Professor (Dr.) M. Saifur Rahman.

MBBS (Dhaka),DCH(Ireland), Dr.Sc (USA) Head of the Dept of Pediatrics Dhaka National Medical College & Hospital

Role of Probiotics and Healthy Infancy.

Along with many developments in medical sciences, Probiotics is also exposing a new dimension in the maintenance of healthy life of human being. Basic concept of Probiotics started from the miracle provided by the flora of intestine, otherwise known as intestinal microbiota. Intestinal microbiota Intestinal microbiota consists of over 500 microbial species among which some are indigenous microflora and some are non-indigenous microflora. It is very interesting that these microflora carries some friendly bacteria as L-acidophilus, L-salivarius, L- casei, Lthermophilus, B.bifidum, B. langum etc. and as well as some unfriendly bacteria as E.Coli, Coliforms and Clostridium and Fungi as Candida albicans. Whatever they are, they remain in all of the GIT as stomach (103-105 cell/ml), distal ileum (108 cell/ml) and colon (1010- 1011 cell/ml).Isnt it very interesting to know that 50% of our faecal mass is bacterial cells. Some factors are there on which microbiota development depends as, initially maternal microbiota, mode of birth, birth environment and subsequently by

;feeding practices and environment of the child. All these occurs in phases as
initial acquisition over 1-2 weeks (Enterobacteria, Coliform, Lactobacilli) remaining period of sole breast feeding (Bifidobacteria, Lactobacilli) beginning of the supplementation and weaning. after completion of weaning and conversion to adult microbiota (Bifidobacteria, Bacteriods and Clostridium) starts developing. Now whatever and however happens, let us concentrate on importance and aberrancy of the intestinal microbiota. Importance and aberrancy of the intestinal microbiota Importance consists of nutritional benefits to host like; vitamin synthesis and break down of complex polysaccharides plays important role in generation of amino-physiological regulation in gut. provides crucial signals for development of immune system in infancy formation and maintenance of gut associated immunologic homeostasis in later life. forms natural defense barrier against harmful microbes in environment. After all these important role for maintenance of good health, if aberrancy of microbiota occurs then this may predispose the person to have condition like inflammatory gut disease, infective diarrhoea due to Rota virus and allergic disease of all sorts. All these

discussions are on intestinal microbiota but question may be asked that why on this? It is because that intestinal microbiota forms basis for Probiotic action. Discussion on Probiotics Probiotics in simple words are bacterial preparations coming from culture of microorganisms which impact clinically verified benefits if added as food supplement and when consumed orally in adequate amount. These improve the gut microbiota and confer a healthy benefit of the host mainly in human infections, inflammatory & allergic diseases. Probiotics are available in the natural sources as; mother (breast milk) which contains Bifidobacteria , Lactobacillus dairy products (curd, yogurt, fruits) which contain Lactobacilli of different types & strains, Bifidobactrium spp, Streptococcus thermophilus ,Enterococcus faecium, Saccharomyces boulardi,S.cerevisiae. Whatever the source is, it is found that if a specific Probiotics bacteria is administered, these helps in development and maintenance of healthy microbiota, transient colonization of healthy microbiota in babies and increase of Bifidobactria in babies if given to mothers during pregnancy. Effect of Probiotics As a result of healthy microbiota these Probiotics keeps tremendous immunological & Non-Immunological effects on the host. Immunological effects of Probiotics are; counteract inflammatory response by stabilizing gut microbial environment stabilize intestinal permeability barrier enhance degradation of enteral antigens & alter their immunogenicity. improve immunological barrier, particularly IgA responses balance between pro & anti inflammatory cytokines contribute to TH cell population that maintains a diseases free state of gut. Non immunological benefits are; digest food & compete for nutrients with pathogens alter local PH to create an unfavorable local environment for pathogens produce bacteriocins to inhibit pathogens scavenge super oxide radicals stimulate epithelial mucin production enhance intestinal barrier function compete for adhesion with pathogens & modify pathogen derived toxins Now with all these effect, isnt it possible to have some health claims with Probiotics as it assist gut micro biota & enhance immunity, prevent AAD, effective on variety of GI & other disorders, helps controlling atopic eczema & naso-bronchial allergy & considered as an effective upcoming weapon for preterm in the germ warfare in NICU.

Conclusion It is too early to come to a conclusion with Probiotics. Many questions are still remaining to be discussed & studied as, which strain? what dose? when to start? etc. But whatever it is we are having great expectation that Probiotics are highly promising group of micro-organism with potentials to improve health, prevent & treat various human ailments. However, their clinical use requires further fine tuning of the product, identification of specific genotypes for specific indications and large scale clinical trials. Till then let us keep ourselves healthy by consuming more naturally fermented food. We look forward to have healthy infant as our coming generation and there is a strong possibility that Probiotic might keep an impact in this development.