The human body contains ten times as many bacteria as it does cells, and we are only just beginning to understand the broader health implications of this fact. More and more research is showing that having a balance between so-called ‘good’ and ‘bad’ bacteria in the intestines is important, not only in newborns but also later in life, and for health in general.
Rethinking Bacteria in Newborns
There has been a big re-evaluation of bacteria in recent years, and many bacteria are now considered to have a key role in treating or even preventing certain diseases related to the immune system. In newborns, for example, these good bacteria, or ‘probiotics’, have been shown to prevent skin diseases such as eczema and atopic dermatitis, as well as allergic rhinitis (inflammation of the inside of the nose) and necrotizing enterocolitis (a potentially serious disease in which part of the lining of the intestinal wall dies). Probiotics have also been shown to prevent and cure some diarrheas in newborns.
Traditionally, it has been generally accepted that babies are not exposed to any bacteria until the moment of birth. This theory has since been shown to be false, with breakthrough studies showing that probiotics given to pregnant women can affect the baby while in the womb, as well as through breast milk after birth.
Delivery and Feeding Influence the Need for Supplementation
The development and balance of bacteria in the bowels during and after delivery is influenced by several factors. For example, babies born vaginally have been shown to have different types of bacteria in the bowel than do babies born by Caesarean section. How a newborn is fed also has an effect on the development of bacteria in the bowels. Breast milk is a natural source of many probiotics that babies who are formula-fed from birth may miss out on. It could be that probiotic supplementation could fill this gap.
So while the research to date has not gone so far as to be able to say that every baby should be given probiotics, in certain situations there is a very clear use for these bacteria. It helps, of course, that probiotics generally have a very good safety profile. Several studies in premature babies have shown no complications from receiving probiotics, only benefits through the prevention of severe illness.
Choosing a Probiotic
The market is full of probiotics, and it is not always easy for a consumer to decide what is effective and what is not. Many products claim to have a probiotic effect, but often no scientific research has been done. Crucially, for a probiotic to be useful the bacteria need to be able to survive passing through the stomach and intestine. The probiotic also needs to be viable – that is, containing live bacteria – in whatever formulation it is sold in. This can be capsules, liquids, and infant formula, to name just a few.
It should also be noted that not all probiotics are created equal. In the same way that we use scissors to cut paper but not to chop wood, there are some probiotics that are helpful for some things but not for others. If a parent wants to see a particular effect in their baby, they need to be specific when choosing the right probiotic to meet their expectations. I find it is sometimes parents who are more knowledgeable than physicians, as they are often more motivated to do the research themselves.
In general, I think that many physicians do not really understand what probiotics are for, so it is worthwhile for us all to go to the proper resources and look at the research. And by proper resources I mean information that is dedicated to instructing the reader on the use of probiotics in a balanced, unbiased way.