A Pediatrician Shares – When to Start a Child on a Probiotic

By Lauren Crosby, MD, FAAP

Probiotics are everywhere these days—on pharmacy shelves, on various social media feeds, and frequently mentioned by healthcare providers and news outlets. This tends to make it very confusing for parents who want to make the right decision for their child’s current and future health. Parents often ask me if their child needs to take a daily probiotic and if so when to start it, when to stop it if they even should, and which one to try. Fortunately, there is a wealth of research and scientific information to answer these questions and guide parents in their decision making.

Live microorganisms

Probiotics are live microorganisms known as friendly or good bacteria that inhabit the digestive system, the gut, and provide a beneficial effect on health. This positive effect is seen at the level of the gut, but evidence shows that probiotics also play an important role in supporting and modulating the immune system. Because of this, I recommend probiotics are taken on a daily basis.

Factors impacting a child’s immune system

Method of delivery

A child’s immune system is impacted right from birth based on the method of delivery.  Term babies born by C-section or those who were exposed to antibiotics around the time of delivery don’t have the same beneficial intestinal bacterial colonization as babies born via vaginal delivery. This impairs their immune system development due to the lack of microbial diversity and low amounts of Bifidobacterium genus and the Lactobacillus genus, highlighting a role for supplementing with probiotics in the newborn period.

Environmental exposures

Often, a child has limited exposure to beneficial microbes, which help balance the exposure to an overabundance of diverse disease-causing microbes. Allowing a child to get a little dirty outside and allowing them to be around animals have shown to have a positive effect on the developing immune system. Exposure to environmental microbes is associated with a lower risk of developing allergies through the effect this exposure has on the gut microbiome. In fact, many of the probiotics on the market today were isolated from soil (some Bacillus strains) or other animals (some Lactobacillus strains). The use of a daily probiotic helps to increase early exposure to a variety of healthy microbes.

Daycare attendance during early life

Most parents know that once their child starts daycare, they will get sick regularly. Their immune systems are constantly being challenged. Studies show that these children suffer from an increase in respiratory infections and gastrointestinal illnesses much more than children who stay at home. There are societal costs related to the care and treatment of these sick children. These illnesses also end up causing many missed days at daycare for the child and many missed days of work for parents. Therefore, adding beneficial probiotics into the diets of children and their parents can go a long way in supporting their immune systems during this critical period.


Picky eating is a common issue during childhood, one that can impact the development and function of the immune system. There are many different types of picky eaters: eating reduced amounts of food, eating only a limited number of foods, being unwilling to try new foods, rejecting vegetables and fruits, exhibiting strong food preferences, and eating (usually unhealthy) snacks instead of proper meals. Studies have shown that consumption of processed foods, high-sugar intake, and/or high-meat and low-vegetable meals have been linked to an increased incidence of recurrent respiratory infections in children. Studies have also demonstrated that these children benefit from supplementation with macronutrients and micronutrients as well as functional ingredients such as a probiotic. (1)

Many children fit into at least one of the categories mentioned above, making them candidates for a daily probiotic supplement. In addition to the immune health benefits, probiotics have been studied and used for a variety of digestive health benefits. They naturally help with occasional abdominal discomfort, gas, bloating, stool frequency and consistency, and susceptibility to gastrointestinal infections. Probiotics produce beneficial metabolites that reduce intestinal inflammation, act as an energy source for intestinal cells, and support immune cell function. 

I believe in the use of a daily probiotic for all of my patients (and their parents). I’m aligned with the TruBiotics brand because their line of probiotics is customized by age and strain to give everyone in the family the right probiotic at the right time.

TruBiotics: choosing the right probiotic

To choose the right probiotic, the decision is based on your child’s age, the strain of the probiotic, and the type of product meaning liquid, chewable or gummy.

For infants, TruBiotics Baby Drops feature Bifidobacterium animalis BB-12.  This product is designed to increase beneficial bifidobacteria, which are important to establish a healthy microbiome and to support a baby’s digestive development. It also helps soothe infants’ upset stomachs, reduce fussiness and crying, and support regularity. This product is clinically proven to aid in reducing infant colic in breastfed infants aged 12 weeks and younger.

Compared to placebo, infants given BB-12 cried for an hour and twenty minutes less per day, had an average of five less crying episodes per day and slept an average of sixty minutes more per day. Parental quality of life scores also greatly improved.

For older children, TruBiotics makes two other targeted products. TruBiotics Kids Sugar-Free Chewable is developed for ages 2 years and up and features Bifidobacterium animalis BB-12 and Lactobacillus rhamnosus GG (LGG) strains. These strains are two of the most clinically researched probiotic strains to support digestive and immune health for children, and several studies have demonstrated that these strains decrease the risk of gastrointestinal and respiratory tract infections, decrease the frequency of these infections, and improve oral health which was shown in children as having fewer cavities.

TruBiotics also comes in a gummy form as TruBiotics Kids Probiotic Gummies for ages 3 years and older. It features the most clinically researched Bacillus probiotic strain B. subtilis DE111 in spore form. This strain can tolerate the processing of gummies, which requires high heat and water. Traditional live probiotic strains would not survive this type of processing. TruBiotics gummies are sugar-free and naturally sweetened with fructooligosaccharides (FOS) which are prebiotic fibers. FOS help to feed the probiotics and other good intestinal bacteria. Vitamin C is also included to provide extra immune support. This product has been demonstrated to decrease frequency of hard stools, diarrhea, GI discomfort, and it has been shown to positively support healthy gut function.

Choosing a probiotic can be an overwhelming task for parents because there are a multitude of products on the market.  This article was written with parents in mind, to help guide them to the right products that are scientifically backed and clinically shown to provide both digestive and immune support. These benefits plus a great tasting product are a win-win for parents and kids alike!


  1. https://pubmed.ncbi.nlm.nih.gov/12739919/I

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*This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

BB-12 and LA-5 are registered trademarks of Chr. Hansen.