For years, probiotics were all the rage. Found in all kinds of kids’ foods, baby formulas and probiotic supplements, these live bacteria and yeasts are marketed mainly to aid digestion, ease constipation, and prevent diarrhea, but also to bolster the immune system, calm colic, and clear up eczema. While science supports some of these uses in certain cases, there are still many unknowns about which strains do what. That’s why — for now, anyway — pediatricians say most healthy kids don’t need to take probiotics on a daily basis.

But what about prebiotics — with an e? One letter changes and a new health trend is born! Prebiotics are touted to aid digestion by boosting gut health. But they are different and equally essential. And, yes, they’re something that would be good for your kids to get more of in their diet. Here’s what you need to know.

Probiotics vs. Prebiotics

While probiotics and prebiotics are related and both generally good for the gut, they are distinctly different. Probiotics, such as Lactobacilli and Bifidobacterium, are themselves microorganisms, so the idea is to repopulate the digestive system with good bacteria to balance out the bad. Normally, most of the bacteria dwelling in our guts are friendly, aiding digestion and other bodily processes. But there are nefarious types too, which can proliferate and take over, causing bloating, gas, diarrhea, and sometimes serious infections.

Prebiotics, on the other hand, are nondigestible food-based carbohydrates — typically plant fibers — that feed friendly gut bacteria. “Because the body can’t digest prebiotics, they go right to the lower part of the digestive system and act as food for healthy bacteria to grow,” says Nicole Avena, Ph.D., assistant professor of neuroscience at Mount Sinai School of Medicine and visiting professor of health psychology at Princeton University. “Or, if new bacteria are forming, prebiotics help them develop.”

So, basically, probiotics and prebiotics are different avenues toward same goal: a healthy gut and a properly functioning digestive system. It’s just that probiotics add more beneficial microorganisms to the mix while prebiotics promote the growth of the good bugs already there. The way prebiotics do it may be the more effective strategy.

“It is important to repopulate the colony of good bacteria that’s there and ensure it stays healthy,” Avena says. “In some ways, prebiotics are more important than probiotics because they feed probiotics. You can take all the probiotics in the world, but they won’t produce health benefits if you don’t also have prebiotics on board.”

But beyond supporting the digestive system, emerging research shows prebiotics have many other benefits. According to Avena, they help the body absorb calcium, key for kids’ bone growth, and preempt blood sugar spikes. Also, by speeding up digestion, they can curtail constipation. Prebiotics are looking to be good for the brain as well. “Now that we’re learning so much about gut-brain interaction, we know that many things related to brain development have a connection to what is happening in the gut,” Avena says. “There is significant amount of research connecting probiotics and brain health, so, de facto, prebiotics are big part of that story too.”

The Case for Prebiotic Supplements

Prebiotics occur naturally in a wide range of foods, including apples, bananas, barley, berries, oats, tomatoes, and wheat. They’re also found in onions, garlic, dandelion greens, Jerusalem artichokes, and soybeans, although these may be a harder sell for most kids. “Yogurt can also be a great source of prebiotics, but avoid the ones marketed for kids, as they are often loaded with added sugars,” Avena cautions. Additionally, food companies are increasingly adding prebiotic fibers and sugars such as inulin and oligosaccharides into nutrition bars, cereals, pastas and other packaged products.

Yet despite prebiotics being readily available, Avena says the average kid doesn’t consume enough of them. “For children, especially toddlers, it can be very difficult to get the appropriate amount into their diets,” she says. “Babies under 12 months are usually OK because breastmilk naturally contains prebiotics and many formulas are fortified with them. But once they transition to food, there tends to be a precipitous drop-off. If they don’t like the particular foods that contain prebiotics, or if they’re a picky eater in general, it can be a struggle to get prebiotics into their diet”

Plus, research shows that overall vegetable and fruit consumption among children is down, “so most kids are not consuming prebiotic-rich foods in high enough quantities to be healthy,” Avena says. “We’re not talking about an apple or banana every other day—these foods need to be a regular part of every meal.” Even when parents prepare kids’ meals and snacks before sending them off to daycare or school, there’s no guarantee they’re actually eating everything. “I have little kids,” Avena says. “Sometimes food ends up in the trash.”

Therefore, while she always advises leading with food, given the realities of most kids’ diets, Avena believes all children — even babies — should take a prebiotic supplement, not just those with digestive issues. “I advise parents to be proactive,” she says. “Don’t wait until the child has a problem and then look to treat it. Knowing kids tend to not consume enough foods with prebiotics, offer a supplement as a preventative measure.”

The other perk of prebiotic supplements is often they contain other nutrients.” For example, Avena recommends the toddler nutritional drink Enfagrow, which contains iron and the omega-3 fatty acid DHA, both important for a child’s development. She also likes Sovereign Laboratories Infant and Child Colostrum-LD, which contains oligosaccharide, as well as helpful antibodies and immunoglobulins to support immune system health.

But whenever shopping for kids’ supplements, read labels closely. These products are regulated more loosely than over-the-counter drugs and don’t need FDA approval to be sold. “Some of the claims made aren’t always quite accurate,” Avena says. “Parents need to be mindful about buying from reputable, established brands. Also look for third-party testing for purity endorsements from medical professionals. You can always ask your child’s pediatrician for recommendations as well.”

This article was originally published on November 24, 2020