Dear Mark: How to Give a Baby Probiotics, and Pre- and Post-Meal Exercise

For today’s edition of Dear Mark, we’ve got a two-parter. First, in light of the recent paper showing that Lactobacillus rhamnosus probiotics given during the first six months of life protects against the development of conditions like ADHD and Asperger’s by age 13, how do you actually give the probiotics to a breastfed baby? It’s pretty easy, as you’ll find. And then, given that acute exercise performed before or after meals seems to change the metabolic response to those meals, would I recommend actually working out every time a person eats? It sounds a little excessive, but it might actually be a good move with some positive effects for people who have trouble with insulin and glucose issues.

Let’s go:

Hi Mark,

I saw this from the blog:

“Infants who received the probiotic Lactobacillus rhamnosus for the first six months of life went on to develop zero neuropsychiatric disorders by age 13. Among 13 year olds who didn’t get the probiotic as infants, 17.1% had developed ADHD or Asperger Syndrome.”

Can you please talk more about this? I am confused how to supplement. My baby is due on Friday, and I have been told exclusively breastfeeding for the first six months is ideal, but my family has a huge history of ADHD and if it could be avoided with baby, that would be ballin’.



Kat, you and your impending baby sound like the perfect candidates for a little L. rhamnosus experimentation. Actually, you can start by taking the supplement yourself. The protocol for other studies showing various benefits (to eczema or atopy) for L. rhamnosus in babies include breastfed infants. For those guys, the mom takes the probiotics for six months in addition to the baby, who continues to take it until age two. Probiotics don’t seem to interfere with breastfeeding (and vice versa).

Do the probiotics you take make it into your breastmilk and into your baby? Maybe not. But a recent mouse study found that maternal supplementation of L. rhamnosus during lactation altered not the microbiota of the milk, but the microbiota of the mammary glands. This suggests that maternal probiotics have the potential to improve the health of the mammary glands and the immune health of the infants, without the need for probiotics in the actual milk.

The study you’re referring to did things differently: babies received the supplements for the first six months of life only. As I don’t have access to the full study, there’s no word on administration method, if the babies were breastfed, nor if the mothers also took it. I can’t imagine the fact that you’re planning to breastfeed will change anything, or nullify the probiotic’s effects.

How to administer?

Well, if you’re pumping and bottle feeding, you can just add a little L. rhamnosus powder to the breastmilk after it’s been warmed up. Avoid heating the milk with the probiotic already added, as this may damage the bacteria. This one should be the same strain used in the original ADHD/Asperger’s study. This one is for adults.

If you’re still breastfeeding, dip your finger in the powder and let your baby suck it off. At that stage in the game, they’ll suck on anything entering their oral vicinity. Alternatively, you can add a bit to whatever food you’re weaning them onto. The only problem is that few if any L. rhamnosus powder supplements are available and made exclusively for infants. I’m sure they’re coming, though.

My suggested move if you can’t find a good L. rhamnosus probiotic? How about some food? Give a little kefir. Kefir is full of L. rhamnosus, plus a dozen other strains  Drink that as you nurse and introduce very small amounts to your baby, a finger at a time. By the time they’re weaning, you can give watered-down teaspoons and tablespoons and, eventually, small cups. Introduce very slowly. If your baby has an adverse response to your milk after you start drinking kefir, hold off and go more slowly.

As for safety, it appears to be pretty safe. Over a 12 year period, 644 preterm infants were supplemented with L. rhamnosus with zero adverse effects. And those are premies, who are more susceptible in general. A healthy term baby will have even less of a chance of a negative reaction.

Hi Mark,

You’ve mentioned a few times that emptying glucose reserves with intense exercise before a heavy carb load can help shuttle glucose directly to muscles (rather than fat storage). That got me thinking. Would it make sense to do a quick workout before EVERY meal (or at least occasionally before meals)? I’m thinking a quick set of pushups or air squats. Would that decrease the chance of fat storage before chowing down?

Thank you as always!


That might seem like overkill to some people, but honestly? There’s not much of a downside to doing that, and a whole lot of upside.

It would emulate the activity patterns of healthy pre-industrial peoples (whether paleolithic or modern hunter-gatherers, or traditional agricultural communities) who have to “earn” their food, either by hunting, gathering, walking to, or growing and harvesting it themselves. Most people reading this blog post aren’t moving constantly. We’re sitting (or standing) in the same general vicinity for hours on end. Many of us are wedded to our computers for work. We just don’t have the opportunity for movement that our ancestors did. And yes: lots of studies indicate that just setting aside a single block of 30-45 minutes for exercise, while beneficial, doesn’t counteract all the downsides of sedentary life.

