children

Moms: Are you limiting your baby’s exposure to antibiotics?

When taken too often, antibiotics are harmful to gut health. Medical evidence proving such damaging effects has grown significantly over the past year.

The main hazards linked to taking too many rounds of antibiotics have centered on a growing vulnerability to Clostridium difficile (C. diff) infections and obesity in adults.

Unfortunately, the harm antibiotics do to human health may start much earlier, during the early stages of childhood development—even before your baby is born—and may last for a lifetime, according to a pair of recent studies.

Reprogramming your baby’s gut health with antibiotics

Researchers at NYU’s Langone Medical Center studied the effect low doses of penicillin given over a lifetime would have on the health of mice in a study published in the medical journal Cell.

The big picture conclusion: Starting in the last week of pregnancy or during nursing, mice given low doses of penicillin were more vulnerable to metabolic abnormalities including obesity than animals exposed to antibiotics later in their lives.

In the main experiment, researchers compared the effect of penicillin on three groups of rodents: Two groups received penicillin—one before birth and the other later after weaning—then for the remainder of their short lives, while a third control group was given no antibiotics at all.

Both groups of mice that were fed penicillin had higher amounts of fat on their little bodies than the control group, but the womb group was the fattest, providing solid proof that mice were “more metabolically vulnerable if they get antibiotics earlier in life,” says Dr. Laura Cox, lead author of the study.

Not only did penicillin-treated mice carry twice as much fat compared those fed only high-fat food, but their bodies also showed signs of metabolic disorders.

Do antibiotics lessen the amount of gut bacteria? Not necessarily…

Scientists took another important step by transferring gut bacteria from penicillin-treated mice and those not given the antibiotic to antibiotic- and germ-free mice shortly after the time they would be weaned (three weeks old).

Mice given gut bacteria from donors treated with antibiotics were fatter than those treated with antibiotic-free gut bacteria.

Another interesting discovery made by NYC researchers during their study may have overturned a long-standing belief that antibiotics (at least penicillin) reduces the amount of gut bacteria contained in the body.

As a whole, gut bacteria didn’t decrease, but four very important strains did: Allobaculum, Candidatus, Arthromitus, member of the Rikenellaceae family and the very popular Lactobacillus (one of the key bacteria ingredients in EndoMune Advanced Probiotic).

These results reaffirm the work conducted by one of the most popular researchers in the field of gut health research, Dr. Martin Blaser, director of the NYU Human Microbiome Program and author of the book, Missing Microbes: How the Overuse of Antibiotics is Fueling Our Modern Plagues.

More evidence broad-spectrum antibiotics may trigger obesity

A more recent study appearing in JAMA Pediatrics gets to the heart of the problem: Health problems occur when exposing babies under age 2 and up to age 5 to broad-spectrum antibiotics.

Using electronic records spanning 2001-13 from a network of primary health clinics, scientists tracked the health of more than 64,000 children from birth to age 5. The numbers speak volumes:

  • Nearly 70 percent of all children were exposed to antibiotics more than twice on average before they reached age 2.
  • Young children who were exposed to all antibiotics or broad-spectrum antibiotics four or more times had a greater risk of obesity.
  • The prevalence of obesity or being overweight increased over time from 23 percent at age 2 to 33 percent at age 4.

One additional factoid from the study that’s worth noting: No link was found between obesity and prescribing children narrow-spectrum antibiotics, medicines that treat a more select group of bacterial types, according to the Alliance for the Prudent Use of Antibiotics (APUA).

However, broad-spectrum antibiotics can handle a greater number of bacterial types and are often prescribed to treat a wider variety of infectious diseases or when the source of the infection is unknown, according to APUA. Varieties of broad-spectrum antibiotics include some synthetic penicillins, quinolones and aminoglycosides.

Because infants are so very vulnerable to antibiotics, especially soon after they’re born, it’s important for moms to work with their family pediatricians to ensure their babies get the healthy start they need to avoid metabolic problems that could lead to lifelong ailments like obesity.

The good news: A multi-species probiotic like EndoMune Advanced Junior can give your baby’s health a much-needed boost by protecting the diversity of beneficial bacteria in their gut and strengthening their tiny but growing immune systems.

