Prebiotics & Probiotics

This afternoon I had the opportunity to attend a lecture on probiotics given by Dr. Yinka Davies (she's a pediatric GI specialist who earned her degree at Stanford and did her residency at DC Children's Hospital). She presented research around the efficacy and benefits of prebiotics and probiotics for pediatric patients (and, truthfully, all children and adults). I know many of the parents I've met through my blog are interested in nutrition and health for our kiddos with Ds, so I thought I would share a few highlights from her lecture. Please keep in mind that although Dr. Davies is an MD, you are only getting a few notes from my own understanding of her lecture, so you should talk to your pediatrician or a GI specialist for more information. I'm just repeating some key points here.

• our GI tracts have both good and bad flora - the good flora is necessary for good digestion, nutrition absorption, and overall health
• 70% of our immune system is in your gut (the flora)
• people should take PRObiotics to help keep the flora in balance - even small things can throw flora off balance (e.g., stress, food sensitivities/allergies, illness, etc.)
• babies born via c-section are at increased risk of imbalance and need probiotics because they didn't travel through the vaginal tract (which is where babies are first exposed to healthy flora and yeasts - it kind of "jump starts" their own flora production)
• PREbiotics help your own DNA (your own natural production of flora) AND probiotics propagate good gut flora (in other words, prebiotics "feed" your own natural production and the probiotics to ensure the good flora thrive)

A few more interesting things to note...

• breastmilk is a natural prebiotic and bifidobacteria (one kind of probiotic)... so more reason to try to breastfeed if you can (I wasn't able to - not because of Sheridan's latch, etc., but simply because I didn't produce enough milk - I'm thankful I had him on probiotics since birth)
• probiotic strains need to be at 10 to the 9th power to work properly (so if a bottle of probiotics only has a few million lactobacilli, it won't even work so it's like taking a placebo)- just as an example, in order to get enough probiotics for one day, you'd have to eat at least 45 containers of Activa yogurt
• only two brands of probiotics have ever been tested with rigorous scientific studies (more on this below)... that doesn't mean that other brands don't work, it just means they haven't been tested so nobody can really say if they are effective
• probiotics are alive, so if a probiotic is purchased off the shelf at a store, likelihood is that it is already dead and at that point it is just a placebo - it's really important to purchase probiotics that are kept refrigerated, and you should keep them refrigerated, too
• probiotics take about 3 weeks to get to full effect in your system (you have to take them every day), and if you stop taking them the flora they produce goes away, too

Dr. Davies suggested that the best probiotic available (based on research and clinical experience) is VSL#3 because it is so well-rounded (meaning it contains all the different strains humans need) and it is proven to be effective (meaning it actually results in flora growth in the gut). Children under 1 year of age should take a 225 billion dose (1/2 packet) and anyone over 1 year of age should take 450 billion (a full packet). It's expensive, but some insurance companies do cover it if you get a prescription for the double strength (the double strength is only available by prescription).

As for prebiotics, Dr. Davis said that 5-10 grams of soluble fiber = prebiotics. In other words, if you consume enough soluble fiber you don't need to supplement. If, however, you don't, any prebiotic off the shelf will work. She did mention that she recommends Healthy Trac for her own family and her patients.

And, I'm just gonna say it one more time... I'm not making any recommendations here and you definitely shouldn't make any decisions simply based on this post. Be sure to talk to your child's pediatrician or GI specialist, or at least do some additional research to determine whether or not this is something that is right for you and your family :)