I’d argue that doing some light (or even brief and intense) exercise before or after every meal would really improve how you partition the nutrients. More into muscle glycogen, less into fat stores, effectively “hacking” an ancestral pattern.

For instance:

Resistance training is good:

  • High volume weight training performed after meals blunts the spike in free fatty acids, probably because you’re burning more of them rather then allowing them to circulate and eventually get stored.

Cardio works:

Intense exercise (sprints, intervals, circuits, etc) is another option:

  • Brief high-intensity “exercise snacks” performed prior to meals can reduce the glucose spike in insulin resistant individuals. In this study, the snacks took the form of either six minute-long uphill walking intervals, or six alternating minute-long uphill walking and resistance training intervals.
  • High intensity intervals performed right before meals is great at reducing postprandial lipemia. It’s far more effective than either moderate cardio or strength training.

Walking has a ton of support:

From looking at the evidence, it’s clear that any kind of physical activity performed prior to or after meals will help mitigate any negative metabolic effects of the meals. Some may work better than others, but anything should help:

  • Air squats.
  • Burpees.
  • Kettlebell swings.
  • Pushups.
  • Jumping jacks.
  • Jump rope.
  • A walk around the block.
  • Sprints on the stationary bike.

Get creative. Just move! Get out of breath, get warm (on the verge of sweating), feel your muscles burn a little bit. It’ll all work.

If you can swing it without driving yourself crazy, go for it! I’d really be curious to see how it works. Maybe a trial run of two to three weeks, tracking body composition, weight, and performance.

Doing this, you might eliminate the need to go to the gym altogether. I’ve done a modified version of this before, peppering my day with short bursts of lifting or sprints or walks for weeks at a time. It worked okay for me, but I’m a gym guy — and probably always will be — so I prefer getting those dedicated workouts. But I absolutely felt “on” all the time when I was on the “workout snack” schedule, like I could go for a game of Ultimate or a long hike or a set of sprints at a moment’s notice. If you work in some resistance training to your pre-meal workout snacks, I think you could get away with it and get pretty fit and strong in the process.

Let me know how it works!

TAGS:  dear mark

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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43 thoughts on “Dear Mark: How to Give a Baby Probiotics, and Pre- and Post-Meal Exercise”

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  1. Adding a set of pre/post-meal air squats or push-ups is recommended in Tim Ferris’ Four-Hour Body. I can’t find my copy at the moment, but I’m fairly certain he had some study results attached to that recommendation. Check it out.

    1. That’s what I came here to say.

      When husband and I go on “food adventures” that include more carbs than I need I do a set of T-TAPP Hoedowns at least after eating and sometimes before. Those are a damn sprint.

    2. I attached a five pound weight to my fort and eat at a moderate pace for 2 minutes followed by quick shoveling of food for 30 second spurts. I super set this with drinking from a cup with a build in gyroscope. This engages my forearm muscles and core to hold it steady to prevent it from spilling all over the floor. I tore my rotator cuff but I’m so ripped now!

        1. Because I am Clay. It’s on my birth certificate. Well almost, my Mom panicked because it looked too short, so she wrote in Clayton instead. She then decided to never call me Clayton again.

          Animanarchy must had time traveled to preemptively steal my schtick.

          That bastard!

        2. Time travel to preemptively steal schtick would be right up his alley. Freaky.

    3. My daughter just got out of the infantry basic training and they were required to do 5 pull-ups before and after every meal. Sure did her some good. Interesting to see the long rows of pull-up bars in the barracks areas.

  2. Wow. I am so glad you wrote about administering probiotics to infants! I’m currently 22 weeks and will definitely be incorporating that to my babies and I regimen.

  3. I’ll second the Tim Ferriss recommendation, interesting observations he draws in his book. Like this article states though, there’s definitely no HARM in doing it! Try it out and see how you respond.

  4. I was just thinking about this very topic! I was watching the Nat Geo series The Legend of Mick Dodge, featuring a guy who lives completely in the depths of the Washington forest, and they show him foraging for food and how hard he has to work for it. They estimate he eats around 1200 calories a day, I think. I thought to myself – wow, how much weight would I lose if I walked the 3 miles roundtrip to Trader Joe’s every time I wanted to eat something. 🙂 And then modified it to – what if I took a 15 minute ‘forage’ walk before each meal to replicate the hunter/gatherer lifestyle. The only thing I was pondering is if I did it before the meal, would the foraging part of my brain want to store the calories as fat, since I had to ‘work hard’ to achieve those calories?

