy it assured me that I am taking the right nutrients for my baby.
Just curious if you use/d probiotics when feeding formula to your babies? Would you recommend probiotics to all formula fed babes, even those that aren’t having issues? I had abx for Strep B, ended up with a C-section and ended breastfeeding at 5 weeks due to a nasty case of thrush. But baby has no problems – should we use a probiotic? Our ped is ambivalent.
I actually did not use a probiotic with my kids once I introduced formula as I was very blessed to be able to always provide breast milk and was able to squeeze both those huge-headed suckers out vaginally. I will say that I did introduce a probiotic to my oldest around 24 months when he developed some eczema. It has been extremely helpful with that. Once my youngest was 12 months old, I just put him on it as well since I give them the probiotic in their sippy cups and they are constantly exchanging 🙂
Hello, do you think the pro- or pre-biotics in breastmilk are killed when the milk is heated? I noticed that probiotics bottles often need to be refrigerated so I wonder if my twin babies for whom I exclusively pump are missing out on the good stuff when I feed them defrosted and heated breastmilk. Thank you.
Hi Lara, awesome question! PREbiotics are actually super stable, so they survive the freezing and re-heating really well. Some of the PRObiotics will not survive the freezing process. The heating process isn’t too harmful since you don’t boil a bottle, you just warm it up to body temp … which is what bacteria like best. Also remember that there are other amazing things in milk that help keep your baby healthy, so loss of a few healthy bacteria does’t worry me at all. Plus, the amount or PREbiotics in breast milk is much larger than the amount of PRObiotics, so the most potent ingredient of the two is well-preserved.
How do you address helping developing micro biome in your infant after you receive IV antibiotics for Strep B? I would think that Prebiotics alone wouldn’t be enough and probiotics don’t provide the ‘food’ for the good bacteria to feed upon.
Hi Keri, This is literally a million dollar question (with a LOT of researchers working on it, and companies trying to sell you things). The real answer is, we don’t know how to help babies restore a “perfect” microbiome because we aren’t even sure what that looks like! And every baby is different. A little breast milk goes a long way, as far as providing lots (and a large variety) of PREbiotics. And probiotics can be very helpful for babies who experience events that can dramatically alter the microbiome (like C-section and antibiotics). But there is NOT one perfect protocol. Anyone that tells you there is …. is probably trying to sell you something. It takes a little experimenting. Also remember that probiotics in the intestines also digest components of the diet and formula, so PREbiotics in formula are not required for health! And there are other things you can do to help your baby develop a super healthy microbiome like: lots of skin to skin time (even if you’re not breastfeeding!) to be sure you share your environment and germs, avoiding as many unnecessary chemical exposures as you can, allowing your child to explore their environment as they become mobile (so don’t panic when you find them putting dirt into their mouth). Even having pets in the house, or exposing them to animals and farm environments is helpful! In short, spending time outside with your baby 🙂 There is SO much about the microbiome that we are still learning, I don’t want it to be a source of stress or anxiety for you.
Thanks for the above article but I have one question. In the National Health and Medical Research Council Infant Feeding Guidelines, do not recommend the routine use of pre-probiotics in infant formula. This is because there is not enough research to judge the long term effect of routine use in infants. Because the microflora of infants is not stable until around 2-3 years of age, could it cause an unbalance with routine use? Also, I read that it all depends on the strain of probiotic, is this true? Another one I always ask myself is how much probiotic is still alive after it sitting in the can, on s shelf, possibly in different temperatures, plus open and closing the lid multiple times? It’s really confusing!
I read another article from the hospital that said it recommends the use of oral, temp controlled, specific strain of probiotics in pre-term infants but only for a certain amount of days. Why would we give s probiotic in formula up to 6 times a day? Could this have the revers affect and cause diarrhoea?
Sorry for all the long comment but I just find there are so many unanswered questions still. ?
Hi Michelle, these are great questions. The short answer is “no one knows what’s perfectly best” and that is why there is differing opinions. The microbiome field is growing so rapidly, and is SO complex that we don’t fully understand it 100{d3431cee00683dd1c43a4eb0fdbd2aadf61cae39541cb3bcdd241b07539079d2}. The reasoning behind probioitcs in formula is to try to replace what formula fed babies aren’t getting from breast milk. Breast milk contains certain probiotics, which are delivered with every meal so we try to replicate that with prbiotics in formula. I do think strain matters and only recommend strains that are known to be present in breast milk and in breast fed babies’ intestines.
I think specific strains are used in premies to try and prevent specific terrible intestinal diseases/damage that premies are prone to. probiotics in healthy term formulas are attempting to optimize gut microbiome development to be more like breastfed babies – so the two situations (and thus protocols of administration) would differ.
I have never seen data suggesting that probitiocs in formula (in the strain and dosages used – which are WELL studied for safety) could cause diarrhea. However, in my personal practice, I have definitely seen a “cold-turkey” switch to probiotics cause intense gas and a few “blow out” stools.
It’s definitely still an evolving field. I recommend parents educate themselves, and then trust their intuition for their individual baby after they are informed on the topic. Sounds like you are a research rockstar!
Hi there — So love your site … beyond helpful in sorting through the sea of formulas out there!
(As FYI, the link on how to incorporate pre-and probiotics into baby’s diet isn’t working.)
Hi Addie – thanks so much for the kind words!
Also huge thanks for the tip on the broken link…. clearly I’m NOT a web designer 🙂
I did manage to fix the link though.
The 2FL added to similac Pro is the first probiotic in formula that is also found in breast milk and it provides some immune development effects to the baby – which is awesome! But we’ve got a LOT to learn about now HMOs (human milk oligosaccharides) work together to help baby’s develope. But it’s great to see the field progressing for formula fed infants. The other non-breast milk derived prebioitcs (like galactooligosaccharides (GOS), fructooligosaccharids (FOS) and polydextrose) have been shown to be safe for babies and help healthy bacteria grow – so they still provide benefit to the microbiome. Every baby is different and may tolerate one better than the other – in my experience.