Effect of a Probiotic Infant Formula on Infections in Child Care Centers: Comparison of Two Probiotic Agents

Published online January 3, 2005
PEDIATRICS Vol. 115 No. 1 January 2005, pp. 5-9 (doi:10.1542/peds.2004-1815)

Effect of a Probiotic Infant Formula on Infections in Child Care Centers: Comparison of Two Probiotic Agents

Zvi Weizman, MD, Ghaleb Asli, MD and Ahmed Alsheikh, MD


From the Pediatric Gastroenterology and Nutrition Unit, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel

Objective. To investigate the effect of 2 different species of probiotics in preventing infections in infants attendingchild care centers.

Methods. A double-blind, placebo-controlled, randomized trial was conducted from December 1, 2000, to September 30, 2002, at 14 child care centers in the Beer-Sheva area of Israel in healthy term infants 4 to 10 months old. Infants were assigned randomly to formula supplemented with Bifidobacterium lactis (BB-12), Lactobacillus reuteri (American Type Culture Collection 55730), or no probiotics. Duration of feeding, including follow-up, for each participant was 12 weeks. All infants were fed only the assigned formula and were not breastfed due to parental decision before recruitment to the study. Probiotic or prebioticfood products or supplements were not allowed. Main outcomemeasures were number of days and number of episodes with fever(>38°C) and number of days and number of episodes withdiarrhea or respiratory illness.

Results. Participants (n = 201) were similar regarding gestational age, birth weight, gender, and previous breastfeeding. The controls (n = 60), compared with those fed B lactis (n = 73) or L reuteri (n = 68), had significantly more febrile episodes (mean [95% confidence interval]: 0.41 [0.28–0.54] vs 0.27 [0.17–0.37] vs 0.11 [0.04–0.18], respectively). The controls also had more diarrhea episodes (0.31 [0.22–0.40] vs 0.13 [0.05–0.21] vs 0.02 [0.01–0.05], respectively) and episodes of longer duration (0.59 [0.34–0.84] vs 0.37 [0.08–0.66] vs 0.15 [0.12–0.18] days, respectively). The L reuteri group,compared with BB-12 or controls, had a significant decreaseof number of days with fever, clinic visits, child care absences,and antibiotic prescriptions. Rate and duration of respiratoryillnesses did not differ significantly between groups.

Conclusions. Child care infants fed a formula supplemented with L reuteri or B lactis had fewer and shorter episodes of diarrhea, with no effect on respiratory illnesses. These effects were more prominent with L reuteri, which was also the only supplementto improve additional morbidity parameters.



Key Words: probiotics • infant formula • child care • infections


Abbreviations: BB-12, Bifidobacterium lactis • CFU, colony-forming units














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