Lactobacillus rhamnosus GG (LGG): Evidence Profile by Condition
What trials and reviews found for Lacticaseibacillus rhamnosus GG (LGG) in children's diarrhea, antibiotic diarrhea, IBS, preterm infants, allergy and colic, and where the evidence disagrees.
Content last updated . This page has not been medically reviewed.
What is Lactobacillus rhamnosus GG good for?
What the body uses it for, and how strong the evidence is. A normal job in the body is not proof that extra supplements add benefit; each card says which.
Prevention of antibiotic-associated diarrhoea in children
Clinically supportedIn children at higher risk, a European paediatric society gave a strong recommendation for LGG (or S. boulardii) to help prevent diarrhoea linked to antibiotics.
Supplements: Supported for this strain in at-risk children; the recommendation does not cover other strains or treating diarrhoea.
Acute gastroenteritis in children (treatment)
Preliminary or mixedResults are mixed. One large US trial of 971 children found no benefit for LGG, while pooled trials elsewhere reported somewhat shorter illness.
Supplements: No benefit versus placebo in the large US trial (moderate-to-severe illness 11.8% vs 12.6%).
Irritable bowel syndrome symptoms
Preliminary or mixedThe NHS says there is some evidence that probiotics in general may ease IBS symptoms. Strain-specific results for LGG were not verified by this writer.
Supplements: Possible symptom relief for some people; the AGA recommends probiotics for IBS only within clinical trials (per the site page).
Tolerance in children with cow's milk allergy
Preliminary or mixedA 2021 pooled analysis of 10 studies found children with cow's milk allergy given LGG were more likely to tolerate milk, but an eczema score did not differ.
Supplements: Moderate-quality evidence for tolerance, very low quality for skin scores; not a way to prevent allergy.
Necrotising enterocolitis in preterm infants (hospital use)
Preliminary or mixedIn randomized trials where LGG was the only probiotic, a 2024 pooled analysis found less severe necrotising enterocolitis, but no change in late sepsis or death, and no effect in observational studies.
Supplements: Not a home or supplement use; the FDA has approved no probiotic for infants and warns of risk.
Eczema in infants
Not enough evidenceA trial of 102 infants with mild-to-moderate eczema found no treatment effect of LGG. The NHS says there is no evidence probiotics treat eczema.
Supplements: No benefit shown for treating infant eczema.
Infant colic
Not enough evidenceOne small trial reported less crying with LGG in breastfed infants, but mothers also changed their diet and a larger trial is needed.
Supplements: Not enough evidence.
General gut balance (microbiome) claims
Lab or animal research onlyMarketing often says probiotics restore a healthy gut balance. The sources read tie LGG to specific conditions, not to general gut balance.
Supplements: No verified benefit for people without a defined condition.
Connected topics
Open a group to see how each topic connects and how strong the evidence is.
Health goals (1)
- Digestive SupportClinically supported
LGG: a European paediatric society strongly recommends it to help prevent antibiotic-associated diarrhoea in at-risk children. Evidence for other digestive uses is mixed, and results do not transfer to other strains.
Body systems (2)
- Digestive SystemClinically supported
LGG has been tested for digestive conditions; support is strongest for preventing antibiotic-associated diarrhoea in at-risk children, and mixed for gastroenteritis and IBS.
- Gut HealthClinically supported
Same as the digestive system: condition-specific support only, for this strain, not general gut health.
Body parts (1)
- GutClinically supported
LGG acts in the gut; trials focus on diarrhoea and bowel symptoms in specific groups.
Functional actions (1)
- Digestive SupportClinically supported
Supported for preventing antibiotic-associated diarrhoea in at-risk children (LGG specifically); mixed for other digestive uses.
Root causes (1)
- Medication Side EffectsClinically supported
Diarrhoea caused by antibiotics: LGG is recommended for prevention in at-risk children by ESPGHAN (strong recommendation, moderate-quality evidence).
Conditions & symptoms (3)
- Antibiotic-Associated DiarrheaClinically supported
ESPGHAN (2016) strongly recommends LGG or S. boulardii to prevent this in at-risk children (moderate-quality evidence). It does not cover treatment or other strains.
- BacteremiaDocumented risk
Rarely, Lactobacillus (including LGG) is found in blood infections, mostly in people with severe illness or weakened immunity.
- Cow Milk AllergyPreliminary or mixed
A pooled analysis of 10 studies found children with cow's milk allergy were more likely to tolerate milk with LGG, with no change in an eczema score; the authors ask for larger trials.
Documented risks and interactions (2)
- Risk: bloodstream infection in very ill or immunocompromised people. In a review of 89 Lactobacillus bloodstream infections, 11 matched LGG, and 82% of patients had severe or fatal underlying illness.
- Risk: invasive disease in preterm infants. The FDA warns that preterm infants given live-bacteria probiotics risk invasive, potentially fatal infection.
