December 2, 2010 — The currently known health benefits of probiotics and prebiotics, including those added to infant formula and other food products for children, are reviewed in an American Academy of Pediatrics (AAP) report published online November 29 in Pediatrics.
"Efforts to optimize the intestinal microbial milieu have increased the interest in adding probiotics and prebiotics to nutritional products. As with antibiotics, the use and efficacy of probiotics and prebiotics should be supported by evidenced-based medicine," write Frank R. Greer, MD, FAAP, and Dan W. Thomas, MD, FAAP, and the Committee on Nutrition; Section on Gastroenterology, Hepatology, and Nutrition. "The purpose of this clinical report is to review the medical uses of probiotics and prebiotics and to summarize what is currently known about their health benefits as dietary supplements added to food products marketed to children, including infant formula. The guidance in this report will help pediatric health care providers to make appropriate decisions regarding the usefulness and benefit of probiotics and prebiotics for their patients."
Probiotics are supplements or foods containing viable microorganisms capable of changing host microflora. Randomized clinical trials (RCTs) have shown probiotics to be modestly effective in treating acute viral gastroenteritis in healthy children. For otherwise healthy children and infants with diarrhea from acute viral gastroenteritis, giving probiotics early in the course may reduce the duration of diarrhea by 1 day.
Despite the lack of evidence for the efficacy of probiotics in treating antibiotic-associated diarrhea in otherwise healthy children, RCTs have shown that they are modestly effective for prevention.
Although more studies are needed, some evidence supports probiotic use to prevent necrotizing enterocolitis in very-low-birth-weight infants (birth weight between 1000 and 1500 g).
Before probiotics can be recommended for treatment of irritable bowel syndrome, Crohn's disease, colic, and constipation, or for prevention of common infections and allergy in children, additional studies are needed.
However, preliminary results were encouraging in RCTs in which probiotics were used to treat childhood Helicobacter pylori gastritis, irritable bowel syndrome, chronic ulcerative colitis, and infantile colic, or to prevent childhood atopy. Evidence to date has not shown a benefit of probiotics in treating or preventing human cancers or in treating pediatric Crohn's disease.
Routine use of probiotics or prebiotics added to infant formula and other foods intended for consumption by children is not supported by currently available evidence of clinical efficacy, but these formulas do not appear to harm healthy infants and children. However, probiotics should not be administered to children with chronic or serious diseases, including children who are immunocompromised, chronically debilitated, or who have indwelling medical devices.
Prebiotics are supplements or foods containing a nondigestible food ingredient that selectively promotes growth and/or activity of indigenous probiotic bacteria. Prebiotics found in human milk may help reduce common infections and atopic eczema in healthy infants, but more evidence is needed before adding prebiotics to infant formula can be recommended.
неск/ моментов из статьи: Рандомизированные клинические исследования (RCTs) показали пробиотики показали скромную эффективность при лечении острого вирусного гастроэнтерита в здоровых детях. Так как иначе здоровые дети и младенцы с диареей от острого вирусного гастроэнтерита, давая пробиотики рано в лечении могут уменьшить продолжительность диареи на 1 день.
Несмотря на нехватку доказательств эффективности пробиотиков в рассмотрении связанной с антибиотиком диареи в общем здоровых детях, RCTs показали, что они скромно эффективны для ее предотвращения.Хотя больше исследований необходимо, некоторые доказательства поддерживают пробиотическое использование, чтобы предотвратить некротизирующий энтероколит у младенцев с"очень низким весом при рождении" (вес при рождении между 1000 и 1500 g)....Однако, предварительные результаты были ободрительны в RCTs, в котором пробиотики использовались для лечения детсткого гастрит,вызванного Helicobacter Пилори, синдром раздраженной толстой кишки, хронический язвенный колит, и инфантильная колика, или предотвратить детские атопические заболевания. Доказательства до настоящего времени не показали выгоду пробиотиков в рассмотрении или предотвращении человеческих раковых образований или в лечении педиатрической болезни Крона.
Обычное использование пробиотиков или пребиотики, добавленной к младенческой формуле и другим продуктам, предназначенным для потребления детьми, не поддержано в настоящее время имеющимся доказательством клинической эффективности, но эти формулы, кажется, не вредят здоровым младенцам и детям. Однако, пробиотиками нельзя назначать детям с хроническими или серьезными болезнями, включая детей, которые с ослабленным иммунитетом, хронически истощенные