Last update: Nov. 30, 2019
Increased level of risk
New scientific evidences have driven the Apilam staff to update the level of risk associated to this product.
Former level of risk, which was Very Low Risk, is now set to Low Risk.
Level of risk reviewed on Nov. 29, 2019
Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.
Since the last update there is no valid scientific evidence that the use of probiotics is effective in treating or prevent mastitis or breast pain in women (Amir 2014, Baeza 2015, Espinola 2016, Amir 2016). Its indiscriminate use may delay other treatments and be economically expensive (Amir 2016).
Evidence that orally administered can get into the milk is lacking (Elias 2011).
The use of presumably preventive probiotics during pregnancy was associated with an increased risk of mastitis and other complications of breastfeeding during the first month of breastfeeding (Karlsson 2019).
The administration of probiotics to the mother may partially alter the composition of milk: changes have been shown in the lipid profile, IgA levels (increase or decrease depending on studies) and in other immunological factors as cytokines IL-27, TGF-β1 and TGF-β2 (Kubota 2014, Nikniaz 2013, Luoto 2012, Hoppu 2012, Prescott 2008, Böttcher 2008). The impact and importance of this are not well known.
Research on the use of probiotics for treatment or prevent various pathological conditions, necrotizing enterocolitis, asthma, atopic dermatitis (Wickens 2013, Rautava 2012 y 2002, Boyle 2011, Foisy 2011, Dotterud 2010), colicky pain, mastitis (Fernández 2014, Arroyo 2010, Jiménez 2008), breast pain, vaginitis, gastroenteritis (see specific sheet of Saccharomyces boulardii) and inflammatory bowel disease, among others, is very promising, but so far with very modest results and the lack of significant scientific level 1 evidence based (Foisy 2011, Thomas 2010, Boyle 2006).
Probiotics seem to be safe (Snydman 2008, Borriello 2002), except in cases of Immune disease, severe intestinal compromise, diabetes or heart disease in the mother and prematurity (Sotoudegan 2019, Doron 2015, Boyle 2006). Although rare, there have been cases of serious probiotic infections when administering probiotics in patients with any of these pathological conditions (Chakravarty 2019, Cavicchiolo 2019, Celis 2019, Land 2005, Mackay 1999, Rautio 1999).
Probiotic mixtures (more than single strains) decrease the risk of necrotizing enterocolitis in premature infants (Robertson 2019, Bührer 2019, Bi 2019).
Breast milk is an important source of probiotics and probiotics (Walker 2013, Weng 2013, Weber 2012, Novak 2001). Contains numerous species of saprophytic bacteria (Staphylococcus epidermidis, Streptococcus salivarius, Enterococci , Lactobacilli) with immuno-modulatory and anti-inflammatory properties that inhibit the growth of pathogenic bacteria such as Staphylococcus aureus (Heikkilä 2003). Also, contains oligosaccharides that promote the growth of these commensal bacteria in the infant gut .
Breastfeeding plays a fundamental role in the colonization of the newborn gut (Walker 2013, Weber 2012, Martín 2012, Thum 2012, Penders 2006). During the first years of life intestinal flora of infants varies according to whether or not breastfed.
We do not have alternatives for Probiotics.
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.
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Thank you for helping to protect and promote breastfeeding.