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Diarrhea in babies and children and probiotics

- Lactobacillus rhamnosus, LGG® and sudden-onset, antibiotic-associated & hospital-acquired diarrhea

Young child diarrhea and the role of some probiotic strains
6 Min read

Supplementation with probiotic products, such as those containing the Lactobacillus rhamnosus, LGG® strain (hereafter referred to by the trademark LGG®), may have beneficial effects on occational sudden-onset,1, 2 antibiotic-associated,3, 4 and hospital-acquired diarrhea.5


Occasional diarrhea occurs frequently in babies and young children. Globally, each child under three years of age will have at least one episode of sudden-onset diarrhea each year.6 

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What is diarrhea?

When the digestive system is healthy and balanced, it is able to absorb fluids.7 However, if infected by pathogenic bacteria or virus, too much water can be drawn into the bowels,8 this result in loose or watery stools.

Evidence supports the potential effect of some probiotic strains at helping to maintain healthy digestion.9, 10 LGG® is one such strain; it has been associated with helping to maintain a healthy digestive system by supporting balance with other bacteria.
Read more about probiotics and what they are.

Sudden-onset diarrhea

Sudden-onset, or acute, diarrhea is a common result of digestive system infections that may be caused by a wide range of bacteria and viruses.11 Acute diarrhea is defined as loose or watery stools at least three times per day, or more frequently than is normal for a particular individual,12 typically lasting less than 7 days and no more than 14 days.13 The incidence of acute diarrhea ranges from 0.5 to 1.9 episodes each year in children under 3 years of age.12

Symptoms of occasional acute diarrhea may be impacted by some probiotic strains

Rehydration is crucial.13 In addition, some studies have associated supplementing with the LGG® probiotic strain with shorter duration of symptoms1, 2 and more rapid improvement in symptoms.1
Read more about the Chr. Hansen LGG® strain.


Antibiotic-associated diarrhea

Antibiotic-associated diarrhea (AAD) is diarrhea that occurs in relation to antibiotic treatment.14 Occurring in up to one third of all people treated with antibiotics, AAD is common and challenging.15 It usually presents as mild diarrhea. Almost any oral and intravenous antibiotic treatment can cause AAD.16 It does not necessarily occur immediately and may instead occur a few weeks or months after antibiotic treatment.14 

Antibiotics destroy not only disease-causing bacteria but also the beneficial bacteria, and therefore AAD is usually caused by a disruption to the balance of bacteria in the gut.14, 15, 17  

AAD and the role of some probiotic strains 

Supplementation with the LGG® strain has been associated with a reduction in the occurrence of antibiotic-associated diarrhea in children.3, 4 Results from clinical studies3, 4 suggest that, LGG® strain supplementation should be started on the same day as starting antibiotic treatment, it should be resumed for a week longer than the antibiotic treatment, and the probiotic product should be consumed a few hours after taking the antibiotics.
Read more about the Chr. Hansen LGG® strain.

Baby being examined for stomach problems

Hospital-acquired diarrhea

Hospital-acquired infections may develop 48 hours or more after being admitted.18 Depending on factors such as time of year and the ward, the incidence of hospital-acquired infections in children in developed countries is high, ranging from 5.1% - 11.6%,19 with digestive system infection accounting for the majority of infections.20, 21, 22 The costs associated with hospital-acquired infections are high, as they can extend the length of hospital stay, slow down recovery, and increase antibiotic resistance.5

Hospital-acquired infections and the use of some probiotic strains 

In one study, supplementation with the LGG® strain was associated with reduced incidence of hospital-acquired digestive and respiratory tract infection in children admitted to pediatric health care facilities.5 
Read more about probiotics for infections that cause colds and flu-like sickness

Probiotics may play a role in the management of occasional diarrhea

No matter what type of diarrhea, it is often the result of an imbalance in the bacteria of the digestive system. Probiotics may help balance and increase the diversity of the bacteria, which can help limit the effects of unwanted bacteria.
Read about other Chr. Hansen probiotic strains, or how to choose a probiotic product.

LGG® is a registered trademark of Chr. Hansen A/S.

The article is provided for informational purposes regarding probiotics and is not meant to suggest that any substance referenced in the article is intended to diagnose, cure, mitigate, treat, or prevent any disease.

