New research suggests that antibiotic use during pregnancy and in early childhood may affect a child’s chances of developing asthma, obesity, Crohn’s and other inflammatory bowel diseases later in life, and increase risk of severe infection in the first 6 years of life.
A baby’s first contact with bacteria is during birth. The organisms in the mother’s birth canal will be the first to become established in the baby’s digestive system and on the skin. If a baby is born by Caesarean section, she will acquire organisms from the mother’s skin and from whatever she contacts in the hospital.
In my June 15th blog, The world inside…, I talked about how the types of bacteria, viruses, fungi and other organisms we have in our digestive systems (collectively known as the “microbiome”) can change the way the immune system works, especially in early life when the immune system is “learning” how to function. Studies I found this week suggest that this effect can extend to later in life and perhaps even to the next generation.
Obesity
In agriculture, animals are given antibiotics to promote their growth and weight gain, increasing production. The effect is believed to occur by changing their gut microbiome. It has been proposed by scientists that a similar effect could be expected in humans. Depending on the antibiotic, growth could be promoted or stunted, the same as what is seen in animals.
An article published in the National Review of Endocrinology suggests an altered microbiome in early life could have long-lasting effects on weight, possibly contributing to 10-15% increases in rates of obesity. This article also describes how researchers have demonstrated in animals that antibiotic exposure early in life has a longer-lasting effect than when given later. This supports the premise that antibiotics have a greater disrupting effect if given while the microbiome is becoming established in the early years. In humans this happens in the first 3 years of life.
Infections
One study published in the International Journal of Epidemiology showed that antibiotics taken by an expectant mother before or during pregnancy, especially in larger amounts and close to the birth, were associated with an increased chance that the child would later be hospitalized for an infection. This is believed to be caused by an antibiotic-induced change in the microbiome, passed from the mother on to the baby, that changes the way the immune system develops in the newborn.
Inflammatory diseases
Another study reported that 7 or more courses of antibiotics in childhood increased risk of developing Crohn’s disease 7-fold. Celiac disease was also associated with early antibiotic use and these effects were greatest when the medications were given during the first year of life.
Asthma
Increased antibiotic use has also been found in many studies to be associated with asthma, but it is yet to be proven that antibiotics or resulting changes in gut microbiome are the cause. Some researchers have suggested that infections severe enough to require an antibiotic or some other factors could be contributing to the increased risk of developing asthma. So, lots of controversy…
The hygiene hypothesis
The “hygiene hypothesis” originally suggested too little exposure to infections as a child could disrupt development of our immune systems and cause increases in allergic and inflammatory diseases. Researchers now also suggest that overuse of antimicrobial soaps and strict avoidance of exposure to non-infectious bacteria in early life in an effort to avoid contact with disease-causing bacteria may contribute to both a poorer quality microbiome and a malfunctioning immune system. It seems that it’s a matter of balance: too little exposure to microorganisms may create immune problems, and too much exposure may increase risk of infectious disease. The big question is, what is the best level? That hasn’t been determined yet but, for now, experts recommend spending lots of time outdoors in nature where we will be exposed to plenty of healthy natural organisms, especially children with developing immune systems.
We need more research…
More research is needed to determine whether antibiotic is increasing risk of allergic and autoimmune diseases. Fortunately, in the past 10 years there has been increased interested in investigating links with antibiotic use, changes in microbiome and how this could affect us. This research is especially important as there have been substantial increases in asthma, allergies, and autoimmune diseases, such as Multiple Sclerosis, Lupus and inflammatory bowel diseases like Crone’s and Celiac disease in the past generation as antibiotics have become more widely used. We need to learn whether it’s just a coincidence or a cause…
There is no question that we benefit from proper use of antibiotics. They can save lives. But too often they are used when unnecessary or for viral infections like colds and flu when they have no effect. Increasingly, healthcare professionals are recommending probiotics to help our microbiome recover after a needed course of antibiotic treatment, as they become aware of the negative consequences of damage to our gut organisms.
So, if you’re sick with an infection, don’t just go to your doctor and demand an antibiotic. Ask if you truly need this medication, take the lowest level antibiotic that will work if you do need one (ideally one that has been identified by a culture to work on the infection you have), and ask what you can do afterward to repair any damage to your gut microbiome. This could include probiotics and a change in your diet to help stimulate growth of your good organisms.
