Probiotics Research: The Pediatric Perspective

Probiotics and Health Claims

Volumn , Issue , 2010, Pages 178-198

  ZwiauerS, Karl ^a  

^a Karl Landsteiner Institute for Implementation of Innovative Techniques in Cardiac Surgery   (Austria)

Author keywords

Acute gastroenteritis and community acquired diarrhea potentially, beneficial effect of probiotics, mild in moderate infectious diarrhea; Antibiotics, prescribing medicines in children for minor infections of urinary and respiratory tracts; Clinical effect of probiotics in children; Clinical efficacy of probiotics assessment preventing atopic disease, hindered by protocol heterogeneity; Maternal nutrition, role in colonization of gastrointestinal tract of newborn; Meta analyses, assessing use of probiotics preventing atopic dermatitis; Probiotic functional foods in infancy and health benefits beyond provision of essential nutrients; Probiotics in preterm infants, preterm infants increased morbidity and mortality from sepsis and necrotizing enterocolitis (NEC); Probiotics research the pediatric perspective; Scientific basis of probiotic use in different diseases in infants and children, probiotics in nutrition in infancy and childhood

Indexed keywords

EID: 84875501356     PISSN: None     EISSN: None     Source Type: Book    
DOI: 10.1002/9781444329384.ch13     Document Type: Chapter

References (108)

1. Abrahamsson TR, Jakobsson T, Bottcher MF, Fredrikson M, Jenmalm MC, Björkstén B, Oldaeus G (2007) Probiotics in prevention of IgE-associated eczema: a double-blind, randomized, placebo-controlled trial. J Allergy Clin Immunol 119:1174-1180.
2. Agarwal R, Sharma N, Chaudhry R, Deorari A, Paul VK, Gewolb IH, Panigrahi P (2003) Effects of oral Lactobacillus GG on enteric microflora in low-birth-weight neonates. J Pediatr Gastroenterol Nutr 36:397-402.
3. Alfaleh KM, Bassler D (2008) Probiotics for prevention of necrotizing enterocolitis in preterm infants. Cochrane Database Syst Rev 1:CD005496.
4. Alfaleh KM, Anabrees J, Bassler D (2009) Probiotics reduce the risk of necrotizing enterocolitis in preterm infants: a meta-analysis. Neonatology 97:93-96.
5. Allen SJ, Okoko B, Martinez E, Gregorio G, Dans LF (2003) Probiotics for treating infectious diarrhoea. Cochrane Database Syst Rev 4:CD003048.
6. Alm JS, Swartz J, Bjorksten B, Engstrand L, Engström J, Kühn I, Lilja G, Scheynius A (2002) An anthroposophic life-style and intestinal microflora in infancy. Pediatr Allergy Immunol 13:402-411.
7. Bartlett JG (1992) Antibiotic-associated diarrhea. Clin Infect Dis 15:573-581.
8. Bartlett JG, Chang TW, Gurwith M, Gorbach SL, Onderdonk AB (1978) Antibiotic-associated pseudomembranous colitis due to toxin producing Clostridia. N Engl J Med 298:531-534.
9. Bausserman M, Michail S (2005) The use of Lactobacillus GG in irritable bowel syndrome in children: a double-blind randomized control trial. J Pediatr 147:197-201.
10. Bengmark S (1998) Ecological control of the gastrointestinal tract: the role of probiotic flora. Gut 42:2-7.
11. Bennet R, Nord CE (1987) Development of the faecal anaerobic microflora after caesarean section and treatment with antibiotics in newborn infants. Infection 15:332-336.
12. Benno Y, Sawada K, Mitsuoka T (1984) The intestinal microflora of infants: composition of fecal flora in breast-fed and bottle-fed infants. Microbiol Immunol 28:975-986.
13. Berger RE (2005) Lactobacillus sepsis associated with probiotic therapy. J Urol 174:1843.
14. Betsi GI, Papadavid E, Falagas ME (2008) Probiotics for the treatment or prevention of atopic dermatitis: a review of the evidence from randomized controlled trials. Am J Clin Dermatol 9:93-103.
15. Bettelheim KA, Breadon A, Faiers MC, O'Farrell SM, Shooter RA (1974) The origin of serotypes of Escherichia coli in babies after normal delivery. J Hyg (Lond) 72:67-70.
