Probiotics for Infants and Babies: Official Advice, Formula Additives and Cautions
What pediatric and health bodies say about probiotic drops and probiotic-added formula for babies, why preterm infants are a separate and riskier case, and when to call a clinician.
Content last updated . This page has not been medically reviewed.
Start here: when a baby needs a clinician, not a supplement
Probiotics are not a way to manage a sick baby. The NHS (UK) says to get urgent advice if you are worried about a baby under 12 months with diarrhea or vomiting, if a child stops breast or bottle feeding while ill, if there is bloody diarrhea, or if a child under 5 has signs of dehydration such as fewer wet nappies. [1] The NHS also says not to make formula weaker than its usual strength during illness. [1] A baby who was born early is in a different situation again (see the preterm section below). This page is general information, not a recommendation for any baby. A pediatrician, nurse or pharmacist should be part of any decision about giving a baby a probiotic.What this page covers
"Probiotic" products for babies come in three forms: drops or powders given by mouth, formula that has probiotics added during manufacture, and products given in hospital to premature babies. Each has a different level of evidence and a different level of risk. Research results belong to one named strain and product; they do not transfer to other products. [2][3] For how strain names and labels work, see Probiotic Strains and Labels.What the sources say
| Question | What the source found | Strength |
|---|---|---|
| Probiotics with no documented benefit | The European pediatric gastroenterology society (ESPGHAN, 2023 position paper on children's digestive disorders) says use of probiotics with no documented health benefits should be discouraged [4] | Guideline statement |
| Formula with added probiotics or prebiotics | ESPGHAN's Committee on Nutrition (2011) reviewed such formulas in healthy infants and found no safety concerns for growth or adverse effects, but also found too little data to recommend routine use [2]. It noted that most trials were company funded [2] | Older review; safety reassuring, benefit unproven |
| Drops for colic | The NHS (UK) says colic remedies, including probiotic supplements, are not recommended and that there is no evidence they help colic [5]. The Canadian Paediatric Society (2022) says Lactobacillus reuteri supplementation can be considered for colic symptoms [6]. A 2019 Cochrane review found no clear evidence that probiotics prevent colic [7] | Disagreement between bodies; see below |
| Eczema | The NHS says there is no evidence that probiotics help treat eczema [8]. The Canadian statement says probiotics can be considered to help prevent it [6] | Mixed |
Colic: why the advice differs
The sources are not contradicting each other on facts so much as drawing lines in different places. NCCIH describes a 2018 review of seven studies, five of which used one strain, L. reuteri DSM 17938, and says the effect was mainly seen in exclusively breastfed babies. [3] The Canadian statement also notes that one study of Lactobacillus rhamnosus GG showed no benefit for colic. [6] The Cochrane review looked at prevention in newborns and rated its own certainty as low across all three outcomes. [7] The NHS notes that colic usually settles by around 3 or 4 months. [5] Details are on Probiotics for Infant Colic. A health visitor, nurse or pediatrician can also check that crying is not a sign of something else.Frequently asked questions
Are probiotic drops safe for newborns?
The FDA's 2023 warning concerns preterm babies, and the FDA, AAP and NCCIH all describe a serious risk for them. [9][10][3] For full-term babies, ESPGHAN's 2023 paper on children's digestive disorders says probiotics with no documented benefit should be discouraged, so ask a pediatrician before using any. [4]
Does infant formula with added probiotics work better?
ESPGHAN (2011) found no safety concerns in healthy infants but not enough data to recommend routine use, and said one product's results should not be applied to another. [2]
Can probiotics fix colic?
The NHS says there is no evidence probiotics help colic. [5] The Canadian Paediatric Society says L. reuteri can be considered. [6] Ask a health visitor or pediatrician.
Are probiotics a treatment for baby eczema?
The NHS says there is no evidence that probiotics help treat eczema. [8] See Probiotics for Eczema, Food Allergy and Asthma in Children.
Who should be asked before giving a baby a probiotic?
