益生菌補充品 對0-6個月大嬰幼兒的潛在好處與風險（下）

 

潛在風險

 

一、首次使用益生菌時，有些人會因為細菌在腸道生產更多的氣體，而造成胃氣、腹脹的現象；但這些副作用通常在數天或數週內便消失

 

二、在罕見的情況下，使用者會有皮膚痕癢等過敏反應，這可能與產品中的致敏源有關。常見的致敏源包括乳糖、麩質和人造色素（產品的包裝通常會標明致敏源成分）。

 

三、研究結果指出，有嚴重疾病 或 免疫力低下的大人和小孩應避免使用益生菌，因爲他們在使用益生菌後，會更容易受細菌或真菌感染。

 

四、研究發現，小腸菌叢過度增生（SIBO）的患者在使用益生菌後，病情有惡化跡象

 

五、罕見地，某些益生菌擁有抗藥性基因。它們能將抗藥性基因和其他有害基因傳給其他細菌，引起細菌感染。為了減少攝取這類益生菌的風險，選擇益生菌品牌時應尋找有信譽的製造商

 

注意：每個人有獨特的腸道菌群結構（即使是雙胞胎的亦不同），因此不同嬰兒對益生菌補充品可能反應各異。然而，益生菌的好處擁有多年來的臨床研究數據支撐，例如有不同研究證明益生菌對懷孕母親、新生兒、甚至住院兒童皆沒有副作用。這能反映益生菌對大部分人來說安全性高

 

選擇嬰兒益生菌時的建議

 

嬰兒益生菌產品眾多，常使人眼花瞭亂；對於挑選哪種益生菌予嬰幼兒，台灣營養師陳怡錞（2021）提供了以下建議：

 

- 避免含有高纖維益生質（prebiotics）的產品

- 絕對不能含有輕瀉成分，如番瀉葉、乳糖、蘆薈素等

- 選擇人體常駐菌種，而非環境菌

- 避免香料、色素、甜味劑、糖、果汁粉等成分

- 若嬰兒有正常消化功能且沒有嚴重過敏，就不需要添加「消化酵素」；不必要地添加消化酵素，會減少了嬰兒接觸大分子食物的機會，增加未來食物過敏的風險

 

 

Reference:

 

陳怡錞（2021）嬰兒可以吃益生菌嗎？Donna營養師破解保健產品迷思！Donnadiet. https://donnadiet.com/archives/5011

 

Araujo, G. V. D., Oliveira Junior, M. H. D., Peixoto, D. M., & Sarinho, E. S. C. (2015). Probiotics for the treatment of upper and lower respiratory-tract infections in children: systematic review based on randomized clinical trials. Jornal de pediatria, 91, 413-427.

 

Ardakani, A. T., Yahyapour, R., Amiri, M., Sharif, M. R., Khairkhah, D., Taghizadeh, M., & Gilasi, H. R. (2021). Investigating the effect of ORS with probiotics, zinc and vitamin A on children’s diarrhea: a randomized clinical trial. ACADEMIC JOURNAL.

 

Azad, M. B., Konya, T., Maughan, H., Guttman, D. S., Field, C. J., Chari, R. S., ... & Kozyrskyj, A. L. (2013). Gut microbiota of healthy Canadian infants: profiles by mode of delivery and infant diet at 4 months. Cmaj, 185(5), 385-394.

 

Crichton-Stuart, C. (2018) Can probiotics cause side effects? MedicalNewsToday. https://www.medicalnewstoday.com/articles/323821#_noHeaderPrefixedContent

 

Doron, S., & Snydman, D. R. (2015). Risk and safety of probiotics. Clinical Infectious Diseases, 60(suppl_2), S129-S134.

 

Galazzo, G., van Best, N., Bervoets, L., Dapaah, I. O., Savelkoul, P. H., Hornef, M. W., ... & Penders, J. (2020). Development of the microbiota and associations with birth mode, diet, and atopic disorders in a longitudinal analysis of stool samples, collected from infancy through early childhood. Gastroenterology, 158(6), 1584-1596.

 

Hungin, A. P. S., Mitchell, C. R., Whorwell, P., Mulligan, C., Cole, O., Agréus, L., ... & European Society for Primary Care Gastroenterology. (2018). Systematic review: probiotics in the management of lower gastrointestinal symptoms–an updated evidence‐based international consensus. Alimentary pharmacology & therapeutics, 47(8), 1054-1070.

 

Isolauri, E. (2003). Probiotics for infectious diarrhoea. Gut, 52(3), 436-437.

 

Isolauri, E., Rautava, S., Kalliomäki, M., Kirjavainen, P., & Salminen, S. (2002). Role of probiotics in food hypersensitivity. Current opinion in allergy and clinical immunology, 2(3), 263-271.

 

Kalliomäki, M., Carmen Collado, M., Salminen, S., & Isolauri, E. (2008). Early differences in fecal microbiota composition in children may predict overweight. The American journal of clinical nutrition, 87(3), 534-538.

 

Kumpu, M., Kekkonen, R. A., Kautiainen, H., Järvenpää, S., Kristo, A., Huovinen, P., ... & Hatakka, K. (2012). Milk containing probiotic Lactobacillus rhamnosus GG and respiratory illness in children: a randomized, double-blind, placebo-controlled trial. European journal of clinical nutrition, 66(9), 1020-1023.

 

Martín-Peláez, S., Cano-Ibáñez, N., Pinto-Gallardo, M., & Amezcua-Prieto, C. (2022). The Impact of Probiotics, Prebiotics, and Synbiotics during Pregnancy or Lactation on the Intestinal Microbiota of Children Born by Cesarean Section: A Systematic Review. Nutrients, 14(2), 341.

 

Nikolopoulou, G., Tsironi, T., Halvatsiotis, P., Petropoulou, E., Genaris, N., Vougiouklaki, D., ... & Houhoula, D. (2021). Analysis of the Major Probiotics in Healthy Women’s Breast Milk by Realtime PCR. Factors Affecting the Presence of Those Bacteria. Applied Sciences, 11(20), 9400.

 

Rao, S. S., Rehman, A., Yu, S., & De Andino, N. M. (2018). Brain fogginess, gas and bloating: a link between SIBO, probiotics and metabolic acidosis. Clinical and translational gastroenterology, 9(6).

 

Rondanelli, M., Faliva, M. A., Perna, S., Giacosa, A., Peroni, G., & Castellazzi, A. M. (2017). Using probiotics in clinical practice: Where are we now? A review of existing meta-analyses. Gut microbes, 8(6), 521-543.

 

Sudo, N., Sawamura, S. A., Tanaka, K., Aiba, Y., Kubo, C., & Koga, Y. (1997). The requirement of intestinal bacterial flora for the development of an IgE production system fully susceptible to oral tolerance induction. The Journal of Immunology, 159(4), 1739-1745.

 

Tapiovaara, L., Pitkäranta, A. I., & Korpela, R. (2016). Probiotics and upper respiratory tract-a review. Pediatric Infectious Disease Journal.

 

Vandenplas, Y., & Savino, F. (2019). Probiotics and prebiotics in pediatrics: what Is new?. Nutrients, 11(2), 431.