EndoMune Jr. now Parent Tested Parent Approved

ptpa-RGB-300dpi-larg1EndoMune Advanced Jr., the only children’s probiotic developed by a board-certified gastroenterologist, has won the much-coveted Parent Tested Parent Approved (PTPA) Winner’s Seal of Approval.

EndoMune Jr. is the first and only probiotic to be recognized by PTPA, the largest volunteer parent-testing organization in North America with more than 60,000 members.

To celebrate their new website (http://ptpa.com), PTPA, will host a Twitter party Oct. 25 from noon to 2 p.m. EDT, which will feature EndoMune Advanced Jr. The fun and informative online gathering also will include prizes of EndoMune Jr. and other PTPA-approved products. Three lucky winners will leave the party with a free jar of EndoMune Jr.

Look for the PTPA Twitter party by checking out @PTPA and looking for the hashtag #ptpaparty.

Endomune Jr.“At PTPA Media, we are proud to play a role in certifying innovative products that families can trust,” says Sharon Vinderine, CEO and founder of PTPA Media Inc. “When consumers search for our Seal of Approval on product packaging and web sites, they are essentially searching for validation from their peers.  Their peers will have objectively tested and approved these products based on their performance in a real life environment. That type of resource for families is priceless.”

Among the glowing compliments EndoMune Jr. received from PTPA reviewers:

  • This product was very easy to use. I really like the scoop that came with the product. It gave my oldest a chance to scoop it out herself and know she got it right. I also like how you just put it directly into the kid’s drink instead of having them take a pill every day.
  • We had been using probiotics for a while, as my kids were preemies and have had a lot of GI issues. I like that this probiotic doesn’t have the extra ingredients that gummies have. The kids drank it fine when put in juice and they had no digestive issues or sicknesses while they were on it. We will continue on this product. Thank you for making a good, safe probiotic for ALL ages.
  • The EndoMune Advanced Junior was easy to take and offered more than the typical probiotic.

Read more of the comments from parents who tested EndoMune Junior.

EndoMune Junior and its adult counterpart, EndoMune Advanced Adult Probiotic, are completely GMO-free and contain no dairy products, preservatives, artificial coloring or gluten.

How to treat colic: 10 ways to calm your baby naturally and safely

endomune-baby colic copyOne of the most helpless feelings a new mom experiences is watching her newborn baby screaming at the top of his or her lungs inconsolably for hours that feel like an eternity, usually after feeding.

You read all the books and watched all the videos you could…but nothing really prepared you for how to treat colic in your otherwise healthy and happy baby.

All babies cry a great deal during the first few months, but how do you know when it’s time to worry? A rule of thumb for determining the difference between emotional crying and unexplainable outbursts of crying connected to colic, health experts say, is all about the “rule of threes.” For a baby to be diagnosed as colicky, he or she must cry for a minimum of three hours, at least three days a week, starting in the first three weeks of life.

Unfortunately, that’s not all. Some pediatric experts are concerned prolonged bouts of crying may affect a baby’s development, too.

Other concerns: Moms may be worsening the problem by overfeeding their babies or exposing them to the flood of emotions they’re feeling, but not doing a good job of shielding, from their newborn.

The good news for moms is that most babies grow out of their colicky ways by the time they’re 6 months old. But, how to treat colic shouldn’t be a waiting game, as there are plenty of ways to end it, safely and effectively.

Here are 10 ways to treat colic and help you and your baby get the rest and relaxation both of you need.

1. Modify your baby’s diet by eliminating irritating foods from your own diet — caffeine, dairy products and spicy cuisine — if you’re breastfeeding.

2. When you feed your colicky baby, make sure to hold that noisy bundle of joy as upright as possible. (This tip can reduce your baby’s risks of heartburn, too.)

3. Introduce soothing sounds like a fan, white-noise machine or a dryer to your baby’s environment.

4. Singing quietly to your baby not only soothes your baby but also lightens your mood.

5. Has your baby used a pacifier? Even breastfed babies can benefit from sucking on a pacifier to calm down.

6. The gentle motion your crying baby feels when taking a drive in a moving car can soothe his or her bad mood.

7. Walk away from your crying, colicky baby for a few minutes. You’ll be a better parent and able to handle those loud emotional cries from your stressed baby if you can take a short break.

