Quick answer

A Cochrane review of 33 trials in 6,352 children found no serious adverse event attributable to probiotics among the 24 trials that reported adverse events. FDA warns that probiotics can cause invasive, potentially fatal infection in preterm infants. No source we read reports teens separately. Ask your child's doctor before giving one.^1,2

Key facts

A 2019 Cochrane review of 33 randomized trials in 6,352 children aged 0 to 18 found no serious adverse event attributable to probiotics in the 24 trials that reported adverse events.¹
In those trials, 4% of children on probiotics and 6% on control had an adverse event, most often rash, nausea, gas, bloating or constipation.¹
The same review noted that observational studies outside it have reported serious events in severely debilitated or immune-compromised children, for example those with a central venous catheter.¹
FDA has not approved any probiotic product as a drug or biological product for infants of any age, and warns of invasive, potentially fatal infection in preterm infants.²
NIH says there are no official recommendations that cover probiotic use by healthy people.³

What did a Cochrane review in children find?

The Cochrane review looked at randomized trials in children from birth to 18 who were given antibiotics, and compared probiotics with placebo or no treatment. Its main question was diarrhea after antibiotics, and safety was a second aim, so it also pooled the adverse events the trials reported. Adverse events were uncommon: 4% of the 2,229 children who took a probiotic and 6% of the 2,186 in the control groups.¹

The reviewers described no serious adverse event attributable to a probiotic, including in small trials in intensive care and newborn units. They added a limit that matters for parents. Serious events had been reported in observational studies outside the review, in severely debilitated or immune-compromised children with risk factors such as a central venous catheter.¹

What is different for babies born early?

FDA reported that probiotic products used in hospitals for preterm infants contributed to invasive disease, including one infant death in 2023, and were linked to more than two dozen other adverse events in the US since 2018.²

FDA's 2023 announcement says the agency has not approved any probiotic product as a drug or biological product for infants of any age. It describes a risk of invasive disease caused by the bacteria or yeast in the product, and it acknowledges that the published data conflict. NIH's fact sheets and NCCIH repeat the warning, and NCCIH says the risks should be weighed carefully for high-risk infants.^2,3,4

The cases FDA describes involved products used in hospitals. The sources we read do not say whether a supplement bought for home use carries the same risk, which is why the parent of an early baby should ask the baby's doctor.²

Do the sources say anything about teens?

Not separately. The Cochrane trials covered ages 0 to 18 together, and the NIH and NCCIH pages do not report adolescents on their own. NCCIH notes only that a national survey found 300,000 children aged 4 to 17 had used probiotics or prebiotics in the past 30 days, which tells us they are used and nothing about their safety.^1,4

NIH says there are no official recommendations for probiotic use by healthy people, and that a health care provider can advise which product to choose, what dose and for how long. The sources give no amount for a child or a teen, and a higher count of CFU, the live organisms on a label, is not necessarily better.^3,5

There are no official recommendations for probiotic use by healthy people, so there is no recommended amount and no set upper limit. NIH notes that products with higher CFU counts are not necessarily more effective.^3,5

Who should ask their child's doctor first?

A parent of a baby born early, or of any baby in hospital, should ask the baby's doctor before giving a probiotic.
A parent of a child with a weakened immune system, a central line or a serious illness should ask the child's doctor.
A parent of a child with a fever, vomiting, bloody diarrhea or severe belly pain should ask the child's doctor.
A parent of a child who takes an antibiotic or an antifungal medicine can ask a pharmacist whether it matters, because NIH says those medicines might reduce a probiotic's effect.⁶
Teens who want to try one can ask their own doctor or pharmacist, who can look at the strains and the label together.

Questions people ask

Is probiotics safe for kids?

A Cochrane review of 33 trials in 6,352 children found no serious adverse event attributable to probiotics, with the limits above. FDA warns about preterm infants. Ask your child's doctor before giving one.^1,2

Is probiotic safe for teens?

No source we read reports teens on their own. The review's trials covered ages 0 to 18 together, so ask a doctor or pharmacist about your teen's situation.¹

Is probiotics good for teens?

This page covers safety only. NIH says no official recommendations cover probiotic use by healthy people, and suggests asking a health care provider.³

Are probiotics safe for kids who take antibiotics?

NIH says antibiotic and antifungal medicines might reduce a probiotic's effect. Ask your pharmacist how a probiotic fits with your child's prescription.⁶

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Sources

This page is information, not medical advice. Talk to your doctor or pharmacist about your own situation.