I can't emphasize this enough: Getting your child's gut health sorted out is absolutely critical. It's central to anyone's health but there are a great many doctors who now think that a dysbiotic gut is one of the key contributing factors to the development of Autism.
Regardless of whether your child is Autistic or not, please, please treat anything other than prime gut health as an urgent and critical problem.
There's a huge amount of information out there to help, which can sometimes be a hindrance.
I've outlined what will probably help the majority of people (kids or otherwise) here but note that at the moment this page mainly deals with probiotics (as time allows I'll add broader info) because that is what I think is needed most of the time. Even when they seem to make matters worse at first!
But be aware I am talking about the majority of people. People are remarkably different.
I'd highly recommend reading https://drruscio.com/gutbook/ Dr Ruscio is a functional medicine doc who has a particular interest in gut health and that book has a self-help section at the back with a protocol you can go through.
But - who has the time?
So, here's some information which should get you off to a quick start.
First it's important to realise that we didn't work out what they do and then decide to introduce them to get a health benefit. It's the other way around (as much of medical practice is!): We realised they had health benefits and only now are we slowly working out why that is.
We now know they do several things, including but not limited to:
They "crowd out" other species which may not be beneficial, restoring a balance where beneficial bacteria can re-establish dominance in the gut community.
Their presence results in specific immune system responses in the host (they can "tune" the immune system).
They actually produce substances which harm other, specific species of bacteria, when in the presence of those bacteria. (Note I can't recall the name of the class of molecules they produce but each species will produce different molecules depending on which other species they sense are around them).
Please take note of a few things which are important and often not obvious:
I am assuming that you are wheat (not just gluten), preferably grain (except perhaps rice), soy product and dairy (or at least dairy protein, so ghee is okay) free!
If you have not cut those things out of the diet you may not be able to get a clear idea of what is wrong. Some things may be able to come back later but for now you sadly must remove a lot to start to isolate root causes.
Everyone is astonishingly, frustratingly, impossibly different and that seems to go doubly for gut health.
What works for one person may do nothing for another, or even make things worse.
Just because you see an increase in symptoms (frustratingly) that does not necessarily mean it's not the right thing to do. It may just mean you just need to go lower and slower (though you might also want to try a different probiotic first, in case you see a better result with that one).
To be clear: Even if you try a probiotic and it doesn't do anything, that does not mean the probiotic is a waste of time it just means it may not be the right one for you. Ignore reviews from people saying it did nothing for them. That's simply bound to happen (see that note above about us being different!).
We currently have no technology, no lab test, no set of rules which can tell us which probiotic(s) is going to work for any given person: We just have to try them. Despite what some testing companies might broadly hint at! (Note: I am not saying that gi testing is not worthwhile. It is! But it just can't tell us which probiotics to take. It can tell us many other valuable things however).
I personally see no reason why there is even a concept of an infant probiotic formula. We certainly haven't been able to introduce these naturally occurring bacteria to our kids on a schedule ever before in history! But I may be missing something critical (you can't know what you don't know) and if I had a very young child I would want to buy things which were deemed to be safe for infants.
Please ignore the strange idea that "spore forming probiotics may be dangerous". The fact is that some of the most well studied probiotics, used medically since the early 1950s are spore forming, soil based organisms. For much more detail see this: https://drruscio.com/bacillus-probiotics-that-can-help-heal-your-gut/ and also https://ngmedicine.com/the-complete-guide-to-soil-based-probiotics/ (written by Lucy Mailing who works with Chris Kresser).
Soil based, spore forming probiotics are some of the most common organisms in soil. They make up a considerable portion of any handful of good fertile soil you pick up. All our plant food which we have ever dug out of the ground is covered in them. And many are dormant in the soil (spores) and literally come alive and live only in animal guts (within eight minutes of entry into the gut apparently!).
Most of the time probiotics do not colonise the gut but slowly die off over a couple of weeks. However in some people they now have been shown to colonise. It is likely that it depends on the prior state of their gut (Bacterially sterile mice get colonised by probiotics. Normal mice generally do not). For more see this Chris Kresser podcast episode.
Probiotics and prebiotics: Probiotics are live organisms (bacteria, fungus or even live parasites. Benign parasites can have an amazing effect apparently but I've not used them). Prebiotics are fibres which feed the "friendly" bacteria (they are the stuff you need before you can grow good gut bacteria; "pre" good bacteria).
Some people do well on both probiotics and prebiotics. Some do badly on one or the other. Most people probably need to be very careful with prebiotics (fibre) until they have used some probiotics (bacteria) to start to balance their gut.
You must start with a very low dose and go slowly up. I generally introduce any new supplement in the morning (to try avoid sleep issues) and then skip the next day since some things take a day to manifest: especially gut related things.
The only time I don't skip the next day is when we suddenly see a marked improvement.