8. Schedule break time from a trusted friend or family to give you a brief, calming respite.

9. Swaddling your baby (wrapping your infant snugly in a blanket to mimic the warmth of the womb) before putting him or her to bed may help them stay asleep.

10. Studies have shown treating your colicky baby with a multi-species probiotic containing 5-10 billion CFUs (colony-forming units) per day may be beneficial. A 2007 study concluded babies treated with a probiotic like EndoMune Advanced Junior cried about 66 percent less than those given simethicone, a drug that reduces gas.

How to treat colic isn’t a mystery, and these 10 tips should help provide you and your baby some much-needed relief.

Probiotics for Pediatric Antibotic-Associated Diarrhea

Welcome to February, readers!

February – the season for love, chocolate and valentines – is also, unfortunately, the season for colds and flu. Your littlest valentines will be especially susceptible to the bad weather bugs during the February freezes. The seasonal sniffles may not only impact your child’s sinuses and energy, but also their bathroom habits and regularity. This month’s newsletter will discuss how the use of probiotics can prevent your child from getting diarrhea when they are prescibed an antibiotic to cure a respiratory infection.

The Curious Case Of The Two Kiddie Colds

While your child may require an antibiotic to quickly and completely cure their cold or infection, prescribed medications often carry unintended negative consequences. Most of the antibiotics pediatricians prescribe to children can cause diarrhea – specifically AAD or Antibiotic Associated Diarrhea.

Consider these two cases:

    1. Peter, a 4-year old preschooler, caught a cold from his classmates. He developed a cough, sore throat and 102º fever. His mom gave him an over the counter children’s cold remedy, but over the next 2 days young Peter developed a productive cough. Worried and upset, Peter’s mother took him to his pediatrician who prescribed an antibiotic to treat his bronchitis. Peter began to get better but was then stricken by a terrible case of diarrhea that left him weak and dehydrated. His mother rushed him to the ER where he was diagnosed with antibiotic associated diarrhea. Peter was hospitalized, received an IV’s and eventually became well enough to return home.

 

  1. Brian, an 8-month old, contracted a fever while at his daycare center and became fussy. His mother took him to the ER where he was diagnosed with an ear infection. The doctor prescribed an antibiotic and recommended a second medicine – a probiotic to be taken two hours after the first medication. Brian’s infection healed, and he never developed diarrhea.

A Serious Side Effect of Antibiotics

More than 100 trillion bacteria live in our intestines and play an important role in intestinal digestion and immunity. Generally, 85-90% of the bacteria are beneficial and keep bad bacteria at bay. However, while antibiotics effectively resolve the bacterial infections like Peter and Brian experienced, the antibiotics also risk causing diarrhea by destroying the good bacteria and upsetting the healthy balance of the bacterial flora. Studies have found that up to 50% of children who receive antibiotics for ear infections will develop AAD1.

A Proof Is In The Probiotics

The November 2011 issue of the Cochrane Database System Review revealed new evidence supporting using probiotics to prevent pediatric antibiotic-associated diarrhea2.

Sixteen studies tested 3,432 children from 2-weeks old to 17-years. The children received a variety of probiotics co-administered with antibiotics for the prevention of AAD.

Final analysis revealed that AAD was reduced by 50% in the group receiving probiotics versus the group receiving a placebo. Even more, the greater the probiotic colony count, the lesser the incidence of AAD – 63% less in fact.

The study’s authors also noted that the probiotic group experienced no significant, unusual side effects due to the probiotics, other than a reduction of AAD.

Take Home Message

If your child requires an antibiotic to recover from a late winter cold, consider administering a probiotic like EndoMune Jr., which contains a 10 billion colony count in each serving. Administer this probiotic two hours after administering the antibiotic to protect the bacteria cultures and effectively protect your child from AAD.

Eat healthy, exercise, take EndoMune and live well!
Best Wishes,
Dr. Hoberman

Probiotics in the News

I receive daily emails from a number of sources about new developments in medicine, particularly in the areas of gastroenterology and probiotics.