16. Bjorksten B (2004) Effects of intestinal microflora and the environment on the development of asthma and allergy. Springer Semin Immunopathol 25:257-270.
17. Bousvaros A, Guandalini S, Baldassano RN, Botelho C, Evans J, Ferry GD, Goldin B, Hartigan L, Kugathasan S, Levy J, Murray KF, Oliva-Hemker M, Rosh JR, Tolia V, Zholudev A, Vanderhoof JA, Hibberd PL (2005) A randomized, double-blind trial of Lactobacillus GG versus placebo in addition to standard maintenance therapy for children with Crohn's disease. Inflamm Bowel Dis 11:833-839.
18. Boyle RJ, Robins-Browne RM, Tang ML (2006) Probiotic use in clinical practice: what are the risks? Am J Clin Nutr 83:1256-1264.
19. Boyle RJ, Bath-Hextall FJ, Leonardi-Bee J, Murrell DF, Tang MLK (2008) Probiotics for treating eczema. Cochrane Database Syst Rev 4:CD006135.
20. Brook I, Barrett C, Brinkman CR, Martin WJ, Finegold SM (1979) Aerobic and anaerobic bacterial flora of the maternal cervix and newborn gastric fluid and conjunctiva: a prospective study. Pediatrics 63:451-455.
21. Brouwer ML, Wolt-Plompen SA, Dubois AE, van der Heide S, Jansen DF, Holjer MA, Kauffman HF, Duiverman EJ (2006) No effects of probiotics on atopic dermatitis in infancy: a randomized placebo controlled trial. Clin Exp Allergy 36:899-906.
22. Burns D, Hurst JR, Hopkins S, Patch D, Burroughs AK, Agarwal B (2007) Purpura fulminans associated with Lactobacillus paracasei liver abscess. Anaesth Intensive Care 35:121-123.
23. Campieri M, Gionchetti P (2001) Bacteria as the cause of ulcerative colitis. Gut 48:132-135.
24. Cannon JP, Lee TA, Bolanos JT, Danziger LH (2005) Pathogenic relevance of Lactobacillus: a retrospective review of over 200 cases. Eur J Clin Microbiol Infect Dis 24:31-40.
25. Chouraqui JP, Van Egroo LD, Fichot MC (2004) Acidified milk formula supplemented with Bifidobacterium lactis: impact on infant diarrhea in residential care settings. J Pediatr Gastroenterol Nutr 38:288-292.
26. Correa NB, Peret Filho LA, Penna FJ, Lima FMLS, Nicoli JR (2005) A randomized formula controlled trial of Bifidobacterium lactis and Streptococcus thermophilus for prevention of antibiotic-associated diarrhea in infants. J Clin Gastroenterol 39:385-389.
27. Cukovic-Cavka S, Likic R, Francetic I, Rustemovic N, Opacic M, Vucelic B (2006). Lactobacillus acidophilus as a cause of liver abscess in a NOD2/CARD15-positive patient with Crohn's disease. Digestion 73:107-110.
28. De Groote MA, Frank D, Dowell E, Glode MP, Pace NR (2005) Lactobacillus rhamnosus GG bacteremia associated with probiotic use in a child with short gut syndrome. Pediatr Infect Dis J 24:278-280.
29. Deshpande G, Rao S, Patole S (2007) Probiotics for prevention of necrotising enterocolitis in preterm neonates with very low birthweight: a systematic review of randomised controlled trials. Lancet 369:1614-1620.
30. Drossman DA (1999) The functional gastrointestinal disorders and the Rome II process. Gut 45(Suppl 2):II1-II5.
31. Duffy LC (2000) Interactions mediating bacterial translocation in the immature intestine. J Nutr 130:432S-436S.
32. Ernährungskommission DACH (2009) Ernährungskommission der Deutschen Gesellschaft für Kinderund Jugendmedizin (DGKJ), Ernährungskommission der Österreichischen Gesellschaft für Kinder-und, Jugendheilkunde (ÖGKJ), Ernährungskommission der Schweizerischen Gesellschaft für Pädiatrie (SGP) Empfehlungen zu Prä-und Probiotika in Säuglingsanfangsnahrungen. Monatsschr Kinderheilkd 157:267-270.
