Probiotics and Children's Health

For adults and children, probiotics are vital for a strong microbiome and overall health. But what are they, exactly? Probiotics are living microorganisms—typically bacteria and yeasts—that are good for the digestive system (aka your “gut”). And recent research shows that probiotics even bolster the immune system and influence mood and energy levels.¹ All of which help explain why probiotics are now abundantly available as dietary supplements in pill, powder, gummy, and capsule form. 

With modern diets often lacking in natural probiotic sources, ensuring balanced gut flora is more crucial than ever for children. Is supplementation the answer? We once again enlisted the help of Rachel Rothman (MS, RD, CLEC), a pediatric nutrition expert and registered dietitian, to give us a rundown on the importance of probiotics for children. More specifically, she’ll help us understand when children should take supplementary probiotics, and the factors that actually matter when choosing one.

Combining Rothman’s expertise with hands-on reviews by TCD parents on staff, we’ve evaluated the four leading children's probiotics from Hiya, Culturelle, Florastor, and Smarty Pants. We’ll help you make an informed choice for your kids’ health: should you supplement with a probiotic, and if so, which one?

One clear winner stood out in terms of probiotic diversity and count, quality, and safety. Read on to find our winner.

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Should My Child Take a Probiotic?

We asked Rothman when parents should consider supplementing their kid’s diet with a probiotic. In short, the best applications are for conditions in which less than optimal digestive health and immunity are causes. For kids, that tends to be A LOT of conditions, including diarrhea, constipation, dermatitis, and more. 

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“Certain strains of probiotics are helpful for gut health and natural immune response” explained Rothman. For example, “Lactobacillus rhamnosus has been shown to reduce episodes of antibiotic associated diarrhea. Lactobacillus rhamnosus and Lactobacillus paracasei have been shown to decrease incidence of atopic dermatitis in children. Lactobacillus paracasei and Bacillus lactis have been shown to help with children’s immunity, specifically by reducing episodes and increasing the body’s ability to fight the common cold.” 

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Choosing the Right Probiotic

What should you look for when choosing a children’s probiotic? For Rothman, it’s a combination of strain diversity (the actual different, proven in children, probiotics), levels of live cultures (measured in “colony forming units” or CFUs), other ingredients, dosage form, and taste.

It’s important to only consider probiotics made specifically for children. “Some strains might not be suitable for kids,” Rothman tells us. “Typically, children’s probiotics are smaller, and developed with kid-friendly flavors and formulations.”

Avoid unnecessary additives, and be sure to look at the age statement for probiotics. Due to their form factor, only Florastor and Hiya probiotics are safe for children under 3. More on that below.

How do Culturelle, Hiya, Smarty Pants, and Florastor compare on strain diversity, live cultures, ingredients, dosage form (and more)? Let’s find out.

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Probiotics Compared

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The Probiotic Profile:

Hiya’s Probiotic with 10 billion CFUs Wins

When compared to the probiotic offerings from Culturelle, Florastor, and Smarty Pants, Hiya is distinct with its formula of three well-studied strains of probiotics shown to be beneficial to children, specifically: Lactobacillus rhamnosus (GG), Lactobacillus paracasei (UALpc-04™), Bacillus lactis (Bl-04®).² “The probiotic strains in Hiya’s probiotic have been shown to reduce diarrhea caused by rotavirus, promote the growth of beneficial gut bacteria, and increase the body’s ability to fight the common cold, while containing a concentration of 10 billion CFU and without added sugar,” Rothman tells us.

Both Lactobacillus paracasei and (UALpc-04™) and Bacillus lactis (Bl-04®) have been shown to help with children’s immunity, specifically by reducing common cold episodes and increasing the body’s ability to fight it.³

Smarty Pants also contains a clinically proven combo of bacteria: Bacillus subtilis and Bacillus coagulans for overall digestive health. However, we’d like to see more research on the impact of these strains in children.

Hiya and Culturelle include prebiotic fiber. Some types have been shown to reduce the severity of GI infections, helping your body absorb certain minerals.⁴ Culturelle and Hiya contain inulin and larch tree fiber, respectively—both well studied prebiotics. But larch tree fiber is special for a few reasons, Rothman tells us. “In addition to increasing the body’s ability to fight the common cold, it can help increase intestinal bacteria in the gut, working in conjunction with the lactobacillus in Hiya’s probiotic.” 

