• Original Articles By Dr. Lavin Featuring Expert Advice & Information about Pediatric Health Issues that you Care the Most About

    Being a Pro with Probiotics

    By Dr. Arthur Lavin

    We are often asked what our take on probiotics is.  This one is easy, they are great.  I think of probiotics as the ladybugs of the body.  It is not only harmless, but very helpful, to let loose zillions of ladybugs on a field.  They kill pests and cause no harm.  A very, very unusual pair of properties.

    Just so with probiotics, they all feature bacteria that are found in everyone’s gut, that help our bodies work, present no harm, and can help.

    Of course, you don’t need me to think about giving them to your child, probiotics have long reigned as one of the 3 most common supplements used.

    But as with all substances we think about giving our children, the same two questions have to be asked:

    1. Does it work?  That is, if used, what will really be better in your child’s life?
    2. Does it hurt?

    For probiotic, two conditions must be met for them to work.  First, there have to be living, good germs in the pill or liquid.  Second, the germs in there have to be helpful.

    As far as harm goes, no harm to date has been found, a very unusual fact.

    Probiotics have been proven to help in two situations:

    1. Stomach flu
    2. Antibiotic side effect of diarrhea.

    Probiotics and stomach flu

    With regard to stomach flu, there are two good germs that seem to help:  Lactobacillus rhamnosis GG (LGG) and Saccharomyces boulardii (SB).

    Most of the studies published have found benefit from LGG, some from SB, and none from 25 other species of germ tried.

    So the first point is that if you want to treat your child’s stomach flu with a probiotic, make sure it contains LGG or SB.

    Then you have to be sure there are actually enough germs in the probiotic to make a difference.  The unit of how many germs are in a probiotic is the CFU, or colony forming unit.  That is, if you take a pinch of the product, how many colonies of the germ will grown in the lab?

    The magic number for LGG is 10 billion CFU daily. So if the liquid has 5 billion CFU per teaspoon, you would need two teaspoons a day.  If it has 1 million CFU per pint, you’ll never get to 10 billion a day.

    How well does it work?  Well if you give 10 billion CFU of LGG daily, you sharply decrease the chance your child’s diarrhea will last longer than 4 days, and the average drop in duration of diarrhea is one day.  It has no impact on vomiting, and does not cease diarrhea, just shortens the time it lasts.

    Probiotics and the diarrhea from antibiotics

    Again, the germs LGG and SB stand out as most effective.  Use of either dropped the chance your child will get diarrhea if placed on antibiotics by 50%.  The dose that makes that happen is 20 billion CFU a day for LGG or 5 billion CFU a day for SB.

    Other benefits

    Like most unregulated products, the claims for probiotics are all over the place.  Why not?  If you make a probiotic and the law lets you claim it can cure anything, why not claim?

    But like most situations, reality has a way of imposing itself.  In this case, there is little evidence that probiotics do anything beyond shorten the diarrhea of stomach flu, and prevent the diarrhea from use of antibiotic.


    1. You have read in these postings that the world of supplements is a Wild West festering with fraud and lies, but probiotics stand out as a product that, if used well, can help.
    2. The species that really help are Lactobacillus rhamnosis GG (LGG) and Saccharomyces boulardii (SD).
    3. LGG at 10 billion CFU a day shortens how long your child’s diarrhea from stomach flu will last.
    4. LGG at 20 billion CFU a day or SD at 5 billion CFU a day can cut the chance of your child developing diarrhea when on an antibiotic in half.
    5. A reliable source of LGG is Culturelle Kids Probiotic (5 billion CFU per dose)
    6. A reliable source of SD is Florastor Kids (5 billion CFU per dose)

    To your health,
    Dr. Arthur Lavin


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