33. European Society of Paediatric Gastroenterology, Hepatitis and Nutrition, Committee on Nutrition (2004) Probiotic bacteria in dietetic products for infants: a commentary by the ESPGHAN committee on nutrition. J Pediatr Gastroenterol Nutr 38:365-374.
34. Ezendam J, van Loveren H (2006) Probiotics: immunomodulation and evaluation of safety and efficacy. Nutr Rev 64:1-14.
35. Gawronska A, Dziechciarz P, Horvath A, Szajewska H (2007) A randomized double-blind placebocontrolled trial of Lactobacillus GG for abdominal pain disorders in children. Aliment Pharmacol Ther 25:177-184.
36. Gewolb IH, Schwalbe RS, Taciak VL, Harrison TS, Panigrahi P (1999) Stool microflora in extremely low birthweight infants. Arch Dis Child 80:F167-F173.
37. Goldmann DA, Leclair J, Macone A (1978) Bacterial colonization of neonates admitted to an intensive care environment. J Pediatr 93:288-293.
38. Grönlund MM, Lehtonen OP, Kero P, Saxelin M, Salminen S (1997) Lactobacillus GG supplementation does not reduce faecal colonization of Klebsiella oxytoca in preterm infants. Acta Paediatr 86:440-441.
39. Grönlund MM, Lehtonen OP, Eerola E, Kero P (1999) Fecal microflora in healthy infants born by different methods of delivery: permanent changes in intestinal flora after cesarean delivery. J Pediatr Gastroenterol Nutr 28:19-25.
40. Guarino A, Albino F, Ashkenazi S, Gendrel D, Hoekstra JH, Shamir R, Szajewska H (2008) European Society for Paediatric Gastroenterology, Hepatology, and Nutrition/European Society for Paediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe. J Pediatr Gastroenterol Nutr 46(Suppl 2):S81-S122.
41. Halken S (2004) Prevention of allergic disease in childhood: clinical and epidemiological aspects of primary and secondary allergy prevention. Pediatr Allergy Immunol 15(Suppl 16):4-5.
42. Harmsen HJ, Wildeboer-Veloo AC, Raangs GC, Wagendrop AA, Klijn N, Bindels JG, Welling GW (2000) Analysis of intestinal flora development in breast-fed and formula-fed infants by using molecular identification and detection methods. J Pediatr Gastroenterol Nutr 30:61-67.
43. Holt PG, Sly PD, Björkstén B (1997) Atopic versus infectious diseases in childhood: a question of balance? Pediatr Allergy Immunol 8:53-58.
44. Huertas-Ceballos AA, Logan S, Bennett C, Macarthur C (2009) Dietary interventions for recurrent abdominal pain (RAP) and irritable bowel syndrome (IBS) in childhood. Cochrane Database Syst Rev 1:CD003019.
45. Huurre A, Kalliomäki M, Rautava S, Rinne M, Salminen S, Isolauri E (2008) Mode of delivery: effects on gut microbiota and humoral immunity. Neonatology 93:236-240.
46. Ishibashi N, Yamazaki S (2001) Probiotics and safety. Am J Clin Nutr 73:465S-470S.
47. Isolauri E, Ribeiro HC, Gibson G, Saavedra J, Salminen S, Vanderhoof J, Varavithya W (2002) Functional foods and probiotics: Working group report of the first World Congress of Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 35:S106-S109.
48. Johnston BC, Supina AL, Ospina M, Vohra S (2007) Probiotics for the prevention of pediatric antibioticassociated diarrhea. Cochrane Database Syst Rev 2:CD004827.
49. Kalliomäki M, Salminen S, Arvilommi H, Kero P, Koskinen P, Isolauri E (2001) Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet 357:1076-1079.
50. Kalliomäki M, Salminen S, Poussa T, Arvilommi H, Isolauri E (2003) Probiotics and prevention of atopic disease: 4-year follow-up of a randomised placebo-controlled trial. Lancet 361:1869-1871.
51. Kalliomäki M, Salminen S, Poussa T, Isolauri E (2007) Probiotics during the first 7 years of life: a cumulative risk reduction of eczema in a randomized, placebo-controlled trial. J Allergy Clin Immunol 119:1019-1021.
52. Kim KH, Fekety R, Batts DH, Cudmore M, Silva J Jr, Waters D (1981) Isolation of Clostridium difficile from the environment and contacts of patients with antibiotic-associated colitis. J Infect Dis 143:42-50.