Culturelle’s combo of Bacillus subtilis DE 111 and Bacillus coagulans MTCC 5856, are well studied for overall gut health. Florastor takes a different approach, focusing solely on Saccharomyces boulardii lyo CNCM I-745, a yeast-based probiotic. However, as Rothman observes, while beneficial for general gut health, the strains in Culturelle and Florastor may not provide the targeted support for children's specific gut flora as effectively as those in found in Hiya and Smarty Pants

Finally, when it comes to the volume of live cultures, Hiya packs the biggest punch with 10 billion CFUs vs. Smarty Pants’ 4 billion, and Florastor and Culturelle’s 1 billion. It’s important to remember that more is not always better – nevertheless when considering blends, we like to see total probiotic counts in the multiple billions, as most individual strains are effective at the 1-2 billion range. 

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Dosage Form & Ingredients:

Hiya’s Probiotic Tablet with Zero Added Sugar Wins

Similar to our thoughts on kids multivitamins: it may be tough to pronounce the bacteria and yeasts found in these probiotic blends (fun fact: they’re almost always derived from ancient Latin and Greek). But there’s that one pesky ingredient we always recommend avoiding: sugar. As a reminder, according to pediatric dentists, added sugars in gummies lead to cavities and can encourage unhealthy sweet preferences at an early age.⁵ Moreover “gummies can be considered a choking hazard in children 3 and under,” Rothman tells us.

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Still, only Hiya probiotics contain zero grams of sugar. The three other probiotics add sugar or sugar-like ingredients and thickeners, some to a significant extent. Florastor’s powder uses maltodextrin and lactose as thickening agents – while not technically a sugar, maltodextrin impacts kids’ blood sugar levels to an even higher extent than sugar.⁶ We recommend you steer clear. Smarty Pants and Culturelle both contain sugar and/or tapioca syrup as the first one or two “other ingredients” — both sweeteners to exercise caution around for children.

“Hiya is also ideal for kids because it is in tablet form,” Rothman adds. “The challenge with powder (like Florastor) is that it is usually mixed into a food or beverage, which kids may not finish in their entirety. Similar to its multivitamin offering, Hiya fits its probiotic blend into a single daily chewable tablet.

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Safe Age Ranges:

Florastor’s Powder Wins

Florastor’s powder is the only probiotic safe for children as young as 1. Hiya’s chewable tablet is safe for children 2+, while Smarty Pants and Culturelle’s gummies are reserved for children 3+. These age ranges are primarily related to the product's form factor, with gummies a choking hazard for children younger than 3, as mentioned. 

For very young children, your only choice is a powder probiotic like Florastor.

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Promoting Healthy Habits:

Hiya Wins

As we did in our multivitamin review, we want to evaluate each brand’s ease of use (important when it comes to adhering to a regular schedule) and impact on the environment. In short, which brand is your child going to enjoy taking every day? Which one can you feel good about buying regularly?

Hiya is the only brand that utilizes reusable containers that drastically reduce landfill waste – in stark contrast to the plastic containers and packets of the others. Again, Hiya gets bonus points for their premium glass container and the stickers they send with every first order. We love the colorful letters that encourage kids to personalize their bottles. 

As mentioned, Hiya’s blend fits into a single daily chewable tablet. The other gummies and powders provide less clear guidance “1-2 times per day.” We prefer Hiya’s clear instructions when it comes to peace of mind and building habits.

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The Overall Winner For Children’s Probiotics:

Hiya

Which probiotic is best for your child? After our thorough testing and analysis, we recommend the probiotic that delivers the most well researched probiotic strains in the highest volume—all in a single daily tablet. And that’s Hiya. Hiya’s high quality combination of probiotic and other ingredients, with an easy to consume, zero sugar form factor is tough to beat.

Rothman, our pediatric nutrition expert, agrees. “I absolutely love that Hiya has no added sugar, contains a prebiotic and probiotic, has a taste kids love, AND has packaging that’s good for the environment. Hiya is my go-to recommendation when it comes to kids’ supplements.”

Ready to try Hiya? With TCD, save 50% on your first order plus get free shipping. Hiya also offers discounts for families with more than one child.

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^{1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6445894/}

^{2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4844131/ https://www.sciencedirect.com/topics/medicine-and-dentistry/lactobacillus-rhamnosus ‍}

^{3. https://www.clinicalnutritionjournal.com/article/S0261-5614(13)00261-6/fulltext}

^{4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6041804/ ;}

^{5. https://www.sciencedirect.com/science/article/pii/S0022316622028206}

^{6. https://southmoorkids.com/kids-dentist-blog/are-gummy-vitamins-safe-for-my-childs-teeth/#:~:text=It%27s%20no%20mystery%20why%20gummy,of%20tooth%20decay%20and%20cavities.}

^{7. https://www.healthline.com/health/food-nutrition/is-maltodextrin-bad-for-me}