Intended for healthcare professionals


Probiotic supplements

BMJ 2013; 347 doi: (Published 04 December 2013) Cite this as: BMJ 2013;347:f7138
  1. David Andrew Osborn, associate professor,
  2. John K H Sinn, associate professor
  1. 1University of Sydney, Sydney, NSW 2065, Australia
  1. john.sinn{at}

No evidence that they prevent childhood asthma when given to infants or to pregnant women

Probiotics are live micro-organisms that, when given in adequate amounts, confer a health benefit to the recipient. Probiotics have been proposed for the prevention and treatment of allergic disorders. They usually contain Bifidobacterium or Lactobacillus spp, or both. These bacteria are delivered orally by a variety of methods including capsules; oil droplets; and suspensions in water, milk, or infant formula. They are not the same species as those found in yoghurt and are given at much higher doses. Evidence suggests that the use of probiotics during pregnancy or infancy may prevent eczema and IgE associated eczema in infants.1 However, in a linked systematic review of randomised controlled trials that evaluated probiotics given to mothers during pregnancy or to infants during the first year of life, Azad and colleagues (doi:10.1136/bmj.f6471) report no effect on asthma diagnosed by a physician or wheeze in young children.2 They conclude that probiotic supplements cannot be recommended for the primary prevention of asthma.

Azad and colleagues assessed 20 trials that enrolled 4866 infants, although not all studies reported outcomes, so individual analyses are limited to a subset of studies.2 The review is …

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