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INCREASING IMMUNE FACTORS IN CORD BLOOD AND BREAST MILK – (09-01-09)
Supplementation with Lactobacillus rhamnosus or Bifidobacterium lactis probiotics in pregnancy increases immune factors in cord blood and breast milk.
Just in case the previous article didn’t convince you…let’s add this one.
DISTINCT COMPOSITION OF GUT MICROBIOTA DURING PREGNANCY – (09-01-09)
Distinct composition of gut microbiota during pregnancy in overweight and normal-weight women
When I describe current research to patients, I note that the lag time between research and clinical practice is about 2 decades. 20 yrs. The frustration I feel with this is truly beyond measure and contributes greatly to the disease burden in today’s society. Probably one of the greatest examples of the chasm between research and clinical practice is with probiotics in natural flora and the wanton destruction with antibiotics.
I had a new patient today that is dealing with multiple health concerns. Lupus, kidney failure, pancreatitis…it’s a long list. Several months ago she was put on IV antibiotics for about 2 wks. Given the strong relationship of the gut to autoimmune disorders, I consider it flat out malpractice that NONE of the specialists she has seen have recommend restoration of the destroyed flora.
In this particular study, we see that the bacterial flora present during pregnancy influences the weight of the unborn child. So, antibiotics given to the mom at any time before pregnancy without instruction in replacement of normal flora is likely a contributing factor to the rise in obesity in children. Quite a disturbing implication.
EFFECTIVENESS OF FLU VACCINES – (09-01-09)
Flu Vaccine Effectiveness Among Children 6 to 59 Months of Age During 2 Influenza Seasons
Medicine’s blind devotion to the flu vaccine never ceases to amaze me. I remember one year an elderly woman was trampled to death in the hysteria to get vaccinated. Despite this, the flu vaccine’s effectiveness is very questionable.
This particular study was unable to find any effectiveness over the course of two years in children under 5. Think of the costs associated with the march to the pediatrician’s office, parents’ time off of work, and side effects of the vaccination on the child, not the mention the profits going to the vaccine manufacturer.
Compare this with studies showing absurdly high protection against the flu (up to 70% reduction in incidence) with the use of probiotics in children. With this in mind, it’s highly likely that antibiotics ADD to the flu incidence!!! Talk about making money on top of money.
ORAL PROBIOTICS PREVENT NECROTIZING ENTEROCOLITIS (08-24-09)
Oral Probiotics Prevent Necrotizing Enterocolitis in Very Low Birth Weight Preterm Infants
Not to beat a dead horse, but if giving probiotics to a preterm infant can positively impact their risk of survival, than why are we taking so long to recognize their benefits in infants and toddlers? I recently had a patient that presented for help with chronic ear infections. As in 35 YEARS of ear infections which of course included untold courses of antibiotics and multiple myringotomy tubes.
Never once, with all the specialists she had seen over the decades, had a single one ever mentioned the importance of normal flora. So much so that she did not even know what probiotics were! How, with all the research out there, is this even possible? (sorry..I feel much better now…)
INCIDENCE OF ALLERGIC MANIFESTATIONS AND INFECTIONS (02-23-09)
Early Dietary Intervention with a Mixture of Prebiotic Oligosaccharides Reduces the Incidence of Allergic Manifestations and Infections during the First Two Years of Life
It should come as no surprise that I continue to be amazed at the complete lack of reverence in the pediatric practice for normal bacterial flora. And we could even go as far as to include to OBs as well, since mom needs a healthy flora during delivery and nursing. The amount of research suggesting that these bacteria are absolutely essential for normal immune system development is staggering, and the near ubitquitous inappropriate use of antibiotics without follow up with probiotics is inexcusable. Any physician charged with the care of their patients health has an absolute responsibility to stay current with the medical literature. This is not happening in medicine, with particular blame on the pediatricians.
Now that my rant is over, I’d like to point out that this is yet another study linking healthy bacterial flora (the oligosacchardides used in this study are given to support the growth of healthy bacterial flora) and protection against both infections and allergies.
IMPACT OF MATERNAL ATOPY AND PROBIOTIC SUPPLEMENTATION – (05-18-09)
Impact of maternal atopy and probiotic supplementation during pregnancy on infant sensitization
A few comments here, beginning with my decade long frustration about medicine’s refusal to accept normal, protective flora as being important. We destroy it only in infancy with antibiotics, with never a thought as to the physiological ramifications of this approach.
In this study, the authors used probiotics in mothers who were allergy-prone (which meant that their infant, as well, would be allergy prone) and nursing to lower the risk in the infants for developing allergies. This likely occurs through 2 mechanisms–one with the modulation of the mom’s own immune status, and two, but direct translocation of the bacteria from the gut into breast milk. Couple this with findings of greatly reduced allergies and asthma in infants whose mothers took in higher levels of EFAs and we would see a drastic reduction in the prevalence of this chronic condition.