Name and strain
Recent papers call it Lacticaseibacillus rhamnosus GG, and give its collection number as ATCC 53103. [2] The old genus Lactobacillus was split into 25 genera in 2020. [3] The AGA (US gastroenterology society) writes the same strain as "L rhamnosus ATCC 53103"; its description of the large US children's trial matches the trial published as an LGG study. [4][5] The AGA lists other rhamnosus strains separately, for example R0011. [4]Evidence labels: promising but limited, mixed, insufficient evidence, no good evidence of benefit. Amounts are study amounts, never advice.
What the research found, by condition
| Condition and population | What the source found | Label |
|---|---|---|
| Children's acute gastroenteritis, US emergency departments | 971 children aged 3 months to 4 years got LGG at 1 x 10^10 CFU twice daily or placebo for 5 days. Moderate-to-severe illness occurred in 11.8% versus 12.6%, and diarrhea lasted about 50 hours in both groups. [5] | No good evidence of benefit in that trial |
| Children's acute gastroenteritis, pooled trials | A 2019 meta-analysis of 18 trials found about 0.85 day shorter diarrhea but called heterogeneity high and noted a larger effect in Europe. [6] A 2022 analysis found a shorter illness in trials from before rotavirus vaccination, but not in the two trials in partly vaccinated populations. [7] | Mixed |
| Same condition, Cochrane | A Cochrane review of 82 trials of many probiotics found no difference in the lowest-bias trials, with similar results in analyses limited to LGG. [8] | Mixed |
| Preventing antibiotic-associated diarrhea in children | ESPGHAN (Europe, 2016) gave a strong recommendation, with moderate-quality evidence, for LGG or S. boulardii where probiotics are considered. [9] | Promising but limited |
| IBS (adults and children) | A 2026 strain-level review of placebo-controlled trials found meta-analyses supporting efficacy for key symptoms. [10] The AGA still recommends probiotics for IBS only within clinical trials. [11] | Promising but limited |
| C. difficile recurrence | One small trial reported that LGG may increase recurrence, very uncertain. [4] | Insufficient evidence |
| Preterm infants (hospital use) | A 2024 meta-analysis of 5 randomized trials (851 infants) found less necrotizing enterocolitis (stage II or higher) with LGG alone, but no difference in late-onset sepsis or mortality. [12] | Promising but limited |
| Cow's milk allergy in children | A 2021 meta-analysis of 10 studies found higher tolerance rates, but no difference in an eczema score (very low quality). [13] | Promising but limited |
| Eczema in infants (treatment) | A trial of 102 infants aged 3 to 12 months found no therapeutic effect of LGG on mild-to-moderate eczema. [14] | No good evidence of benefit |
| Wheeze and asthma-related events | A trial in 131 young children found no clinical effect of LGG on eczema or asthma-related events. [15] | No good evidence of benefit |
| Infant colic | One small trial (45 breastfed infants) reduced crying with LGG, but the mothers also stopped cow's milk and the authors asked for a larger trial. [16] | Insufficient evidence |
Proper evidence not found: for pooled, LGG-specific trials on preventing eczema or allergy in healthy infants. We searched PubMed (LGG with eczema, atopic dermatitis and allergy prevention) and read the 2025 Cochrane review, which pooled many different probiotics. [17]
Frequently asked questions
Is LGG proven to treat diarrhea in children?
No. A large US trial found no benefit, and pooled results are mixed. [5][6]
Is Lactobacillus rhamnosus the same as LGG?
No. LGG is one strain of the species; results do not transfer to other strains. [1]
Does LGG help IBS?
A 2026 strain-level review found meta-analyses supporting efficacy for key symptoms, while the AGA recommends probiotics for IBS only in clinical trials. [10][11]
Can LGG prevent eczema in babies?
Proper evidence not found for LGG alone in the sources we read. Two LGG trials in affected children found no clear clinical effect. [14][15]
Can LGG cause infections?
Rarely. Lactobacillus bloodstream infection is infrequent and mostly affects people with severe illness or weakened immunity. [20][18]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
Why results disagree
Safety
- Immunocompromised, critically ill, central lines. A review of 89 Lactobacillus bloodstream infections found that 11 matched LGG, and 82% of patients had severe or fatal underlying illness. [18] Finnish data found that rising LGG use did not raise the overall rate of Lactobacillus bloodstream infection. [19] A 2023 review linked LGG directly to blood isolates in bacteremia patients. [20]
- Premature infants. The FDA (US, 2023) warns that preterm infants given probiotics risk invasive, potentially fatal disease. [21] Only the neonatal team should decide.
- Everyone else. The NHS says most people with a healthy immune system should not get unpleasant side effects. [22] Ask a clinician or pharmacist about medicines, pregnancy, surgery, kidney or liver disease; we found no LGG-specific guidance on these (Proper evidence not found in the sources searched). See how medicine interactions work.
- Product quality. Look for the full strain designation and check quality testing.
