The gut microbiome is made up of trillions of bacteria, fungi and other microbes as well as their genetic material. The gut microbiome plays a very important role in our health by helping control digestion and benefiting our immune system (more than 70% of the immune system is in the gastrointestinal tract) and many other aspects of health. The microbiome changes most throughout infancy and childhood-even into adolescence, so the bottom line is that this is a critical time to set the stage for long-term health.
Factors that influence the microbiome:
- C section vs. vaginal delivery
- Use of antibiotics
- Formula vs. breastfeeding-breast milk contains HMOs that stimulate the growth of bifidobacterial and support the babies’ immune system.
- Mom’s health and nutrition
- Having older siblings
An imbalanced microbiome is associated with:
- Immune impairment
- Infantile colic
- Neurological/Developmental abnormalities. A 2019 study found that imbalanced gut bacteria measured at 3-6 months of age was associated with developmental abnormalities in motor skills, communication as well as personal and social skills assessed at 3 years of age.
- Asthma and allergic disorders such as eczema
- Adult onset diabetes and obesity
Where do we start: Pregnancy is a critical time since mom’s nutritional status can influence diseases for their children well into adulthood.
Studying the 1940’s Dutch famine indicated that a low protein diet during pregnancy was a risk factor for future cardiovascular risk in her children. Low birth weight babies are even at increased risk for high cortisol levels with exaggerated responses to stress.
Evidence is also supporting the fact that if mom has unhealthy gut bacteria (dysbiosis), this can be a trigger for preterm birth.
A higher maternal intake of higher sugar during pregnancy was associated with allergy and asthma.
Lower vitamin E, zinc and carotenoids (colorful fruits and veggies) in pregnant women are associated with increased risk of wheezing and asthma in childhood.
Fiber in pregnant women is protective against allergic diseases such as eczema and asthma.
Supplementing with Probiotics:
A double-blind study from 2012 found that in high risk families, if mom supplemented from 35 weeks gestation through 6 months (after birth) with lactobacillus Rhamnosus GG it halved the incidence of eczema in her baby.
Further follow up published in 2018 also found that Lacto GG additionally protected against eczema at 2, 4 and 6 years of age and allergic sensitization at 6. They went up to 11 years and found this benefit extended to that time and also included lowered risk for hay fever. This was the first probiotic study to show positive outcomes for at least the first decade across the spectrum of allergic disease.
Lastly, a study published in Clinical Exp Allergy found that lacto GG given in the first 2 years of life protected against rhinoconjunctivitis (allergy symptoms) which are often a trigger for asthma.
Lacto GG species improved growth, diarrhea and respiratory symptoms.
Probiotics aren’t just effective for allergies: A study just published in January found that using a Bifidobacterium animalis probiotic vs placebo for 28 days improved crying episodes, sIgA levels (that’s the immune border patrol in the gut), and even showed lower GI inflammatory levels.
A meta-analysis review of 20 publications found that using bifidobaterium lactis and strep thermophilus reduced incidence of GI infections, colic, irritability.
We always recommend probiotics to our pregnant patients and continued support during breastfeeding. If formula fed, we recommend using powder and even with breastfeeding, if a baby is born via C-section we may supplement the child as well as the mom.
Omega 3: fatty acids: EPA and DHA, mainly found in fish oil
During pregnancy and the first few years of life, DHA, an important omega 3 fatty acid, accumulates in the brain and retina and plays an important role in neural and visual development. Breast milk contains DHA in varying concentrations, depending on how much is in the mother’s diet. But in the United States, many women don’t seem to be getting enough DHA. Women of childbearing age consume an average of 60 milligrams of DHA per day, but many experts recommend at least 200 milligrams per day during pregnancy and breastfeeding.
Research that examined over 19,000 women compared pregnancy outcomes with omega 3 use (food or supplements) vs. placebo. They found that with omega 3s there was a significantly lower risk for:
- Infant death
- Babies whose moms were supplemented were taller and had higher birthweight
- Reduced risk for egg allergy in babies
- There is a higher risk for Postpartum Depression with lower DHA levels. We can measure and target this since an omega 3 index of <5 had a 5x increased risk for depression. This is measured with a simple blood test.
Also, low vitamin D is linked to increased risk for depression in moms and supplementing helps prevent:
- Gestational diabetes
- Low birthweight/preterm birth and may reduce risk for postpartum hemorrhage
Fat soluble vitamins: It has also been found that higher maternal intake of vitamins D and E were protective for asthma in her children. In fact, kids with asthma test lower for vitamins D and A.
Kids with higher magnesium levels are less likely to have asthma.
