Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomised

doi:10.1136/bmj.322.7298.1327

BMJ 2001;322:1327 ( 2 June )

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Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomised trial

Katja Hatakka, research nutritionist, ^a Erkki Savilahti, professor of pediatrics, ^b Antti Pönkä, chief of environmental health, ^c Jukka H Meurman, professor of dental infectious diseases, ^e Tuija Poussa, biostatistician, ^d Leena Näse, specialist in clinical dentistry, ^f Maija Saxelin, senior microbiologist, ^a Riitta Korpela, assistant professor. ^g

^a Valio Research and Development, PO Box 30, FIN-00039 Valio, Helsinki, Finland, ^b Hospital for Children and Adolescents, Helsinki University Central Hospital, FIN-00029 Helsinki, Finland, ^c Centre of the Environment, Helsinki City, Helsinginkatu 24, FIN-00530 Helsinki, Finland, ^d STAT-Consulting, Takojankatu 15 B, FIN-33540 Tampere, Finland, ^e Department of Oral and Dental Diseases, Helsinki University Hospital, PO Box 263, FIN-00029 HUS, Helsinki, Finland, ^f Helsinki City Health Department, Kytösuontie 9, FIN-00030 Helsinki, Finland, ^g Foundation for Nutrition Research, PO Box 30, FIN-00039 Helsinki, Finland

Correspondence to: R Korpela riitta.korpela{at}valio.fi

Objective: To examine whether long term consumptionof a probiotic milk could reduce gastrointestinal and respiratoryinfections in children in day carecentres.
Design: Randomised, double blind, placebo controlledstudy over sevenmonths.
Setting: 18 day care centres in Helsinki,Finland.
Participants: 571 healthy children aged 1-6 years: 282 (mean(SD) age 4.6 (1.5) years) in the intervention group and 289 (mean(SD) age 4.4 (1.5) years) in the controlgroup.
Intervention: Milk with or without Lactobacillus GG. Averagedaily consumption of milk in both groups was 260ml.
Main outcome measures: Number of days with respiratory and gastrointestinalsymptoms, absences from day care because of illness, respiratorytract infections diagnosed by a doctor, and course ofantibiotics.
Results: Children in the Lactobacillus group had fewerdays of absence from day care because of illness (4.9 (95% confidenceinterval 4.4 to 5.5) v 5.8 (5.3 to 6.4) days, 16% difference,P=0.03; age adjusted 5.1 (4.6 to 5.6) v 5.7 (5.2 to 6.3) days,11% difference, P=0.09). There was also a relative reduction of17% in the number of children suffering from respiratory infectionswith complications and lower respiratory tract infections (unadjustedabsolute % reduction $-$ 8.6 ( $-$ 17.2 to $-$ 0.1), P=0.05; age adjustedodds ratio 0.75 (0.52 to 1.09), P=0.13) and a 19% relative reductionin antibiotic treatments for respiratory infection (unadjustedabsolute % reduction $-$ 9.6 ( $-$ 18.2 to $-$ 1.0), P=0.03; adjusted oddsratio 0.72 (0.50 to 1.03), P=0.08) in the Lactobacillus group.
Conclusions: Lactobacillus GG may reduce respiratory infectionsand their severity among children in day care. The effects ofthe probiotic Lactobacillus GG were modest but consistently inthe samedirection.

What is already known on this topic
Children attending day care centres are at high risk of respiratory and gastrointestinal infection

The successful prevention of respiratory infections could be extremely useful for families and for society in general

Short term use of probiotic bacteria has been shown to reduce the severity of rotavirus diarrhoea and the incidence of diarrhoea associated with the use of antibiotics

What this study adds
In a double blind, randomised, long term study milk containing Lactobacillus GG slightly reduced the incidence of respiratory infections and antibiotic treatment in children

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