There are two interesting articles I would like to briefly discuss this month:

  • Benefits of Lactobacillus probiotic bacteria against gas-producing E. Coli found in colicky infants(1)
  • Probiotics for prevention of antibiotic-associated diarrhea and Clostridium difficile-associated disease in hospitalized adults(3)


Benefits of Probiotic Bacteria for Colicky Infants

The first report details the research that has been underway to determine how probiotics can lessen the problem of “Infantile Colic.” This is a condition in which a healthy baby shows periods of intense, unexplained fussing/crying lasting more than 3 hours a day, for more than 3 days a week over a duration of three or more continuous weeks. Parents have sleepless nights and stressful days trying to calm their baby. The pediatricians used to recommend trying simethicone drops, which works no better than tap water.

The exact cause of infantile colic is unknown, but a number of reports have associated colic to changes in the bacterial balance in a baby’s intestine.

A study published in the journal Pediatrics in 2007(2) reported on the benefits of taking a probiotic. In the study, 83 colicky babies were divided into two groups: 41 were given a Lactobacillus probiotic and 42 babies received simethicone. The results were astounding:

After one week, babies treated with the probiotic had close to 20% less crying time

  • By 4 weeks, probiotic treated babies had 74% less crying
  • Overall, there was a 95% positive response to the Lactobacillus probiotic drops in colicky infants.

To better understand how probiotics lessen infantile colic, this study was performed to evaluated the interaction between Lactobacillus probiotics and gas-forming coliforms that were isolated from stools of colicky infants. The results showed that several strains of Lactobacillus produced antibiotics against six different species of gas-forming coliforms.

The authors concluded:

  1. There was a greater presence of of coliform bacteria in colicky infants, and
  2. Certain Lactobacillus probiotic bacteria can improve colicky symptoms by reducing the ability of coliform bacteria to colonize the gut.


Probiotics for Prevention of Antibiotic-Associated Diarrhea, C. Difficile

This report published in the American Academy of Nurse Practioners reviewed all the relevant studies on probiotic efficacy for preventing diarrhea and colitis due to taking antibiotics.

I have written several newsletters on how antibiotics can upset the healthy balance of the intestinal bacteria, resulting in mild diarrhea or life-threatening clostridia difficile colitis. There are a 100 trillion bacteria in the gastrointestinal tract. Generally, 85% or more are healthy beneficial bacteria that help in digestion and immunity.

Antibiotics prescribed for an infection like sinusitis or bronchitis can destroy the healthy intestinal bacteria and result in problems with diarrhea. A particular bacteria called Clostridia difficile can multiply when the healthy bacteria are destroyed.

C difficile produces toxins that cause a severe colitis. Unfortunately, this bacteria is becoming more common in hospitals and other health care facilities. As a result, the risk of developing colitis and diarrhea has increased. In 2006, it was reported that patients with C difficile colitis stayed in the hospital 3.6 days longer and the additional hospital costs averaged $3,669 per patient day.(4) A conservative estimate of the cost of this disease in the United States was $3.2 billion annually.(5)

This report was to determine if giving probiotics to patients receiving antibiotics would lessen the risk of developing antibiotic-associated diarrhea and C difficile-associated disease.

The meta-analysis found that the administration of probiotics led to a statistically significant relative risk reduction. Compared to patients given a placebo, the patients receiving probiotics had a:

  • 44% reduction for antibiotic-associated diarrhea
  • 71% reduction for C difficile-associated disease

The authors concluded that administering probiotics concurrently with antibiotics in hospitalized patients could potentially lessen the healthcare spending, morbidity and mortality due to the gastrointestinal complications related to the use of antibiotics.

Articles like these two indicate the amount of research that is going on to determine the health benefits of probiotics. Since I started researching the importance of the healthy intestinal bacteria and probiotics in 2005, the amount of new scientific information published annually is amazing.

(1) Antagonistic effect of Lactobacillus strains against gas-producing coliforms isolated from colicky infants.Savino F, Cordisco L, Tarasco V, Locatelli E, Di Gioia D, Oggero R, Matteuzzi D. BMC Microbiol. 2011 Jun 30;11(1):157.