53. Kopp MV, Hennemuth I, Heinzmann A, Urbanek R (2008) Randomized, double-blind, placebo-controlled trial of probiotics for primary prevention: no clinical effects of Lactobacillus GG supplementation. Pediatrics 121:e850-e856.
54. Kosloske AM (1984) Pathogenesis and prevention of necrotizing enterocolitis: a hypothesis based on personal observation and a review of the literature. Pediatrics 74:1086-1092.
55. Kunz AN, James NM, Fairchok MP (2004) Two cases of Lactobacillus bacteremia during probiotic treatment of short gut syndrome. J Pediatr Gastroenterol Nutr 38:457-458.
56. Kunz C, Rodriguez-Palmero M, Koletzko B, Jensen R (1999) Nutritional and biochemical properties of human milk. Part I: General aspects, proteins, and carbohydrates. Clin Perinatol 26:307-333.
57. Land MH, Rouster-Stevens K, Woods CR, Cannon ML, Cnota J, Shetty AK (2005) Lactobacillus sepsis associated with probiotic therapy. Pediatrics 115:178-181.
58. Langhendries JP, Detry J, Van Hees J, Lamboray JM, Darimont J, Mozin MJ, Secretin MC, Senterre J (1995) Effect of a fermented infant formula containing viable bifidobacteria on the fecal flora composition and pH of healthy full-term infants. J Pediatr Gastroenterol Nutr 21:177-181.
59. Larson HE, Barclay FE, Honour P, Hill ID (1982) Epidemiology of Clostridium difficile in infants. J Infect Dis 146:727-733.
60. Ledoux D, Labombardi VJ, Karter D (2006) Lactobacillus acidophilus bacteraemia after use of a probiotic in a patient with AIDS and Hodgkin's disease. Int J STD AIDS 17:280-282.
61. Lee J, Seto D, Bielory L (2008) Meta-analysis of clinical trials of probiotics for prevention and treatment of pediatric atopic dermatitis. J Allergy Clin Immunol 121:116-121.
62. Lin HC, Hsu CH, Chen HL, Chung MY, Hsu JF, Lien RI, Tsao LY, Su BH (2008) Oral probiotics prevent necrotizing enterocolitis in very low birth weight preterm infants: a multicenter, randomized, controlled trial. Pediatrics 122:693-700.
63. Link-Amster H, Rochat F, Saudan KY, Mignot O, Aeschlimann JM (1994) Modulation of a specific humoral immune response and changes in intestinal flora mediated through fermented milk intake. FEMS Immunol Med Microbiol 10:55-63.
64. Loguercio C, Del Vecchio Blanco C, Coltorti M (1987) Enterococcus lactic acid bacteria strain SF68 and lactulose in hepatic encephalopathy: a controlled study. J Int Med Res 15:335-343.
65. Mackie RI, Sghir A, Gaskins HR (1999) Developmental microbial ecology of the neonatal gastrointestinal tract. Am J Clin Nutr 69:1035S-1045S.
66. Majamaa H, Isolauri E (1997) Probiotics: a novel approach in the management of food allergy. J Allergy Clin Immunol 99:179-185.
67. Mattar AF, Drongowski RA, Coran AG, Harmon CM (2001) Effect of probiotics on enterocyte bacterial translocation in vitro. Pediatr Surg Int 17:265-268.
68. Michail SK, StolfiA, Johnson T, Onady GM (2008) Efficacy of probiotics in the treatment of pediatric atopic dermatitis: a meta-analysis of randomized controlled trials. Ann Allergy Asthma Immunol 101:508-516.
69. Millar MR, Bacon C, Smith SL, Walker V, Hall MA (1993) Enteral feeding of premature infants with Lactobacillus GG. Arch Dis Child 69:483-487.
70. Näse L, Hatakka K, Savilahti E, Saxelin M, Pönkä A, Poussa T, Korpela R, Meurman JH (2001) Effect of long-term consumption of a probiotic bacterium, Lactobacillus rhamnosus GG, in milk on dental caries and caries risk in children. Caries Res 35:412-420.
71. Niers L, Martín R, Rijkers G, Sengers F, Timmerman H, van Uden N, Smidt H, Kimpen J, Hoekstra M (2009) The effects of selected probiotic strains on the development of eczema. Allergy 64:1349-1358.