A pediatrician, nurse or pharmacist. NCCIH says to consult a health care provider first and not to use probiotics as a reason to delay seeing one. [3]
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.
Premature and very sick babies: a separate and riskier case
In 2023 the US FDA warned health professionals that preterm infants given probiotics are at risk of invasive, potentially fatal disease caused by the bacteria or fungi in the products, and that it has not approved any probiotic product as a drug or biological product for use in infants. [9] The American Academy of Pediatrics (2021) said current evidence does not support routine, universal probiotic use in preterm infants, especially those under 1,000 g, noting that products in the US are sold as dietary supplements without drug-level review. [10] The Canadian Paediatric Society (2022) takes a different position for multi-strain combinations in preterm and low birth weight infants, but only where the treating care team judges that benefits outweigh risks. [6] A 2015 US health report described a premature baby who died of a rare fungal infection (gastrointestinal mucormycosis) after receiving a dietary supplement beginning on day 1 of life; the report's title calls the supplement contaminated. [11]
Any use in a neonatal unit is a hospital decision. Parents should not buy or give probiotics to a premature baby on their own. See Probiotics in Preterm Infants and Necrotizing Enterocolitis.
Safety points that apply to all babies
- The Canadian Paediatric Society lists four possible concerns in at-risk individuals: sepsis, metabolic effects, immune effects and transfer of antimicrobial resistance. [6]
- Product quality is known to vary widely, and NCCIH notes that some products contain organisms not listed on the label. [6][3] See Probiotic Label Accuracy, Contamination and Third-Party Testing.
- Do not stop or change medicines because of a probiotic, and tell the prescriber about any supplement. Interaction checks are on Medication Interactions.
- If a baby has swallowed far more than a label says, or seems unwell after any product, treat it as poisoning guidance: see Poisoning: What to Do First, or call Poison Help (US) at 1-800-222-1222; call 911 for an emergency.
What we did not find
The NHS page on types of infant formula that we read does not describe probiotic-added formula as a type. [12] Official advice from the NHS on probiotic drops for healthy babies: not described in the sources we read. Proper evidence not found in the sources we read for long-term outcomes of giving probiotic drops to healthy full-term babies (we read the ESPGHAN abstracts, NCCIH, the Canadian Paediatric Society statement, the Cochrane colic abstract and NHS pages).
References
- NHS (UK). Diarrhoea and vomiting. Read 2026-10-23.
- ESPGHAN Committee on Nutrition. Supplementation of infant formula with probiotics and/or prebiotics: a systematic review and comment. J Pediatr Gastroenterol Nutr 2011. PubMed 21150647 (abstract). Read 2026-10-23.
- NCCIH (US National Center for Complementary and Integrative Health). Probiotics: Usefulness and Safety. Read 2026-10-23.
- ESPGHAN Special Interest Group on Gut Microbiota and Modifications. Probiotics for the management of pediatric gastrointestinal disorders: position paper. J Pediatr Gastroenterol Nutr 2023. PubMed 36219218 (abstract). Read 2026-10-23.
- NHS (UK). Colic. Read 2026-10-23.
- Schneider R, Sant'Anna A; Canadian Paediatric Society. Using probiotics in paediatric populations. Paediatr Child Health 2022;27(8):482-491. Read 2026-10-23.
- Cochrane review. Probiotics to prevent infantile colic. Cochrane Database Syst Rev 2019. PubMed 30865287 (abstract). Read 2026-10-23.
- NHS (UK). Probiotics (page last reviewed 24 November 2022). Read 2026-10-23.
- 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.
- Poindexter B; AAP Committee on Fetus and Newborn. Use of probiotics in preterm infants. Pediatrics 2021. PubMed 34031231 (abstract). Read 2026-10-23.
- Notes from the field: fatal gastrointestinal mucormycosis in a premature infant associated with a contaminated dietary supplement, Connecticut, 2014. MMWR 2015. PubMed 25695322 (abstract). Read 2026-10-23.
- NHS (UK). Types of infant formula. Read 2026-10-23.
Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.