  5. The protocol in Tim Ferriss book was a trick to use on cheat days. I have used this and it has worked perfectly on my “refeed” days. Long term effects for a CW eater may be interesting to try however these types of exercises are only necessary for carb meals. Since we shouldn’t be eating carb meals consistently I’m confused at why this question was even asked. Honestly since you shouldn’t ever be going over your caloric requirements and eating low carb this is never something that needs to be addressed.

    1. Hey, Ron. Have you ever heard of the 80/20 don’t sweat it rule? I think it was in Mark’s first book . . . .

      1. By all means if your obese yes do the 80/20 or even the 50/50, but for us advanced readers recognize it was his first book and he has since corrected himself. I think the issue in the early days of this blog people just expected to do Marks diet and you’ll look like Mark. The problem was that Mark never cheated, never did refeeds, fasted much more then he let people on to believe and did low intensity cardio (uphill fast pace walking) every morning for 90 days to get there. Its a little easier for me to see the truth as I live in Malibu as well and bump into Mark all the time at some random place. Everything Mark posts I know to believe as true, but the problem is Mark sugar coats a lot of it to make it digestible and doable for the general public and I get that but if you really want to give yourself the best you can give yourself, feel the best you can and look the best you can the 99/1 rule is what you need to do

        1. I’ll add that it really isn’t *that* difficult to be 99:1 primal. Really, it isn’t. “Primal” food is delicious and satisfying, and covers a wide variety of tastes and textures. Find an exercise plan that works (I do a set of heavy kettlebell swings and get-ups every day) and the benefits keep you going.

        2. Even 99:1 won’t do it.

          1. Mark has to look good. His empire is built upon how good he looks. That is his proof. If he was pasty and bloated no one would take him seriously. So if your career and your reputation was centered around looking lean and ripped, we’d all look better than we do now.

          2. He’s a genetic anomaly. He maintains a lot of muscle mass when on a caloric restrictive diet. I’m sorry but “coffee for breakfast, then a work out, then a salad – or maybe even skipping lunch when intermittent fasting – then veggies and meat for dinner” is a severely restrictive diet for his activity level and musculature. Even when he was an endurance athlete his build was more muscular than his peers. That doesn’t even factor the genetics that give him a six pack, a tiny waist, and wide shoulders. You can’t Primal that.

          Yes, I said it, a six pack is entirely genetic. My cousin had one at 9 years old. He went on to compete in bodybuilding. There’s an old alcoholic homeless guy at the beach. He does nothing good for his health. No exercise, nothing.Yet he’s got a six pack and he’s built like Adonis.

          We can all look better, but Mark looks like Mark, because he is Mark.

          Your mileage may vary.

        3. Exactly. I call myself an 80/20 guy but for me it’s really 95/5. Whose perfect, come on. :).

        4. I for one, am happy Mark sugar coated things at first or I would have never started the paleo diet and then moved into the paleo lifestyle. I would never have attempted it at first if the diet didn’t allow wine, as for lack of a better term, my head was firmly up wine’s butt. Then over the last couple of years reading Mark’s modified opinion on wine and then reading about his break from it inspired me to try too, and am happy to say I’ve now broken a 20 year habit, have had success for 5 months now. I still haven’t dipped my toe into IF, but will be trying that next too, as much for health reasons as weight loss.

        5. “But in our pursuit of perfection, many of us lost our way in the quagmire of health dogma. In short, we became so militant about becoming perfectly Primal, we forgot that the end goal was to attain an awesome life, not achieve an elusive perfect score. My focus for this event was to emphasize that we should swing the pendulum back the other direction to give ourselves a little more breathing room in our lifestyle and dietary choices. We’re all here to live awesome, and if that means doing something outside of what the Paleo Police deem acceptable, or indulging in a glass of wine every so often, we should go for it!”
          -From the Future

        6. Without the sugar coating, Mark’s audience would defect en masse. Not too long ago a post went up where he indirectly, barely and vaguely insinuated that there was just maybe perhaps some tiny measure of responsibility you might bear regarding your own weight…and the backlash in the comments was pretty severe. I can well imagine the fallout if he chose to speak plainly about anything at all. For the sake of business, Mark walks a very thin tightrope.

