Are antibiotics making children sicker?

Are antibiotics and our modern lifestyle contributing to the recurrent infections and symptoms many children are experiencing?

I started asking myself this question several years ago after seeing countless repeat prescriptions for antibiotics for the same children over and over again; only to see parents back again more frustrated or beginning to accept the fact, that yes it was yet another ear infection.

Full disclaimer: I am not a mother currently - though I do hope to be one day. However, I do speak personally and professionally to a lot of Mothers. I fully appreciate that being a Mother is the most challenging yet most rewarding job on the planet, hands down!  So to all the mums out there reading this, know you are a superstar in my eyes, even if you don’t feel like one. I also appreciate that every mother has their children’s best interest at heart. Hence, why I wanted to shed some light on this extremely important topic. I will also give some practical advice to ensure you are well informed and supported if you are faced with the above dilemma.

No-one (!!!), including myself and any other health practitioner for that matter, can tell you how to raise your children. At the end of the day, that is your responsibility and your circumstances that determine how you do the best job you can.

One of the biggest problems we face as a society today, is that we have lost touch with our own inner “gut feeling.” Which by the way is an actually “thing.” Often referred to as the second brain, the Enteric Nervous System is housed within our digestive tract. The ENS is a rich and complicated network of neurons and neurochemicals that can sense and cause changes in our body, including in our brain.

Turns out the feeling of butterflies before a big event are very real (not actual butterflies but you get what I am saying). We are bombarded with so much information and differing opinions that we forget to listen to our own inherent intuition and what feels right for us. But let me tell you, a mothers intuition, is almost always right. Remember this, tune into this and act on it.

As a health practitioner, we abide by an oath, of which, “Do no harm”, is listed first and foremost. When it comes to the use of antibiotics in children I really want to believe that we thought we were abiding by this rule. “Hey, better to treat the infection, bacterial or viral it doesn't really matter, as what is the worst the antibiotics can do, cause a little diarrhoea, no biggy. Better than leaving it untreated and have complications.” Sounds reasonable, right?

That was until an alarming amount of growing research and studies have identified the importance of having a healthy, robust microbiome (sciencey term for all the various little critters living within you and on you) for overall health.

In 2008, the Human Microbiome Project was established. With a mission to “generate resources that would enable the comprehensive characterisation of the human microbiome and analysis of its role in human health and disease.” Today, a simple google search will bring forth an enormous amount of research and information linking poor gut health with a myriad of health complaints, from Eczema to Autism.

But this wasn't always the case.  Remember back to when we had only one little blue-pill bouncing around on the tele screeching, “Have you had your Inner Health Plus today?”  That was an effective Ad campaign! 

Nowadays, every supplement company has a probiotic product or entire range. Fermented foods have made it into mainstream and are now readily available to health conscious consumers. Connections have been made such as, the a gut-brain axis,  gut-skin axis, a gut-hormone axis, a gut-immune axis and multiple links to common health complaints, from mental illness to obesity.

This last decade has really given rise to the importance of GUT health for OVERALL health.

But It turns out this concept is not that new …

Hippocrates, the Greek father of modern medicine said some 2000 years ago - “All disease begins in the gut.”

Only now when we are faced with crippling statistics affecting our children’s health and wellbeing, are we starting to take notice of his message.

    •    Autism prevalence has more than doubled since the year 2000, and that’s not just because of increased rates of detection

    •    Food intolerances are only growing

    •    1 in 4 children are overweight or obese

    •    Today is the first generation of kids in modern history that’s expected to live shorter lifespans than their parents. Think about that for  just a moment… That is scary stuff!

So who are these critters I speak of and what is all the fuss about?

I like to think of the human body more like a living ecosystem. We have microbial parts (majority are located in our gut but also in our lungs, mouth, vaginal canal and on our skin) and human parts. And together we make a kind of super organism. They help us out, we help them out.

As it turns out, we haven’t really had "their back". The introduction of sterilisation, overuse of antibiotics, C-section births, sanitisation and highly processed foods has severely impacted our microbial friends.

If we really want optimal health for ourselves and our children we simply cannot continue to disrespect our microbial counterparts, as they are such an important part of our biology. If they aren't happy (diverse, abundant, plentiful in the right places), they are going to cause havoc until we listen up.