Bifidobacterium, BB-12® 

The probiotic strain Bifidobacterium, BB-12® is the world’s most documented probiotic bifidobacterium. It has been extensively studied and has been associated with improved outcomes across various health areas.

BB-12® is a registered trademark of Chr. Hansen A/S

BB-12 consumer logo TM

References Open Close

1. Aggarwal S, et al. Lactobacillus GG for treatment of acute childhood diarrhoea: an open labelled, randomized controlled trial. Indian J Med Res. 2014;139(3):379-85. (PubMed)
2. Isolauri E, et al. A human Lactobacillus strain (Lactobacillus casei sp strain GG) promotes recovery from acute diarrhea in children. Pediatrics. 1991;88(1):90-7. (PubMed)
3. Arvola T, et al. Prophylactic Lactobacillus GG reduces antibiotic-associated diarrhea in children with respiratory infections: a randomized study. Pediatrics. 1999;104(5):e64. (PubMed)
4. Vanderhoof JA, et al. Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children. The Journal of Pediatrics. 1999;135(5):564-8. (PubMed)
5. Hojsak I, et al. Lactobacillus GG in the prevention of nosocomial gastrointestinal and respiratory tract infections. Pediatrics. 2010;125(5):e1171-7. (PubMed)
6. Thiagarajah JR, et al. Secretory diarrhoea: mechanisms and emerging therapies. Nat Rev Gastroenterol Hepatol. 2015;12(8):446-57. (PubMed)
7. Hodges K, Gill R. Infectious diarrhea: Cellular and molecular mechanisms. Gut Microbes. 2010;1(1):4-21. (PubMed)
8. Walker CLF, et al. Global burden of childhood pneumonia and diarrhoea. Lancet. 2013;381(9875):1405-16. (PubMed)
9. Lemberg DA, et al. Probiotics in paediatric gastrointestinal diseases. J Paediatr Child Health. 2007;43(5):331-6. (PubMed)
10. Yan F, et al. Soluble proteins produced by probiotic bacteria regulate intestinal epithelial cell survival and growth. Gastroenterology. 2007;132(2):562-75. (PubMed)
11. Lo Vecchio A, et al. Rotavirus immunization: Global coverage and local barriers for implementation. Vaccine. 2017;35(12):1637-44. (PubMed)
12. World Health Organisation. Diarrhoea: Why children are still dying and what can be done. 2009.
13. Szajewska H, et al. Use of probiotics for management of acute gastroenteritis: a position paper by the ESPGHAN Working Group for Probiotics and Prebiotics. J Pediatr Gastroenterol Nutr. 2014;58(4):531-9. (PubMed)
14. McFarland LV. Epidemiology, risk factors and treatments for antibiotic-associated diarrhea. Dig Dis. 1998;16(5):292-307. (PubMed)
15. Barbut F, Meynard JL. Managing antibiotic associated diarrhoea. BMJ. 2002;324(7350):1345-6. (PubMed)
16. McFarland LV, et al. Risk factors for Clostridium difficile carriage and C. difficile-associated diarrhea in a cohort of hospitalized patients. J Infect Dis. 1990;162(3):678-84. (PubMed)
17. Hasan N, Yang H. Factors affecting the composition of the gut microbiota, and its modulation. PeerJ. 2019;7:e7502-e. (PubMed)
18. World Health Organization. Prevention of Hospital-acquired Infections. Geneva, Switzerland; 2002.
19. World Health Organisation. Report on the Burden of Endemic Health Care-associated Infection Worldwide. Geneva, Switzerland; 2011.
20. Muhlemann K, et al. Prevalence of nosocomial infections in Swiss children's hospitals. Infect Control Hosp Epidemiol. 2004;25(9):765-71. (PubMed)
21. Rutledge-Taylor K, et al. A point prevalence survey of health care-associated infections in Canadian pediatric inpatients. Am J Infect Control. 2012;40(6):491-6. (PubMed)
22. Kinnula S, et al. Hospital-associated infections in children: a prospective post-discharge follow-up survey in three different paediatric hospitals. J Hosp Infect. 2012;80(1):17-24. (PubMed)

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