The use of Probiotics to Prevent Diarrhea in Young Children Attending Child Care Centers: A Review

The incidence of diarrheal disease in children has been reduced because of public health measures, improved hygiene, and a better understanding of nutrition. However, it remains a particular problem where young children come into close contact with other children, such as in child day care centers. Probiotics are defined as products that contain an adequate dose of live microbial agents that have been shown in target-host studies to confer a health benefit. They have been used for the treatment and prevention of many diseases, but particularly of gastrointestinal diseases. Prebiotics are inactive food components, commonly oligosaccharides or polysaccharides, that stimulate growth of beneficial bacteria in the gastrointestinal tract and are commonly used in combination with probiotics.The initial searches identified 5860 articles from the PubMed database, but only 154 included the keyword “trial.” Probiotics share the problem of limited systematic research with other traditional medications and foods, and only seven studies were included in the final analysis. A variety of probiotic organisms and prebiotics were used in the studies, and the end points were not standardized. However, examination of the six studies that used live cultures showed that five studies resulted in a decrease in either the number of episodes or the duration of diarrhea or both. However, the studies support a reduction of around 20% in diarrheal episodes or days of illness. Findings of this review have important implications for working parents. The regular use of a probiotic or probiotic/prebiotic combination will reduce the incidence and duration of diarrheal disease in children attending childcare centers (risk ratio, 0.72–0.82). Further research is needed to better define the most effective probiotic organisms and the optimal dosage.