The Journal of the American Medical Association (JAMA) recently published this study, linking antibiotic use in infancy with early childhood obesity.
The study enrolled 64,580 children with annual paediatric visits during ages 0-23 months, and a subsequent follow-up visit during age 24-59 months. Infants who were given antibiotics in their first 2 years of life had an increased risk for developing early childhood obesity, and the study confirmed that 69% of children were exposed to antibiotics prior to age 2.
The risk for development of obesity was higher with cumulative exposure to antibiotics, and also most predominant with use of broad spectrum antibiotics. Broad spectrum antibiotics, such as Amoxicillin, Ampicillin and Ciprofloxacin, are active against a wider range of both Gram-positive and Gram-negative bacteria. These antibiotics wipe out more of the normal and beneficial flora of the digestive tract, and result in more cases of Candida (yeast or “thrush”) overgrowth and Clostridium overgrowth (C. difficile). Use of a more specific and narrow spectrum antibiotic did not correlate with early childhood obesity.
The significance of this study is that is correlates gut health and microflora in the digestive tract with obesity. Obesity poses many health risks to the developing child, who often remains overweight into their teenage years and adulthood. Preventing or reducing these risk factors (frequent infections, antibiotic usage) in infancy may reduce childhood obesity rates.
How can we minimize antibiotic use in infancy?
- – Support immune health in infants: The most important factor in early infancy is breastfeeding. Infants who are exclusively breastfed have lower risk for upper and lower respiratory tract infections (croup, pneumonia, bronchitis), colds, flus, allergies, and SIDS (sudden infant death syndrome). Exclusive breastfeeding until age 6 months is essential, and continuing to breastfeed during solids introduction is also highly recommended.
- – Use a probiotic supplement to support your child’s gut health and immunity
- – Treat signs of immune dysfunction: Conditions such as digestive, skin, and respiratory issues in infancy may be signs of a weakened immune system. Many children with allergies, asthma, wheezing, eczema, bloating, constipation or loose stools are also prone to frequent infections and overuse of antibiotics.
- – Use food sensitivity testing to identify foods that may be inflammatory to the immune system
- – Delay or avoid inflammatory food introduction, such as cow’s milk or soy formula
How can we use antibiotics with less risk?
- – Use antibiotics only when absolutely necessary. Viruses do not require antibiotics, only confirmed bacterial infections do. As an example, upwards of 90-95% of ear infections are viral and will resolve without antibiotic use, yet many infants are given unnecessary courses of antibiotics for recurrent ear infections.
- – Use a narrow spectrum antibiotic if possible. A narrow spectrum antibiotic is more specific to the type of bacteria present, rather than a broad spectrum antibiotic which wipes out many different strains of bacteria.
- – Always use a probiotic supplement during and after a course of antibiotics. I cannot stress the importance of this enough. A probiotic supplement containing Lactobacillus acidophilus, Bifidobacterium species, and potentially other beneficial bacterial strains is essential for restoring the bacterial balance in the digestive tract after antibiotic use. Probiotic yogurt or fermented foods such as kefir do not contain adequate levels of beneficial bacteria following antibiotic use and these foods are not a sufficient alternative to a probiotic supplement. Consult with your ND regarding the appropriate dose and type of probiotic for your child.