72. Oberhelman RA, Gilman RH, Sheen P, Taylor DN, Black RE, Cabrera L, Lescano AG, Madico G (1999) A placebo-controlled trial of Lactobacillus GG to prevent diarrhea in undernourished Peruvian children. J Pediatr 134:15-20.
73. Orrhage K, Nord CE (1999) Factors controlling the bacterial colonization of the intestine in breastfed infants. Acta Paediatr Suppl 88:47-57.
74. Osborn DA, Sinn JK (2007) Probiotics in infants for prevention of allergic disease and food hypersensitivity. Cochrane Database Syst Rev 4:CD006475.
75. Peltonen R, Ling WH, Hanninen O, Eerola E (1992) An uncooked vegan diet shifts the profile of human fecal microflora: computerized analysis of direct stool sample gas-liquid chromatography profiles of bacterial cellular fatty acids. Appl Environ Microbiol 58:3660-3666.
76. Penders J, Thijs C, Vink C, Stelma FF, Snijders B, Kummeling I, van den Brandt PA, Stobberingh EE (2006) Factors influencing the composition of the intestinal microbiota in early infancy. Pediatrics 118:511-521.
77. Reid G, Howard J, Gan BS (2001) Can bacterial interference prevent infection? Trends Microbiol 9:424-428.
78. Rosenfeldt V, Benfeldt E, Nielsen SD, Michaelsen KF, Jeppesen DL, Valerius NH, Paerregaard A (2003) Effect of probiotic Lactobacillus strains in children with atopic dermatitis. J Allergy Clin Immunol 111:389-395.
79. Saavedra J, Bauman NA, Oung I, Perman JA, Jolken RH (1994) Feeding of Bifidobacterium bifidum and Streptococcus thermophilus to infants in hospital for prevention of diarrhea and shedding of rotavirus. Lancet 344:1046-1049.
80. Salminen MK, Rautelin H, Tynkkynen S, Poussa T, Saxelin M, Valtonen V, Järvinen A (2004) Lactobacillus bacteremia, clinical significance and patient outcome, with special focus on probiotic L. rhamnosus GG. Clin Infect Dis 38:62-69.
81. Salvana EM, Frank M (2006) Lactobacillus endocarditis: case report and review of cases reported since 1992. J Infect 53:e5-e10.
82. Savino F, Cresi F, Pautasso S, Palumeri E, Tullio V, Roana J, Silvestro L, Oggero R (2004) Intestinal microflora in breastfed colicky and non-colicky infants. Acta Paediatr 93:825-829.
83. Savino F, Pelle E, Palumeri E, Oggero R, Miniero R (2007) Lactobacillus reuteri (American Type Culture Collection Strain 55730) versus simethicone in the treatment of infantile colic: a prospective randomized study. Pediatrics 119:e124-e130.
84. Schultz M, Göttl C, Young RJ, Iwen P, Vanderhoof JA (2004) Administration of oral probiotic bacteria to pregnant women causes temporary infantile colonization. J Pediatr Gastroenterol Nutr 38:293-297.
85. Schurman JV, Friesen CA, Danda CE, Andre E, Welchert E, Lavenbarg T, Cocjin JT, Hyman PE (2005) Diagnosing functional abdominal pain with the Rome II criteria: parent, child and clinician agreement. J Pediatr Gastroenterol Nutr 41:291-295.
86. Scientific Committee on Food of the European Commission (2004) Report of the Scientific Committee on Food on the Revision of Essential Requirements of Infant Formulae and Follow-on Formulae (adopted on 4 April 2003) Available at http://ec.europa.eu/food/food/labellingnutrition/children/formulae_en.htm (July 2010).
87. Sistek D, Kelly R, Wickens K, Stanley T, Fitzharris P, Crane J (2006) The effect of probiotics on atopic dermatitis confined to food sensitized children? Clin Exp Allergy 36:629-633.
88. Stark PL, Lee A (1982) The microbial ecology of the large bowel of breast-fed and formula-fed infants during the first year of life. J Med Microbiol 15:189-203.