CORTICOSTEROID USE ON BONE MINERAL DENSITY IN CHILDREN (05-04-09)
Effect of Long-term Corticosteroid Use on Bone Mineral Density in Children
This study look at the use of chronic and short burst use of inhaled steroids in children w/ mild to moderate asthma. Frighteningly, this pattern of use was associated with reduction in bone mineral accrual at a very important time of there bone forming years.
I guess the frustrating aspects of this study is that asthma treatment in children rarely takes a comprehensive course. You can bet that, in many of these children, both food allergies and poor gut health are contributing if not causative factors. Prolonged courses of antibiotics without any thought of the importance of normal, healthy flora, will lead to imbalances of immune function and Th2 dominance of cytokine expression (consistent w/ asthma and allergies).
Add into this nasty mix the new research that gut inflammation negatively impacts bone health and you’ve got a recipe for diminished bone health.
CESAREAN DELIVERY MAY AFFECT THE EARLY BIODIVERSITY OF INTESTINAL BACTERIA (5-11-09)
Cesarean Delivery May Affect the Early Biodiversity of Intestinal Bacteria
Regular readers of Updates will confirm how much I rant and rave about the critical importance of normal, healthy bacterial flora in our newborns, infants and toddlers. Words alone are inadequate at explaining just how important this is to healthy, balanced development of our immune system and gut ecology.
Because of this, importance of the pregnant mom’s vaginal flora (has she ever been on antibiotics?), the route of delivery (C-section or vaginal) and has the child ever received antibiotics without replacing the normal flora w/ probiotics? This study again confirms that birth by C-section alters the normal flora that is supposed to be present.
KNOW THE FORMULA TO PREVENT INFECTIONS
A formula containing galacto- and fructo-oligosaccharides prevents intestinal and extra-intestinal infections
I KNOW I sound like a broken record!!! How do you think I feel after writing about the benefits of supporting the normal flora of the human body for over a decade now and STILL have yet to see a pediatrician or urgent care doc recommend anything beyond Florastor??
HAVE YOU HEARD OF NAFLD?
I’m floored. Look at the outcomes in this study. It’s sickeningly scary. And we’re worried about vaccinating our healthy kids for the flu. Ten years ago we never even heard about NAFLD, let alone in children. This is really only the tip of the iceberg. As our children get heavier and heavier and more insulin resistant we will see increasing prevalence of NAFLD. This is scary. These are just children. The parents and the pediatricians should both be strung up and beaten (the pediatricians for not illustrating the contribution of poor lifestyle to the condition, the parents if they don’t adopt the changes if the pediatrician recommends them). Sorry to be so strong on this one, but I’m sick of seeing toddlers being fed Coke and chicken fingers…
_The natural history of non-alcoholic fatty liver disease in children: a follow-up study for up to 20 years — Feldstein et al._(http://gut.bmj.com/cgi/
The natural history of non-alcoholic fatty liver disease in children: a follow-up study for up to 20 years
A E Feldstein1, P Charatcharoenwitthaya2, S Treeprasertsuk2, J T Benson3, F B Enders3, P Angulo2
1 Department of Pediatric and Adolescent Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
2 Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
3 Department of Health Sciences Research, Division of Biostatistics, Mayo Clinic, Rochester, Minnesota, USA Correspondence to Dr P Angulo, Division of Digestive Diseases and Nutrition, University of Kentucky, 800 Rose Street, Rm MN469, Lexington, KY 40536, USA; _paul.angelo@uky.edu_ (mailto:paul.angelo@uky.edu)
Objectives: The long-term prognosis of non-alcoholic fatty liver disease (NAFLD) in children remains uncertain. We aimed at determining the long-term outcomes and survival of children with NAFLD.
Design: Retrospective longitudinal hospital-based cohort study.
Patients: Sixty-six children with NAFLD (mean age 13.9 (SD 3.9) years) were followed up for up to 20 years with a total of 409.6 person-years of
follow-up.
Results: The metabolic syndrome was present in 19 (29%) children at the time of NAFLD diagnosis with 55 (83%) presenting with at least one feature of the metabolic syndrome including obesity, hypertension, dyslipidaemia and/or hyperglycaemia. Four children with baseline normal fasting glucose developed type 2 diabetes 4–11 years after NAFLD diagnosis. A total of 13 liver biopsies were obtained from five patients over a mean of 41.4 (SD 28.8) months showing progression of fibrosis stage in four children. During follow-up, two children died and two underwent liver transplantation for decompensated cirrhosis. The observed survival free of liver transplantation was significantly shorter in the NAFLD cohort as compared to the expected survival in the general United States population of the same age and sex (log-rank test, p<0.00001), with a standardised mortality ratio of 13.6 (95% confidence interval, 3.8 to 34.8). NAFLD recurred in the allograft in the two cases transplanted, with one patient progressing to cirrhosis and requiring re-transplantation.
Conclusions: Children with NAFLD may develop end-stage liver disease with the consequent need for liver transplantation. NAFLD in children seen in a tertiary care centre may be associated with a significantly shorter survival as compared to the general population.
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