Once you have a healthy gut you can drop the frequency of dosing. Maybe two or three days per week or possibly less (see Kiran Krishnan (developed both MegaSporeBiotic and Just Thrive) on this: https://www.youtube.com/watch?v=IolxUHdiX3Y&feature=youtu.be&t=1736 )
Probiotics vary enormously in their quality. Just enormously. Getting some random thing from Amazon is probably not going to help (though some great ones do happen to be on Amazon so you might have got lucky!).
You can add probiotics to food. Most taste just fine.
Open capsules to add to food or drink. Always start with a very small amount. Like the rounded part at the end of the capsule.
Food and drink should not be very much hotter than body temperature for probiotics but prebiotics are fine at higher temperatures (even resistant starch. The earlier idea that it reverts to non-RS at higher temperatures seems to have been wrong).
That being said, all probiotics I have investigated are actually perfectly temperature stable and can be shipped without refrigeration despite what the manufacturers sometimes claim. Once I've got into a conversation with a couple of manufacturers who make such claims they've said that it's just to avoid people thinking they can leave it in a hot car or similar (I also think it's actually a marketing ploy).
However, since our mailbox gets baked in the sun I do tend to avoid the height of summer when I buy them!
This was the second one we found which worked (after Mutaflor). But it does also contain inulin (a prebiotic) and prebiotics can result in more problems for some people as they can feed "bad" bacteria too.
It's relatively cheap and easy to try but I might be inclined to try the Equilibrium first.
(AKA; "S. boulardii" or even "S. boul")
This is very important and probably should be on hand in everyone's home. It's a probiotic in a class of its own as it's actually a strain of yeast.
Therefore it's not killed by antibiotics. There is a lot of data showing that taking it during a course of antibiotics can avoid antibiotic caused diarrhea (in fact there's data showing that taking bacterial probiotics helps avoid that as well!).
This changed the smell of our son's nappies overnight and stopped the "yeasty" smell they had.
There are many suppliers of this but the only one I'd recommend is Kirkman since they do not add any excipients (things to make it flow into the capsules better) or prebiotics (which Jarrow use and which then started to cause SIBO symptoms in both my son and me!).
They are on iHerb and other places but this is them:
Dose: We ramped to 4 per day.
Taste: Reasonably tasteless but rather savoury.
This was recommended by our doc and was game changing for the whole family. No, I don't mean we all suddenly woke up with perfect guts and could suddenly eat whatever we liked but we did see a marked increase in overall gut health. Much less wind. Less cramping. Able to eat several foods which we were historically sensitive to without issue.
The research behind this is amazing. The US NIH's Human Microbiome Project, which did a full DNA analysis of over two thousand people's gut bacteria, found that people from urban environments had half the number of species as people from rural environments. So this company looked at the "missing" species, checked for species which had no pathogenic activity (they are safe) and formulated a probiotic out of 115 of them. That's a huge, huge strain count. Far and away the largest of any probiotic.
We get ours from Amazon:
https://www.amazon.co.uk/gp/product/B017L0PT8Y/
Note: Look for the "Promotions" link beneath the price! In the EU they always seem to have a promo you can apply and they keep renewing the promo so I get a discount every time.
Dose: We ramped to 1 per day.
Taste: Almost tasteless.
This was also recommended by our doc and is just excellent. Our son had developed very, very painful wind for some weeks when he was three. His school thought he was having some kind of panic attacks (sigh...). We found that all it took (every, single time) was to get him to relax and stop him flailing about and screaming. That was easy; show him a cartoon on my phone. He'd stop, and sit... and within two minutes he'd let out a proper Barney Gumble burp; and all was well again.
This probiotic stopped that dead in one day. We've had a handful of small incidents since introducing it.
It was recommended by our doc and I've also seen it mentioned very favourably on a couple of Facebook threads.
The research into the formulation is first-rate (no D-lactate producing strains for example).
They do also make an infant formula but our doc says she's had parents with very small children who have seen better results with the normal formulation.
It isn't cheap but it's actually more economical than most other probiotics since it comes as a very pure powder. No excipients or prebiotics. So the small bottle is probably the equivalent of several normal bottles of capsules. You'll also need to buy the special measuring spoons the first time you buy it.
It can be found in many online shops via a Google search but we got ours here:
Dose: We started with less than 1 "drop" (measured by the spoons. Approximately the size of the broken tip of a pencil) but found that 1 drop per meal had a really good effect on him and allowed us to survive a Swedish Xmas just fine (lots of cabbage and even some sweeter things).
Taste: Delicious! It's rather sweet. Easy to hide regardless since it's so small.
I personally had a huge increase in gut health and massively decreased my histamine intolerance (diagnosed by my mystifed GP via a DAO blood level test which I got him to order for me).
I mentioned this above but please ignore the strange idea that "spore forming probiotics may be dangerous". The fact is that some of the most well studied probiotics, used medically since the early 1950s are spore forming, soil based organisms. For much more detail see this: https://drruscio.com/bacillus-probiotics-that-can-help-heal-your-gut/
It can be a little hard to get hold of this since it seems that the makers want to portray it as a kind of medical aid that you need a doctor's help with (sigh...).
