The early years of a child’s life are critical for growth, brain development, and the establishment of a robust immune system. Nutrition plays a central role in supporting these processes, not only by providing energy and essential nutrients but also by shaping the gut microbiome—a complex ecosystem of microorganisms residing primarily in the digestive tract. In recent years, increasing attention has been given to the role of biotics—namely probiotics, prebiotics, synbiotics, and postbiotics—in promoting optimal health during infancy and early childhood. Understanding how these biotics interact with nutrition in the first years of life can help caregivers make informed choices that support long-term health (Braegger et al., 2011). Here we discuss biotics and feeding babies, toddlers and children.
What Are Biotics?
Biotics are bioactive compounds that influence the gut microbiota, the immune system, and overall health. They can be categorized into several types:
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Probiotics: Live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. Common probiotic strains include Lactobacillus and Bifidobacterium species.
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Prebiotics: Non-digestible food ingredients that selectively stimulate the growth and/or activity of beneficial microorganisms in the gut. Examples include human milk oligosaccharides (HMOs), inulin, and fructooligosaccharides (FOS).
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Synbiotics: Combinations of probiotics and prebiotics that synergistically enhance the survival and colonization of beneficial microbes.
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Postbiotics: Non-living microbial cells or their components that provide health benefits, such as short-chain fatty acids (SCFAs), cell wall fragments, or enzymes.
Each type of biotic plays a distinct role in gut health, immune function, and potentially in reducing the risk of diseases such as allergies, eczema, and gastrointestinal disorders.
Biotics and Infant Feeding
Breastfeeding: The Gold Standard
Breast milk is widely recognized as the optimal source of nutrition for infants. It contains a complex mix of nutrients, immune factors, enzymes, and most importantly in this context, human milk oligosaccharides (HMOs)—a form of prebiotics uniquely tailored to nourish beneficial bacteria in the infant gut, especially Bifidobacterium species. HMOs are the third most abundant solid component in human milk, after lactose and fat.
Breastfed infants typically develop a gut microbiota dominated by Bifidobacteria, which is associated with improved digestion, reduced incidence of infections, and better immune development. Additionally, breast milk may naturally contain beneficial microbes (probiotics), passed from the mother’s skin and gut.
Formula Feeding and Fortification with Biotics
For infants who are formula-fed, manufacturers have developed formulas fortified with prebiotics (such as GOS and FOS), probiotics, or synbiotics in an effort to mimic the benefits of breast milk. Studies show that these fortified formulas can help support a healthier microbiota composition and improve stool consistency, though they may not fully replicate the diversity and function provided by breast milk.
Some formulas now include specific strains like Lactobacillus reuteri or Bifidobacterium lactis, which have shown promise in reducing colic, diarrhea, and constipation in infants.
Transition to Solid Foods: Supporting the Microbiome in Toddlers
Complementary Feeding and Gut Development
Around six months of age, complementary feeding begins—a time when infants are introduced to solid foods alongside continued breastfeeding or formula feeding. This period represents a significant shift in gut microbiota composition, moving from a milk-oriented microbiome to one more similar to that of an adult.
The diversity and quality of foods offered during this time influence microbial diversity and long-term health. Diets rich in fiber, fruits, vegetables, and whole grains provide natural prebiotics that promote the growth of beneficial bacteria. In contrast, diets high in processed foods and sugar may favor harmful microbes and promote inflammation.
Including Biotics in the Toddler Diet
Parents and caregivers can support the developing microbiome by including foods rich in natural biotics:
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Probiotics: Found in fermented foods like yogurt (with live cultures), kefir, sauerkraut, and miso. For young children, yogurt is often the most accessible and accepted source.
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Prebiotics: Present in bananas, asparagus, garlic, onions, leeks, and oats.
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Synbiotics: Consuming both yogurt (probiotic) and oatmeal (prebiotic) in the same meal can offer synbiotic effects.
While postbiotics are less commonly discussed in everyday dietary choices, they are byproducts of healthy gut microbial activity and are naturally produced when prebiotics are fermented in the gut.
Biotics and the Immune System
Approximately 70% of the immune system resides in the gut. A well-balanced microbiome acts as a gatekeeper, helping to prevent pathogen colonization, reducing inflammation, and teaching the immune system to distinguish between harmless and harmful stimuli. This is particularly important in early childhood, when the immune system is still developing.
Studies have shown that probiotics and prebiotics may reduce the risk of common childhood illnesses such as:
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Eczema and allergies: Some evidence suggests that probiotic supplementation (especially Lactobacillus rhamnosus GG) during pregnancy and infancy may reduce the incidence of eczema in high-risk infants.
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Respiratory infections: Certain probiotics have been associated with fewer and shorter upper respiratory tract infections in daycare-attending children.
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Gastrointestinal issues: Probiotics can help prevent antibiotic-associated diarrhea, reduce colic symptoms, and manage constipation.