(2)Lactobacillus reuteri (American Type Culture Collection Strain 55730) versus simethicone in the treatment of infantile colic: a prospective randomized study. Savino F, Pelle E, Palumeri E, Oggero R, Miniero R. Pediatrics. 2007 Jan;119(1):e124-30.

(3) Probiotics for prevention of antibiotic-associated diarrhea and Clostridium difficile-associated disease in hospitalized adults-A meta-analysis.Avadhani A, Miley H.J Am Acad Nurse Pract. 2011 Jun;23(6):269-74

(4) Health care costs and mortality associated with nosocomial diarrhea due to Clostridium difficile.Kyne L, Hamel MB, Polavaram R, Kelly CP. Clin Infect Dis. 2002 Feb 1;34(3):346-53. Epub 2001 Dec 17.

(5) Strategies to prevent clostridium difficile infections in acute care hospitals. Dubberke ER, Gerding DN, Classen D, Arias KM, Podgorny K, Anderson DJ, Burstin H, Calfee DP, Coffin SE, Fraser V, Griffin FA, Gross P, Kaye KS, Klompas M, Lo E, Marschall J, Mermel LA, Nicolle L, Pegues DA, Perl TM, Saint S, Salgado CD, Weinstein RA, Wise R, Yokoe DS. Infect Control Hosp Epidemiol. 2008 Oct;29 Suppl 1:S81-92

How Can Probiotics Keep Children Healthy?

During the holiday season, I thought I would dedicate this newsletter to discussing how probiotics can help keep children healthy. This discussion will review two articles that have been published in the last month about the benefits of probiotics for children.

Probiotics and Acute Infectious Diarrhea

The first study was to determine whether probiotics have clinical benefit for children with acute infectious diarrhea (1).

Study design:
The study involved 304 children, ages 3 months to 6 years who were hospitalized for acute diarrhea. All the children received rehydration therapy via intravenous fluids and oral rice or half strength formula as age appropriate. The children were randomized to receive a probiotic preparation or a placebo. The benefit of the treatment was assessed in terms of recovery time to the first normal stool. Other clinical symptoms evaluated included fever, vomiting, abdominal pain and appetite.

Results:
The average duration of diarrhea after start of therapy was reduced from 86.3 hours in the placebo group to 60.1 hours in the probiotic group. There was also lessening of abdominal pain, fever and overall length of hospital stay.

Discussion:
To understand how probiotics benefited these children, the immunologic effects of probiotics were evaluated. The study reveals the immune cells of the intestine reacted in two ways; 1) by increasing production of molecules that decrease inflammation and 2) by increasing the quantity of protective intestinal bacteria (bifidobacteria and lactobacillus).

While other studies have shown that probiotics can lessen infectious diarrhea in children, this is the first study that has simultaneously evaluated the clinical, immunologic, and microbiologic effects of probiotics.

Probiotics and Chronic Abdominal Pain (CAP)

The second article deals with the occurrence of chronic abdominal pain (CAP) in children. CAP accounts for approximately 25% of pediatric gastroenterology office visits.

This study’s purpose was to determine if excess build up of intestinal bacteria in the small intestine could be a common cause of the CAP symptoms (2). This condition is called small intestinal bacterial overgrowth and is referred to as “SIBO”. Sometimes, the bacteria in the small intestines can increase and disrupt the normal digestive process. When this occurs, diarrhea, excess gas, and abdominal pain can occur.

Study Design:
This study evaluated children ages 8 to 18. Of those involved in the study, 40 were healthy and 75 had chronic abdominal. Using a breath hydrogen test, it was possible to determine if there was abnormal buildup of small bowel bacteria.

Results:
The study found 91% of children with CAP had abnormal breath hydrogen indicating excess small intestinal bacteria, or SIBO. The control group had a 35% positive breath test.

Discussion:
This study found an objective measure to explain chronic abdominal pain in these children.  Often, psychological explanations are proposed to explain the ongoing symptoms, and the correct diagnosis is missed.

To the best of the authors’ knowledge, this is the first report on the frequency of abnormal breath hydrogen test in children with CAP.

