What You Should Know about Prebiotics and Probiotics

There is a lot of interest in prebiotic and probiotics generated mainly by companies producing infant milk formula on the beneficial effects of these two agents. Probiotics are the 'good' bacteria that is found in the intestines. Prebiotics are food nutritients for probiotics or the 'good' bacteria. The idea of giving a baby prebiotics is to provide nutrition to the good bacteria so that it will grow in the intestine. It is postulated that the presence of good bacteria (probiotics) helps the newborn's intestine to develop their immune response to infection and maybe allegy. Human milk contains prebiotics.

The newborn intestine is sterile. Colonisation of the intetsine begins almost immediately with different bacterias, differing by whether the baby is exclusively breast fed or formula fed. Nevertheless by six weeks, the organisms in the intestines of these two groups are the same. Does this warrant the addition of prebiotic and probiotic to infant formula? Apparently these companies think so because they are marketing the addition to infant formula of prebiotics and probiotics as directly responsible to improve the child's immune response and to reduce allergy.

What are the facts?

• while probiotics is useful in the treatment of infective and antibiotics diarrhea, there is no evidence available that prebiotics and probiotics improve or strengthened a child's immunity.
• a Cochrane review in 2007 conclude that there is insufficient evidence to warrant routine supplement of probiotics to either pregnant women or infants for prevention of allerguc disorders in infant. The Cockrane review is a database for evidence-based medicine.
• The American Academy of Pediatrics (AAP) recently issued an extensive Clinical Report: Probiotics and Prebiotics in Pediatrics authored by Dan W. Thomas, MD, Frank R. Greer, MD, and the Committee on Nutrition and the Section on Gastroenterology, Hepatology, and Nutrition.

Medscape conducted an interview with Dr Thomas concerning this report,
 

Medscape: While the report makes clear that human milk is the preferred food for infants, what would you suggest primary care providers advise parents who choose to bottle-feed? Should infant formula supplemented with probiotics be recommended?

Dr. Thomas: No one can answer this question at this time. The health benefits of feeding infant formula containing probiotics and/or prebiotics are unproven. In essence, this report challenges industry and healthcare researchers to conduct high-quality, evidence-based studies to answer these questions.

 
The addition of prebiotics and probiotics to infant formulas is another example of industrial driven marketing based on doubtful or unproven scientific data. The inclusion of prebiotics and probiotics follow a trend of additional of supplements to infant formulas. As with prebiotics and probiotics, all these supplements have no or doubtful evidence that they are of actual value. With each inclusion, the price of the infant formula increase. This is a burden to mothers who are unable to breast feed because they could not produce milk or they have to work. In the meantime, these infant formula companies which are usually multinationals make millions.