Best brand of probiotic

[maliee]

I've increased my son's dose of Augmentin to 1000 twice a day and would like a recommendation on the best approach to probiotics- dose? brand?

Thanks!

[ChrissyD]

I don't think there's a simple answer to that question. My son is on Augmentin as well, and after a little trial and error we have him on florastor twice a day, as well as Klaire labs children's chewable probiotic mid-day. It has 25 billion units per tablet. He used to be on a super potent probiotic, VSL #3 which was 450 billion units and seemed to trigger him. We thought it might be die off but itnever got better.

On the new regimen his tics are gone. We also made other changes so its hard to say if it was the change in probiotic that helped or just coincidence.

I'm a nurse practitioner (sadly I don't treat children) and I registered with Klaire to get the health care professional wholesale discount. They sent me some educational monographs. I have their technical summary entitled "making sense of probiotics". If you want a coy, DM me and I can scan it and email it to you.

I'm not endorsing Klaire labs or their probiotics, and I don't sell supplements---I only registered to get the wholesale price. But I'm happy to pass on their literature if you are interested.

[LNN]

I think there is no "best" for everyone, just best for your child. Some have great results at a moderate dose (20-40 billion CFUs), some do well on 100+ CFUs. Some do well on probiotics with yeast/Sacc. Boullardi (e.g. florastor), some do poorly on Sacc B strains. You just have to do trial and error at a time when nothing else changes.

 

You can also look into other things, such as odorless garlic capsules or grapefruit seed extract - in addition to probiotics - to keep yeast under control. We use garlic + 15-40 Billion CFUs probiotics (we rotate between 4 brands/kinds during the week) in order to keep costs down. Probiotics aren't cheap! I personally trust ones that are refrigerated over ones that require no refrigeration - no telling how many are still alive in a capsule that might've spent all summer in a hot warehouse.

[ThinkGutBacteria]

If you're looking to prevent antibiotic-associated diarrhea, the evidence seems more available for Lactobacillus rhamnosus GG and Saccharomyces boulardii (yeast) some say 5 billion CFU/day. Some say 10 billion. BUT Lactobacillus reuteri, Lactobacillus casei, Lactobacillus paracasei, Bifidobacteria species have also shown benefit. More species isn't necessarily better and neither is a higher dose. Very interesting benefits on preventing allergies, asthma, inflammatory bowel diseases, and other autoimmune diseases (in humans and animal models) have been found with Acinetobacter lwoffi, Lactococcus lactis, Bacteroides fragilis, and even Helicobacter pylori, among others. We're still learning. Probiotics should be given an hour or two after the antibiotic.

 

Personally, if the child has had a decent inoculation of good bacteria since birth--that is, she's born vaginally as opposed to C-section, she's been breastfed for at least 6 months, she took no antibiotics in the first year or two of life, she took no Tylenol in the first year of life--then I'd wager that giving her just the sugars (oligosaccharides, actually) that spur growth of health-promoting bacteria may be enough. Adding the oligosaccharides FOS and GOS to meals/drinks is a very easy way to help heal the gut of someone on antibiotics.

 

How often antibiotics are given is another consideration. For example, if you clear cut a forest, roughly the same types of species will re-grow. If you keep doing it, however, you'll start getting many different species repopulating and altering the delicate balance of the ecosystem. Same with guts, bacteria, and antibiotics.

 

The gut is very much an ecosystem, which is exactly how we have to think about it. In an ecosystem, all critters interact with their environment and often with each other. They are not all created equal, however. Some animals are considered "keystone species," which have a disproportionately large effect on the environment relative to its abundance. An example is the jaguar, whose numbers are very few but since it has a widely varied diet, it balances the mammalian jungle ecosystem by consuming 87 different species of prey. In the gut, helminths (worms) may represent a keystone species. In the presence of the "right" ones, beneficial bacteria thrive further benefitting the host. But that's a story for another time...