Baby’s gut microbiome lacks the right kinds of bacteria in the right balance?
That means greater chance for ailments later in life.
Researchers are zeroing in on specifics.
By Dona Suri
Looking after a child in its first years is difficult enough even when the little one is perfectly healthy. If it soon becomes apparent that Baby suffers an allergy, the problems of parenting increase substantially. It would help if problems could be predicted within the first few months, and it would help even more if doctors knew how to step in and prevent them from developing in the first place.
GOOD NEWS ! This year, medical researchers took a big step closer to exactly that: predicting and preventing. A team of researchers at the University of British Columbia and BC Children’s Hospital, led by pediatrician, Dr. Stuart Turvey, found that food allergy, atopic dermatitis, allergic rhinitis and allergic asthma have a common cause, characterized by immunoglobulin E (IgE) and inappropriately activated Type Two inflammatory response. All follow the same pattern in their onset. (It’s called the Allergic March.)
The reason why some babies have problems with immunoglobulin E and Type Two inflammatory response is because their little guts lack the right kinds of bacteria in the right bacterial balance.
Surprised? Well don’t be. If you are alive and reasonably healthy, thank your gut microbiome. Microbiome means the whole vast army of bacteria that inhabits our intestines. These bacteria stimulate our immune system, provide neurotransmitters, break down food to release energy, and produce vitamins. The idea that maladies are directly linked to what is going on in the stomach and intestines is centuries old, but it is only in the last 20 years that medical research has gained accurate information about the exact role of specific bacteria.
Obviously, not all bacteria are desirable. Some species — for example Streptococcus, Staphylococcus, and E. coli — immediately trigger inflammatory signals that send our immune cells into attack mode. On the other hand, millions of bacteria live in our guts. Not only does the body tolerate them, it welcomes them. Why are these bacteria not attacked?
Keeping law and order in your bowels is the work of the intestinal barrier. When it is functioning properly, it will not allow even one little bacterium or endotoxin to penetrate the intestinal wall and enter human tissues, organs, and microcirculation. A compromised gut barrier, often dubbed “leaky gut,” permits bacteria to infiltrate the bloodstream.
The body knows which varieties of bacteria are “approved” and so long as they remain where they are supposed to be, they don’t trigger inflammation signals. One of the things Dr Turvey’s team observed in babies on the verge of developing allergies, was a breakdown in the body’s mechanism for keeping bacteria and immune cells separate and for over-riding inflammation signals.
Every healthy adult is home to a bacterial zoo.
But what about babies? Are they born with microbiomes? Do they get bacteria from their mothers?
This was a hotly debated question until 2019 when researchers at Cambridge University could finally give a definite answer backed by solid scientific proof. Thanks to them, we now know that the placenta is a sterile environment – no bacteria of any sort. Bacteria start moving in at the very moment that the infant is emerging from the birth canal. Once Baby is out in the world, bacteria colonization happens really FAST!
Incidentally, infants born by cesarean section aren’t so quick to acquire bacteria and for weeks, their gut microbiome is less complex. This impacts the development of their immune system and their digestive system.
The development of a baby’s gut microbiome is accelerated if it is breastfed. A group of oligosaccharides produced in the lactose gland (Human Milk Oligosaccharides) ensure enrichment of the gut microbiome and regulate microbial adhesion. The interplay of HMO and specific bacteria (Bifidobacterium genus and some strains of Bacteroides and Lactobacillus) directly modulate the intestinal immune response. This is why breastfed infants are protected from infections.
It is now certain that a healthy microbiome’s maturation accompanies the immune system’s maturation. As Baby’s gut microbiome matures during the first year of life, its bacteria population not only becomes diverse, but the growth rate of different bacteria species changes. Some become more abundant and some less. This process is so clearly linked to early-life development that the composition of the infant microbiota alone can accurately predict an infant’s chronological age. The first months of an infant’s life are crucial because that is when the gut microbiome is settling in. It is this initial colonization that will lay the foundation for a lifelong, relatively stable adult microbiome.
The exciting thing about recent research is that it demonstrates how the composition of the infant gut microbiome can predict the risk of many health conditions, including obesity, type 2 diabetes, hypertension, necrotizing small bowel colitis, inflammatory bowel disease … and especially asthma and allergies. As doctors learn how to predict, they also learn how to intervene and regulate. If we can learn how to modulate the composition of the infant gut microbiome, it opens the door to many strategies to keep babies healthy and ensure that they grow into healthy adults.
Research into the infant gut microbiome has also led doctors to look at immune systems and risk of disease in families … and, beyond families. It points the way to understanding patterns of disease in whole societies. For example, statistics from all over the world reveal that the prevalence of allergies is increasing.
This is not just a matter of better diagnosis and better reporting. As doctors learn more about the role of the gut microbiome, they are starting to look at systematic changes in the diet of entire populations. Changed diet inevitably leads to changed gut microbiome, which in turn leads to changed nutritional status and immune response in the individual.
When it comes to babies, risk factors for allergies and microbiome alterations have much in common, including the mode of delivery (natural or caesarean), living in a city or in the country, diet, and antibiotic use. Even the size of an infant’s family is a factor in development of gut microbiome and consequent risk of allergy.
[This is the “hygiene hypothesis”. It argues that in a large family, particularly a rural family, babies acquire more bacteria – and infections — at an early age and because of this, they develop strong immune systems.]
Here’s what parents can do to help their baby develop a healthy gut microbiome:
Diet
Before six months –
A mother should breastfeed as long as she can. Withhold all forms of food other than breast milk. Exclusive breastfeeding for the first four months of life can prevent the development of all sorts of allergies. If a mother cannot breastfeed exclusively for the first few months of life, give as much breast milk as possible.
After six months —
Start introducing a variety foods — cereals, fruits, vegetables.
Just like adults, babies need fiber. It promotes an abundant and diverse population of gut bacteria.
Introduce those foods that are often allergy culprits, such as peanuts and fish. Give a small amount of a single new food, then wait and watch. Give Baby’s bacteria a chance to deal with it.
Protect good bacteria
If Baby falls ill, do not immediately rush for the amoxicillin and gentamicin. Reserve antibiotics for serious cases only.
Antibiotics wipe out sensitive and important bacteria which is a setback for the immune system, particularly in the first year of life.
The use of antibiotics is likely to result in allergic disorders. The British Columbia University researchers found that having a food allergy as a baby is associated with an increased risk of both asthma and reduced lung growth at six years of age.
In general, when it comes to warding off allergies, the rule is Do Not Over-Protect …
Or, if you like, Apply Common Sense in Protecting.
A baby’s body does not develop an antibody to something it has never been exposed to. Early exposure means reduced chance of allergy later.
Time spent romping on grass, sand and dirt, means a better immune system.
Get fresh air, along with a helping of pollen. Go out every day, weather permitting.
Get a pet. (Occasional contact with an animal is not enough.) Allow Baby to develop a tolerance of pet dander.
And a final piece of advice:
Consider Family History.
Some allergies are genetic. For example, a child is more likely to develop asthma if one or both parents are asthmatic. When parents, grandparents or siblings are strongly allergic to something, Baby needs a proactive strategy. Get an allergy specialist’s advice on preemptive measures and/or what to do in case it looks like Baby is starting to show signs of allergy.
Remember: even when there is increased risk, or susceptibility, it is also quite possible that the parent’s allergy will NOT show up in the child.