You can get it from here (they ship internationally): https://rebelhealthtribe.com/rht-products/megasporebiotic/
If you're in Scandinavia you can get it here: https://www.tarjarunfeldt.se/shop/product/megasporebiotic-60-capsules
Note that at least one of the strains in this probiotic has been shown to have an effect on Clostridium difficile (C. diff).
Dose: We ramped to 1 capsule for a time but seem to be doing fine on less than a quarter now.
Taste: I don't recall but easy to hide.
NOTE: "Just Thrive" is made by the same company but has one less strain. For my own histamine intolerance issue, MegaSporeBiotic worked amazingly but Just Thrive did not. I guess that one extra strain was key.
See also Miyarisan, below.
https://aor.ca/products/probiotic-3
Or
https://www.iherb.com/pr/Advanced-Orthomolecular-Research-AOR-Probiotic-3-90-Capsules/43463
This is particularly relevant in the case of high numbers of Clostridium species (the OAT can show this) or specifically a C. diff infection (the GI Map can show this).
It contains three species:
Clostridium butyricum has been given to many Japanese hospital patients since the 1970s as a prophylactic against C. diff infections. So there is excellent safety data on it and it's been extensively studied; see Miyarisan on this page for more detail.
Enterococcus faecium has been shown to be active against C. diff. When I say "active" I mean is specifically creates a molecule to disrupt C. diff. This is a very common behaviour in bacteria: They develop specific attacks against competitor species.
Bacillus subtilis is a very, very well studied bacterium with wide-ranging effects on our immune system. It has been used clinically since the 1950s.
For much more on the Bacillus species see this podcase episode by Dr Ruscio (functional medicine doc who specialises in gut health) where he interviews a researcher: https://drruscio.com/bacillus-probiotics-that-can-help-heal-your-gut/
Dose: We ramped to half a capsule per day but could probably do more.
Taste: I don't recall but easy to hide.
I'm mainly noting this since it is useful for C. dif infections and might be useful on top of the AOR Probiotic-3 (above) in such cases.
Note: This does contain some lactose so if you are sure you have a dairy allergy (not just an intolerance) this probably isn't suitable.
This is available from Japan and contains a Clostridium strain which has been given to many patients in Japanese hospitals since the 1970s as a prophylactic against Clostridium difficile (C. diff) infections. It is quite cheap as it contains one thousand tablets.
Because it's a tablet it will need crushing for children who can't swallow a pill, which is inconvenient (but it tastes fine).
It is particularly worth having if there is a C. diff infection as it actively creates a toxin against that strain (the creation of strain specific toxins by bacteria is very normal and many probiotics almost certainly work by doing exactly that against pathogenic strains in our guts).
Order direct from Japan (shipping takes about two to four weeks to the EU but has worked every time for me
It's also usually on eBay (but usually still ships from Japan!)
UK: https://www.ebay.co.uk/sch/i.html?_nkw=Miyarisan
US: https://www.ebay.com/sch/i.html?_nkw=Miyarisan
Note: There is also a prescription version which I assume it stronger (assume!): https://synapse.inc/medicine/13113/Agents_affecting_individual_organs/MIYA-BM_FINE_GRANULES So if you can get that it would be worth a try.
Dose: We started at 1 crushed tablet per day.
Taste: Slightly sweet.
Good for small children. There are trials showing it reduced colic.
It’s in BioGaia ProTectis:
Dose: We ramped to 5 drops per day.
Taste: Almost tasteless but slightly savoury.
This is hard to get in the USA (though should be fine in the EU) and is generally considered to be a class of probitioc on its own. It's extremely well studied having first been isolated in 1917!
When my son developed stinking green liquid poo when he was a few months old, a dose of this returned him to normal "baby poo" overnight, after three weeks of messed up guts.
We used the liquid suspension but I imagine the caps are fine.
You can find it on Amazon Germany:
Or from these German pharamacies (you have to dig deep through Google search results but they are there). Note I have not personally bought from any of these except the firs one:
https://shop.berlinda-apotheke.com/keywordsearch (just type "mutaflor" into the search)
https://www.medpex.de/search.do?method=similarity&sort=&filter=&q=mutaflor
Dose: We used only occasionally for a few days and gave a whole 1ml vial at a time and then later gave parts of a 5ml vial (they keep for 7 days once opened).
Taste: Slightly salty. He was always happy to have them squeezed between his lips and swallowed them fine.
This might be just wonderful but in February of 2018 they heavily reformulated it and nobody seems to know why. The old formulation was excellent and we had a lot of success with it (in fact I bought ten bottles of the original formulation before it ran out!). Perhaps it's amazing but until I see some good data on what's in it I think there are other more well understood formulations.