If the breath test is abnormal, then the current recommended therapy is to use antibiotics to decrease the bacterial count in the small bowel (3).  Studies have shown up to a 75% improvement in symptoms after a course of antibiotics. Sometimes there is a relapse and further courses of antibiotics are required (4).

Another approach to treat SIBO is to give probiotics.  A recent study using a probiotic in patients with SIBO found a 47% decrease or normalization of the breath hydrogen test (5). The authors concluded that, “probiotics are a promising, easily handled and well-tolerated treatment option for SIBO”. In addition, since SIBO has a high recurrence rate, the availability of a treatment alternative to antibiotics could reduce both the risk of antibiotic resistance and the incidence of side effects.

Take Home Message

Current medical research continues to gain a better understanding of how the intestinal bacteria affect the function and health of our intestines. The results of these studies certainly further our knowledge about how probiotics can improve gastrointestinal disorders in children. Consider discussing with your child’s doctor taking a good probiotic, like EndoMune, if your child is having a problem with infectious diarrhea or chronic abdominal pain.

Best wishes for a very healthy happy holiday season and New Year!!

Eat healthy and live well!
Lawrence J Hoberman MD

(1) Probiotics Have Clinical, Microbiologic, and Immunologic Efficacy in Acute Infectious Diarrhea Chen, Chien-Chang; Kong, Man-Shan; Lai, Ming-Wei; Chao, Hsun-Chin; Chang, Kuei-Wen; Chen, Shih-Yen; Huang, Yhu-Chering; Chiu, Cheng-Hsun; Li, Wen-Chen; Lin, Pen-Yi; Chen, Chih-Jung; Lin, Tzou-YienThe Pediatric Infectious Disease Journal.2010 Feb;29(2)

(2) Chronic Abdominal Pain in Children Is Associated with High Prevalence of Abnormal Microbial Fermentation.Collins BS, Lin HC.Dig Dis Sci. 2009 Nov 4.

(3) Small intestinal bacterial overgrowth: diagnosis and treatment.Gasbarrini A, Lauritano EC, Gabrielli M, Scarpellini E, Lupascu A, Ojetti V, Gasbarrini G.Dig Dis. 2007;25(3):237-40.

(4) Small intestinal bacterial overgrowth recurrence after antibiotic therapy. Lauritano EC, Gabrielli M, Scarpellini E, Lupascu A, Novi M, Sottili S, Vitale G, Cesario V, Serricchio M, Cammarota G, Gasbarrini G, Gasbarrini Am J Gastroenterol. 2008 Aug;103(8):2031-5.

(5) Bacillus clausii as a treatment of small intestinal bacterial overgrowth. Gabrielli M, Lauritano EC, Scarpellini E, Lupascu A, Ojetti V, Gasbarrini G, Silveri NG, Gasbarrini A.Am J Gastroenterol. 2009 May;104(5):1327-8. Epub 2009 Apr 7.

 

Probiotics Prevent Colds in Children?

“When given preventively over the winter months, probiotics reduce fever, cough, and runny noses in children, researchers said.”

This is very exciting news for parents across the country. Many parents deal with the frustration of sick children during the winter months and the many associated problems including missed school, missed work and restless nights.

A recent study evaluated 326 children ages 3 to 5 years. Two groups of these children in a childcare center in China were given “twice-daily doses of L. acidophilus or L. acidophilus in combination with Bifidobacterium animalis for six months from November 2005 to May 2006.” The third group was given a placebo.

Both the single strain and the multi-strain probiotic doses were effective at reducing fever, cough, and rhinorrhea; the combination strain, however, had a more profound, positive impact. This seems to imply multi-strain, multi-species probiotics continue to prove more efficacy for prevention rather than their single-strain counterparts.

With profound research studies, such as this study in China, physicians may be able to begin moving away from antibiotics toward other forms of prevention like probiotics. While more studies are necessary, probiotic research continues to move forward in a very exciting direction.

For the article in its entirety, visit:
http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/15251

Source reference:
Leyer GJ, et al “Probiotic effects on cold and influenza-like symptom incidence and duration in children” Pediatrics 2009; DOI: 10.1542/peds.2008-2666.

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