89. Strachan DP (1989) Hay fever, hygiene, and household size. Br Med J 299:1259-1260.
90. Szajewska H, Mrukowicz J (2001) Probiotics in the treatment and prevention of acute infectious diarrhea in infants and children:a systematic review of published randomized, double-blind, placebo controlled trials. J Pediatr Gastroenterol Nutr 33:S17-S25.
91. Szajewska H, Ruszczyñski M, Radzikowski A (2006) Probiotics in the prevention of antibiotic-associated diarrhea in children: a meta-analysis of randomized controlled trials. J Pediatr 149:367-372.
92. Szajewska H, Skorka A, Dylag M (2007) Meta-analysis: Saccharomyces boulardii for treating acute diarrhoea in children. Aliment Pharmacol Ther 25:257-264.
93. Szajewska H, Albrecht P, Topczewska-Cabanek A (2009) Randomized, double-blind, placebo-controlled trial: effect of Lactobacillus GG supplementation on Helicobacter pylori eradication rates and side effects during treatment in children. J Pediatr Gastroenterol Nutr 48:431-436.
94. Taylor AL, Dunstan JA, Prescott SL (2007) Probiotic supplementation for the first 6 months of life fails to reduce the risk of atopic dermatitis and increases the risk of allergen sensitization in high-risk children: a randomized controlled trial. J Allergy Clin Immunol 119:184-191.
95. Teitelbaum JE, Walker WA (2002) Nutritional impact of pre-and probiotics as protective gastrointestinal organisms. Annu Rev Nutr 22:107-138.
96. Thibault H, Aubert-Jacquin C, Goulet O (2004) Effects of long-term consumption of a fermented infant formula (with Bifidobacterium breve C50 and Streptococcus thermophilus 065) on acute diarrhea in healthy infants. J Pediatr Gastroenterol Nutr 39:147-152.
97. Turck D, Bernet JP, Marx J, Kempf H, Giard P, Walbaum O, Lacombe A, Bloch K (2003) Incidence and risk factors of oral antibiotic-associated diarrhea in an outpatient pediatric population. J Pediatr Gastroenterol Nutr 37:22-26.
98. Van Niel CW, Feudtner C, Garris MM, Christakis DA (2002) Lactobacillus therapy for acute infectious diarrhea in children: a meta-analysis. Pediatrics 109:678-684.
99. Vendt N, Grunberg H, Tuure T, Malminiemi O, Wuolijoki E, Tillman V, Sepp E, Korpela R (2006) Growth during the first six months of life in infants using formula enriched with Lactobacillus rhamnosus GG: double-blind, randomized trial. J Hum Nutr Diet 19:51-58.
100. Viljanen M, Savilahti E, Haahtela T, Juntunen-Backman K, Korpela R, Savilahti E (2005) Probiotics in the treatment of atopic eczema/dermatitis syndrome in infants: a double-blind placebo-controlled trial. Allergy 60:494-500.
101. Weizman Z, Alsheikh A (2006) Safety and tolerance of a probiotic formula in early infancy comparing two probiotic agents: a pilot study. J Am Coll Nutr 25:415-419.
102. Weizman Z, Asli G, Alsheikh A (2005) Effect of a probiotic infant formula on infections in child care centers: comparison of two probiotic agents. Pediatrics 115:5-9.
103. West CE, Hammarström ML, Hernell O (2009) Probiotics during weaning reduce the incidence of eczema. Pediatr Allergy Immunol 20:430-437.
104. Westerbeek EA, van den Berg A, Lafeber HN, Knol J, Fetter WP, van Elburg RM (2006) The intestinal bacterial colonisation in preterm infants: a review of the literature. Clin Nutr 25:361-368.
105. Williams K, Chambers M, Logan S, Robinson D (1996) Association of common health symptoms with bullying in primary school children. Br Med J 313:17-19.
106. Yoshioka H, Iseki K, Fujita K (1983) Development and differences of intestinal flora in the neonatal period in breast-fed and bottle-fed infants. Pediatrics 72:317-321.
107. Young RJ (1997) Successful probiotic therapy of chronic recurrent abdominal pain in children. Gastroenterology 112:A856.
108. Ziegler EE, Jeter JM, Drulis JM, Nelson SE, Haschke F, Steenhout P, Brown C, Hager C (2003) Formula with reduced content of improved, partially hydrolyzed protein and probiotics: infant growth and health. Monatsschr Kinderheilkd 151(Suppl 1):S65-S71.