Let’s jump ahead to allergies and asthma more specifically: Let’s first consider why the epidemic of these disorders: Less fruits and veggies, lower fiber, and imbalances in fat qualities are all contributing factors and this isn’t just in children, but in pregnant moms as well. The corollary is that increased consumption of these foods in pregnant women and children in the first years of life is associated with reduced risk.
A huge review of more than 18 studies found that a higher intake of fruits, veggies, vitamin E, zinc and selenium during pregnancy and childhood lowers the risk for asthma, wheezing and eczema.
Diets lower in salt, processed fats, higher in omega 3, fruits and veggies improve allergic symptoms.
Obesity is a risk for asthma in children.
Low vitamins D and E and omega 3s increase risk for skin allergies.
Low zinc is linked to increased risk for infections, allergies and autoimmunity. Low zinc is associated with higher IgE antibody levels to allergens. Zinc repairs linings, so think about the skin and gut linings. If your child has irritated, broken skin that doesn’t seem to repair well, consider a zinc deficiency.
Let’s discuss Natural Anthistamines:
QUERCETIN: This is a type of polyphenol, which are antioxidants, found in foods like onions, broccoli, fruits, teas and wine. Proven to improve lung function in asthmatic,s associated with lower requirement for inhalers, rescue medication and nasal drops. VERY GOOD SAFETY PROFILE. Can be used with other antihistamines and medications. Also helps with inflammatory skin disorders.
It is anti-inflammatory, antihistamine, antiviral, antiallergic. It can help control the IgE antibody response. It is more effective than cromolyn as an antihistamine. Mast cells release histamine and quercetin helps to stabilize the mast cells.
Orthomolecular is a supplement company that has a nice allergy formula for kid: D hist in a chewable form that also contains vitamin C which helps to activate quercetin.
Local honey, started 2-3 months prior to allergy season, 1-2 tsp/day not in kids under 2 years of age.
A recent 16 week study in elementary school kids found that those supplemented with a fruit/veggie concentrate, fish oil and probiotics showed SIGNIFICANT improvement in lung function testing and a much lower use of inhaled medications in asthmatic kids.
Another study found that in 5-17 year olds with asthma, vitamin E also helped to improve pulmonary function testing and symptoms.
What are some nutritional preventive measures for keeping our kids from becoming ill?
Pneumonia: Studies have found that kids who develop pneumonia may be at higher risk due to higher rates of iron, zinc and vitamins D and A deficiencies.
How about flu and cold prevention:
Consider supplementing with a good multivitamin, additional vitamin D, omega 3s i.e. cod liver oil. Additional zinc is often warranted. Vitamin C 500-1000mg depending upon age/weight.
Probiotics: proven to reduce fever and upper respiratory symptoms during cold and flu season. Lacto and Bifio species are key. The probiotics we recommend include a blend of proven strains of lactobacillus and bifidobacteria. For moms: Klaire Labs: Therbiotic Complete. For infants, especially if not breastfed: Klaire Labs Infant Formula. For children: Klaire Labs Children’s Chewable.
Oscillococcinum: A homeopathic remedy: 1 vial/week during flu season and after germfest parties, and if sick 1 vial 3x/day for first 24 hours. Cold calm homeopathy is great for symptoms. Elderberry: Compares to Tamiflu in terms of antiflu action. Kids 1-2tsp up to 4x/day. X clear nasal spray after exposures or at end of day. WATER!
Arabinogalactan: From larch tree bark enhances the immune response: Vital nutrients brand powder, can mix easily at ½ -1 tsp.
Immu Max: Has Echinacea, C, Proplis: Proven to reduce illness and fever when given during the winter months: I don’t recommend echinacea for extended periods especially with autoimmune disorders.
Esberitox is similar but it’s a chewable and tastes pretty good. Children 7-12 years old: 2 tablets, 3 times daily. Children 2-6 years old: 1-2 tablets, 3 times daily. Not to be used in children under two years of age.
X clear: Clean those noses so germs don’t colonize. Has saline, xylitol and grapefruit seed which are antimicrobial. Non-addictive. Helps prevent infections from taking hold.
Mullein/garlic pure ear oil by Herb Pharma. Run bottle under warm water, insert 3-4 drops in the painful ear 3-4x/day. Have the child lie down with that ear up for a minute or so and put a little cotton in to hold the drops in place.
Focus/Concentration: Consider blood sugar. Especially breakfast/protein, not fast-acting carbs. Smoothies. Mini meals: Complex carbs, protein and fats, especially the protein and fats. Load up on the good fats. Especially omega 3’s.
What if your child needs antibiotics: Not a deal breaker, especially if you SUPPORT with probiotics-take the probiotics as far apart from the antibiotics as possible. Add Saccharomyces boullardi which is a beneficial yeast, especially helpful during and following antibiotic usage as it helps prevent unfriendly bacteria and yeast from colonizing. L glutamine powder for gut lining repair.