A child with severe or bloody diarrhea, fever, or signs of dehydration needs medical care first. [23] Call 911 in a US emergency.
Related: Lactobacillus and Bifidobacterium overview, strain specificity.
References
- McFarland LV, Evans CT, Goldstein EJC. Strain-Specificity and Disease-Specificity of Probiotic Efficacy: A Systematic Review and Meta-Analysis. Front Med 2018. PMID 29868585. Read 2026-10-22.
- Shehata HR, Newmaster SG. Probiotics Antimicrob Proteins 2021. Enumeration of Probiotic Strain Lacticaseibacillus rhamnosus GG (ATCC 53103) Using Viability Real-time PCR. PMID 34591288. Read 2026-10-22.
- Zheng J et al. A taxonomic note on the genus Lactobacillus: Description of 23 novel genera, emended description of the genus Lactobacillus Beijerinck 1901, and union of Lactobacillaceae and Leuconostocaceae. PMID 32293557. Read 2026-10-22.
- Preidis GA et al. AGA Technical Review on the Role of Probiotics in the Management of Gastrointestinal Disorders. Gastroenterology 2020 (full text read via PMC8018518). PMID 32531292. Read 2026-10-22.
- Schnadower D et al. N Engl J Med 2018. Lactobacillus rhamnosus GG versus Placebo for Acute Gastroenteritis in Children. PMID 30462938. Read 2026-10-22.
- Szajewska H et al. Aliment Pharmacol Ther 2019. Systematic review with meta-analysis: Lactobacillus rhamnosus GG for treating acute gastroenteritis in children - a 2019 update. PMID 31025399. Read 2026-10-22.
- Lo Vecchio A et al. Benef Microbes 2022. Rotavirus immunisation status affects the efficacy of Lacticaseibacillus rhamnosus GG for the treatment of children with acute diarrhoea: a meta-analysis. PMID 36004717. Read 2026-10-22.
- Collinson S et al. Cochrane Database Syst Rev 2020 (CD003048). Probiotics for treating acute infectious diarrhoea. PMID 33295643. Read 2026-10-22.
- Szajewska H et al. (ESPGHAN Working Group) J Pediatr Gastroenterol Nutr 2016. Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Children. PMID 26756877. Read 2026-10-22.
- Strain-Specific Systematic Review with Meta-Analysis of Probiotics Efficacy in the Treatment of Irritable Bowel Syndrome. PMID 41682832. Read 2026-10-22.
- Su GL et al. AGA Clinical Practice Guidelines on the Role of Probiotics in the Management of Gastrointestinal Disorders. Gastroenterology 2020 (guideline text read from a hosted copy of the published PDF). PMID 32531291. Read 2026-10-23.
- Ananthan A et al. Eur J Clin Nutr 2024. Lactobacillus rhamnosus GG as a probiotic for preterm infants: a strain specific systematic review and meta-analysis. PMID 39060543. Read 2026-10-22.
- Tan W et al. Front Pediatr 2021. Lactobacillus rhamnosus GG for Cow's Milk Allergy in Children: A Systematic Review and Meta-Analysis. PMID 34746056. Read 2026-10-22.
- Grüber C et al. Allergy 2007. Randomized, placebo-controlled trial of Lactobacillus rhamnosus GG as treatment of atopic dermatitis in infancy. PMID 17919141. Read 2026-10-22.
- Rose MA et al. Clin Exp Allergy 2010. Efficacy of probiotic Lactobacillus GG on allergic sensitization and asthma in infants at risk. PMID 20604800. Read 2026-10-22.
- Savino F et al. Nutrients 2020. Lactobacillus rhamnosus GG (ATCC 53103) for the Management of Infantile Colic: A Randomized Controlled Trial. PMID 32517123. Read 2026-10-22.
- Wang HZ et al. Cochrane Database Syst Rev 2025. Probiotics in infants for prevention of allergic disease. PMID 40511642. Read 2026-10-22.
- Salminen MK et al. Clin Infect Dis 2004. Lactobacillus bacteremia, clinical significance, and patient outcome, with special focus on probiotic L. rhamnosus GG. PMID 14679449. Read 2026-10-22.
- Salminen MK et al. Clin Infect Dis 2002. Lactobacillus bacteremia during a rapid increase in probiotic use of Lactobacillus rhamnosus GG in Finland. PMID 12410474. Read 2026-10-22.
- Kullar R et al. Microorganisms 2023. Lactobacillus Bacteremia and Probiotics: A Review. PMID 37110319. Read 2026-10-22.
- FDA (US Food and Drug Administration). Risk of Invasive Disease in Preterm Infants Given Probiotics Formulated to Contain Live Bacteria or Yeast (safety communication, 2023). Read 2026-10-23.
- NHS (UK). Probiotics. Page last reviewed 24 November 2022. Read 2026-10-22.
- NHS (UK). Diarrhoea and vomiting. Read 2026-10-22.