How to Give a Probiotic Sachet to a Child

Empty the sachet into a small amount of cool or room-temperature liquid or soft food, stir, and give it straight away so the child finishes it all. Avoid hot foods and drinks, keep sachets dry and sealed until use, and follow the label and your paediatrician for the dose and age.

What can a probiotic sachet be mixed with?

The carrier should be cool or at room temperature, soft and in a small enough amount for the child to finish. Good options include:

• plain water or cool boiled water
• breast milk or formula at room temperature
• plain curd or yoghurt
• mashed banana, apple puree or other soft fruit
• cool porridge or khichdi after it has cooled

Small amounts work best, such as a tablespoon of curd or a few spoonfuls of liquid. A large cup is risky because a child who leaves half has taken half the dose.

What should be avoided?

Hot food or drink. Heat harms live bacteria. A rule of thumb is that anything too hot to hold comfortably against the wrist is too hot for a probiotic .

Acidic juices and fizzy drinks. Strong acid reduces survival, and fizzy drinks are not advised for young children.

Mixing into a full bottle. Babies often do not finish bottles, so the dose may be incomplete. Use a few millilitres in a spoon or syringe.

Preparing in advance. Once mixed, the cells start to revive in moisture and slowly lose potency. Mix just before giving.

How do I give it to a baby?

For infants, stir the powder into a teaspoon or two of expressed breast milk, formula or cooled boiled water. Give it using a clean spoon or an oral syringe placed against the inner cheek, not at the back of the throat. Keep the baby upright and let them swallow between small amounts. Do not add the powder to a full feed unless the paediatrician advises.

A baby under six months should have a probiotic only after a paediatrician agrees on the product and dose.

What if the child refuses?

Try a different carrier, such as a favourite fruit puree, or give it at a different time of day. Let an older child help open the sachet and stir, which gives a sense of control. Avoid force-feeding, bargaining or presenting it as medicine. If the dose is only partly taken, do not repeat it straight away. Resume at the next time.

Never hide the powder in a large portion that the child may not finish, and do not add it to food that might be refused whole.

When should it be given?

Giving the sachet with or just after a meal may improve survival of the bacteria through stomach acid. A regular time, such as breakfast, makes it easier to remember. If your child is taking antibiotics, separate the probiotic from each antibiotic dose by two to three hours after checking with the doctor.

How should sachets be stored?

Keep sachets sealed, in a cool, dry place away from heat, humidity and sunlight. Do not keep them in a bathroom or near the stove. Store them out of reach of children and check the expiry date before use. Follow any refrigeration instruction on the label. Little One's from ELMED Life Sciences, with NCFM and Bi-07 at 10 billion CFU per sachet, has an 18-month shelf life when stored as directed.

How long and how much?

The number of sachets per day and the length of use should follow the label and the paediatrician's advice. Do not increase the dose because a child seems unwell. A higher count does not give a stronger effect. Background on strains, evidence and safety is in the guide to probiotic sachets for children.

When should a probiotic be avoided or checked first?

Ask a doctor before giving a probiotic to a premature baby, a child with a weakened immune system, a central line, serious illness or recent bowel surgery. Stop the probiotic and call the doctor if a child develops a high fever, blood in the stool, repeated vomiting or a rash with swelling after a dose.