        7. Actually tightrope walking was one of the very skills Mark promoted for fun (see the low hanging tightrope “strap”) – I follow the primal 80/20, but also remember mark Has a omelette for breakfast, not just coffee, and meat with the lunch. For me, I add in extra carbs (rice) and fruit, but not a lot. I don’t obsessively follow the “palio” diet, but that’s one good thing about the primal – it allows room to move. Exercise, and making sure to do the sprint session (or sprint cycling if injured) is a keystone component, and of course heavy lifting (low reps, high reps is not heavy lifting, that’s cardio)

    2. I tend to eat high carb, but apparently do not exceed my caloric requirements since I’m not gaining weight year over year. Perhaps my “fat bank”, such as it is, is a high transaction volume account.
      ; )

  6. I second the use of the Culturelle powders for the kiddos. We’ve been giving those to our son, daily (in his morning bottle, now morning sippy cup) since he was only a few months old, and he’s almost 2 now. Our pediatrician had us use them to help clear up a stomach bug that he had. We find ours at Target for just under $20, and sometimes they’re doing a “buy 2, get a gift card” promotion, or there’s a discount on the Cartwheel app.

  7. From what I have read, the most important way to prevent ADHD in children is to keep them away from TV screens and such until age 4.

    1. Rick, I love that you bring this up! Probiotics are probably great too, but I’m so in favor of letting kids experience self-directed play in the real world (indoors & out) as much as possible. I’m convinced it’s best for their bodies & brains!

      1. I appreciate that. I believe the problem is not so much a lack of self-directed play (great as that is), as that TV has such rapidly changing content–the developing brain gets wired for such an environment. Perhaps the child of such development feels, in the more normal environment of everyday life, with it’s need for focus and patience, like they’re in a sensory-deprivation tank all the time.

    2. I agree! I like to debate with professional behavior therapists that AAD more aptly represents Acquired Digital Distraction. I win every time.

  8. Gerber makes a probiotic drop called Soothe that you can just drip into the bottle or onto your nipple right before you feed your baby. It works like the Vitamin D drops that pediatricians recommend to breastfeeding moms. They are a little pricey – $22 for a 30 day supply (on amazon) but it’s easy to use and we’ve had no digestion issues with our newborn. Of course, I’m also 80/20 paleo and most triggers are dairy, sugar, wheat, etc, that I already avoid.

  9. If I recall correctly pre insulin injections the standard protocol for diabetics was to exercise vigorously after meals.

  10. I use the Klaire labs infant formula for my baby girl. She is breast fed, but gets bottles of breastmilk when she is watched at my mothers. So every morning I make the bottles and add a drop of 400iu vitamin D and add a little probiotics to each bottle. I would just give one bottle each day with the supplements that you need, makes it easy. We heat the bottle in warm water until luke warm so I’m not worried about killing the bugs. Here is the stuff I use:

    Includes rhamnosis among a lot of other beneficial probiotics.

  11. Our kids (preschool/elementary age) have taken probiotics for several years now with no problems. What I’m curious about are general supplements for kids? My husband and I take the Damage Control Master Formula… how should we ensure our kids get the same vitamins and minerals?

  12. Mark – thanks for taking time to research & post my question today. Much appreciated! Totally gonna give it a try and see how it goes.

  13. How about thoughts on feeding a little kombucha? Is it only kefir that has the L rhamnosus?

  14. Kat, Mark said I best right up front. Start taking the supplements yourself. I would also suggest actively culturing it yourself. One of the best ways to expose a baby to healthy pathogens is in the birth canal. L. rhasmosis helps to prevent colonization of bad microbes on mucosa.

  15. I used to stand a lot but I have intuitively moved to a little less standing and instead going for a quick brisk walk. I am software developer by profession, but I manage to get it 2-4 10 minutes brisk walks on top of 2-3 standing and 30 minute lunch walk. Works for me.

  16. Susan, ahahahahaha.
    You should go to one of our gatherings, there are virtually no fat people, we all eat real food, including meat and become healthy and typically at a weight that is appropriate for our height.
    It’s ok if you don’t want to eat meat, however, refrain from calling us fat people with clogged arteries because we got rid of that part as we began eating this way.
    To say nothing about any of the actual current research about eating in this manner, nor that most of humans for thousands of years survived quite well eating this way.

  17. The cells in babies’ intestines do not close together until 6+ months. This is why exclusive breastfeeding for at least 6 months is recommended. The minute you put something else in their guts, it wrecks the protective coating that breastmilk creates. Breast milk also has factors in it that feed gut flora. I would hesitate to mess with the symphony that is the evolving gut flora of a newborn. Babies have a gag reflex for many months which prevents them from eating food. It does not seem natural to create a work-around on this by having them suckle kefir or probiotics from your finger.

    P.S. Big thanks for everything Mark.