Special Considerations in Early Childhood Nutrition
Antibiotic Use and Microbiota Disruption
Antibiotics, while lifesaving, can significantly disrupt the gut microbiota, killing both harmful and beneficial bacteria. In young children, repeated or unnecessary use can lead to longer-term imbalances (dysbiosis) that may influence obesity risk, allergy development, and autoimmune conditions.
Supplementing with probiotics during and after antibiotic treatment can help restore microbial balance, though the specific strains and timing should be discussed with a healthcare provider.
Allergies and Biotic Modulation
Early life exposures and feeding choices may impact the development of food allergies. The gut microbiome plays a role in modulating immune tolerance. Studies suggest that probiotic and prebiotic supplementation may reduce the risk or severity of food allergies, although more research is needed to establish clear guidelines.
Practical Guidelines for Parents and Caregivers
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Breastfeed if possible: Breastfeeding for at least six months provides natural biotics and supports optimal gut and immune development.
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Choose biotic-fortified formulas wisely: If breastfeeding is not possible, look for formulas enriched with clinically supported strains and prebiotics.
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Introduce solids gradually: Begin with iron-rich foods and gradually include a variety of vegetables, fruits, legumes, and whole grains to encourage microbial diversity.
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Include fermented foods: Age-appropriate fermented foods like yogurt and kefir are excellent sources of probiotics for toddlers.
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Avoid unnecessary antibiotics: Use antibiotics only when prescribed, and discuss probiotic support with your pediatrician if your child is undergoing treatment.
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Be cautious with supplements: While biotic supplements are widely available, their use in young children should be evidence-based and guided by a healthcare professional.
The first few years of life are a unique window of opportunity to shape a child’s health trajectory. The interplay between diet, the gut microbiome, and immune development is increasingly recognized as a cornerstone of well-being. By understanding the role of biotics—probiotics, prebiotics, synbiotics, and postbiotics—parents and caregivers can make informed choices that support a healthy microbiome, robust immunity, and proper growth. Whether through breastfeeding, biotic-enriched formulas, diverse solid foods, or fermented products, integrating biotics into a child’s diet offers a science-backed strategy to build a strong foundation for lifelong health
References
Boehm, G., Jelinek, J., Stahl, B., Van Laere, K., Knol, J., Fanaro, S., … & Vigi, V. (2004). Prebiotics in infant formulas. Journal of Clinical Gastroenterology, 38, S76-S79.
Braegger, C., Chmielewska, A., Decsi, T., Kolacek, S., Mihatsch, W., Moreno, L., … & ESPGHAN Committee on Nutrition. (2011). Supplementation of infant formula with probiotics and/or prebiotics: a systematic review and comment by the ESPGHAN committee on nutrition. Journal of Pediatric gastroenterology and nutrition, 52(2), pp. 238-250
Fanaro, S., Boehm, G., Garssen, J., Knol, J., Mosca, F., Stahl, B., & Vigi, V. (2005). Galacto‐oligosaccharides and long‐chain fructo‐oligosaccharides as prebiotics in infant formulas: a review. Acta Paediatrica, 94, pp. 22-26 (Article).
Mugambi, M. N., Musekiwa, A., Lombard, M., Young, T., & Blaauw, R. (2012). Probiotics, prebiotics infant formula use in preterm or low birth weight infants: a systematic review. Nutrition Journal, 11, pp. 1-18.
Mugambi, M. N., Musekiwa, A., Lombard, M., Young, T., & Blaauw, R. (2012). Synbiotics, probiotics or prebiotics in infant formula for full term infants: a systematic review. Nutrition Journal, 11, pp. 1-32.
Skórka, A., Pieścik-Lech, M., Kołodziej, M., & Szajewska, H. (2018). Infant formulae supplemented with prebiotics: Are they better than unsupplemented formulae? An updated systematic review. British Journal of Nutrition, 119(7), pp. 810-825. .
Vandenplas, Y., Greef, E. D., & Veereman, G. (2014). Prebiotics in infant formula. Gut Microbes, 5(6), pp. 681-687.
Vandenplas, Y., Zakharova, I., & Dmitrieva, Y. (2015). Oligosaccharides in infant formula: more evidence to validate the role of prebiotics. British Journal of Nutrition, 113(9), pp. 1339-1344
Veereman-Wauters, G. (2005). Application of prebiotics in infant foods. British Journal of Nutrition, 93(S1), S57-S60.
Zhang, W., Zhang, Y., Zhao, Y., Li, L., Zhang, Z., Hettinga, K., … & Deng, J. (2024). A Comprehensive Review on Dietary Polysaccharides as Prebiotics, Synbiotics, and Postbiotics in Infant Formula and Their Influences on Gut Microbiota. Nutrients, 16(23), 4122.
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