Lactobacillus Therapy for Diarrhea

Mother feeling son's forehead
Diarrhea in Children. Tom Merton / Getty Images

Taking care of children with diarrhea is frustrating for both parents and pediatricians, both because the symptoms can often linger for several weeks and because there are few (if any) treatment options.

Classic Treatments for Diarrhea

The usual recommendations for treating children with simple diarrhea that is caused by a virus is to continue with the child's regular diet if it is being tolerated (not causing vomiting or increased diarrhea), give extra fluids, such as a few ounces of Pedialyte or other electrolyte solution, every time that he has diarrhea, and to avoid over-the-counter anti-diarrheal medications.

For children not tolerating their usual diet, a more bland diet, such as the BRAT (Bananas, Rice, Applesauce, Toast) diet, may be tried. If the diarrhea is made worse by milk and dairy products, then your child may have a secondary lactase deficiency and might benefit from a trial off of milk, or a change to a lactose-free or soy milk/formula.

Lactobacillus Therapy for Acute Infectious Diarrhea

A review article in the journal Pediatrics, "Lactobacillus Therapy for Acute Infectious Diarrhea in Children: A Meta-analysis," offers another treatment. While the treatment has been used for centuries, the article offers some proof that it can be safely used in children. The article states that 'Lactobacillus is safe and effective as treatment for children with acute infectious diarrhea.'

What is Lactobacillus? It is a bacteria and includes the strains L. bulgaricus, L. reuteri, L. GG, and L. acidophilus. Although it seems strange that you would actually want to feed your child bacteria, Lactobacillus is normally found in our intestinal tract.

How effective of a treatment is Lactobacillus for children with diarrhea? Well, children in the studies who received Lactobacillus had about a half a day (0.7 days to be exact) decrease in the duration of their diarrhea, and 1.6 fewer episodes of diarrhea after the second day of treatment. So the effects of treatment weren't very impressive.

The main treatment remains the 'tincture of time' as they used to teach us in medical school, which means that you just need to give your child some time until he gets better on his own. If you feel the need to do something while you are waiting for the diarrhea to go away, or you think the small benefits are worth it, then giving Lactobacillus is definitely an option.

Giving Kids Lactobacillus

How do you give your child Lactobacillus? In the studies from the Pediatrics' journal report, most children received 10 to 100 billion colony forming units of Lactobacillus once or twice a day, so you would want to give an equivalent dose to get a comparable effect. Or at least try to reach the 'threshold dose' of 10 billion colony forming units during the first 48 hours.

One common way to give Lactobacillus is to just feed your child yogurt with live and active cultures, which means that the yogurt contains Lactobacillus bulgaricus and Streptococcus thermophilus. Some brands of yogurt also contain Lactobacillus acidophilus. Although most brands of yogurt do not list the amount of live and active cultures on the label, you can look for brands with the National Yogurt Association's Live and Active Culture seal, which must contain at least 100 million active cultures per gram. In a 4 ounce pack of yogurt, that should equal about 10 billion colony forming units, so eating 1-2 packs of yogurt a day should be about equivalent to what the children got in most of the studies.

Another way to give your children Lactobacillus is to have him take Acidophilus supplements or other probiotics. These are commercially available in powder, liquid, capsule, or chewable tablets and they generally have about 1.5 billion colony forming units per teaspoon or tablet. To reach the 'threshold dose', you would have to give 6 to 7 teaspoons or tablets a day, though.

You may also be able to offer your child Acidophilus milk (cow's milk supplemented with acidophilus), although I am not sure how widely available or well-tolerated it is.

Diarrhea in Children

When considering whether or not to offer your child Lactobacillus supplements when he has diarrhea, there are a few factors to consider.

First, the children in the studies were hospitalized. There is no evidence yet that children with mild diarrhea who do not require hospitalization will have the same results. Also, keep in mind that the effects were not that impressive and children only had about 1/2 day less diarrhea. And it may be hard to get your child to eat yogurt or take a supplement when he is already feeling sick and likely has a decreased appetite.

In these children, pushing fluids will likely be your top priority to prevent dehydration.

Still, since it is safe and has some proven benefits, giving your child Lactobacillus is a good treatment option for children with acute infectious diarrhea.

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