This is a partial list of conditions associated with a disrupted gut microbiome:

    •    Acne

    •    Antibiotic- asscoated diarrhoea

    •    Asthma/allergies

    •    Autism spectrum disorders

    •    Autoimmune disease

    •    Cancer

    •    Dementia

    •    Dental cavities

    •    Depression and anxiety

    •    Diabetes, Eczema

    •    Fibromyalgia

    •    Gastric ulcers

    •    heart disease

    •    Inflammatory bowel ideas

    •    Neurological disorders

    •    Parkinson's disease

*New ones are added almost monthly

Gut bacteria influence our:

    •    Immune function - 70% of the immune system resides in the gut. It's called the Gut Associated Lymphoid Tissue (GALT). These little critters “speak to” the immune system to protect and defend us.

    •    Metabolism - the presence of different species of bacteria and the ratio of these can affect how much energy or calories we extract from our food

    •    Nutrition - microbes help us to digest and assimilate nutrients. Some actually produce certain nutrients as by products that we can then use. Like Vitamin K & B vitamins.

    •    Mental health - the gut and brain are connected via the vagus nerve and through the ENS. The brain can also be affected by chemical signals that these microbes secrete and can get absorbed into the bloodstream. Neurotransmitter like serotonin and melatonin are produced in the gut.

    •    Detoxification - the liver is directly linked to the gut, so any upset in the gut will burden the liver.

    •    Inflammation - the largest amount of microbes live within our large intestine. They consume the food substances that we humans cannot digest, namely fibre, and produce short chain fatty acids, that then have anti-inflammatory properties in our body. A leaky gut, or increase intestinal permeability is associated with an immune response, leading to inflammation.

    •    Weight gain - due to disruptions in metabolism and thyroid hormone production, conversion of T4 to active T3 takes place in the gut.

    •    Autoimmunity - has been linked to the the production of endotoxins like lipopolysaccharide, which activates zonulin. Zonulin is a protein that regulates intestinal permeability via its effect on the tight junctions. If food proteins are getting through the gut lining into the blood stream the body sees this as foreign and mounts an attack which can result in attacking its own tissues.

Now that you can appreciate the enormity of the role these microbes have on our body systems and potential links to so many chronic diseases, I hope you can start to appreciate my concern.

Antibiotics are up there among the most frequently prescribed medications for children. “By age 20, the average American child has received 17 courses of antibiotics.” Crikey that’s a lot! 

Antibiotic resistance has become a real, worldwide problem that has alarmed the medical community. These smart little critters (did I mention they are super smart, so much so they can influence our gene expression) have found ways to protect themselves from antibiotics giving rise to super bugs that have no cure.

What causes antibiotic resistance?

    •    Yep you guess it, multiple antibiotics.

    •    Using antibiotics when not needed (viral infections)

    •    Not taking them at appropriate doses and duration to kill off pathogenic bacteria. (My observation is that most children's antibiotic doses are actually under doses).

    •    Overuse of antibiotics in agriculture and veterinary medicine and us humans consuming these meat products. (Hence, always ensure you choose pasture raised, organic, animal products)

Fortunately the medical community is aware of this issue and many doctors have cut back their use and only prescribe antibiotics when strictly appropriate (much to many patients disgust). So next time you (or a friend) goes to the doctor with a viral cold feeling like death and they so NO to antibiotics, cut the Doc some slack and think of the bigger picture. You will be doing your gut health and immune system a good thing by skipping them this time. Make friends with a cosy bed & a pot of chicken broth (Grandma knows best) to support your bodies immune system to fight of the virus.

Here is what every mother needs to know to make an informed decision:

Antibiotics kill bacteria - not viruses, not fungal infections.

    •    The majority of ear (60-73%), upper respiratory (80%) and throat infections (95%) are viral in origin.

    •    Upper Respiratory Infections (URI) and ear infections are the two most common conditions which paediatric antibiotics are prescribed

    •    URI are mainly caused by viruses, so antibiotics will have no effect on the outcome.

    •    Most ear infections recover after 24 hours regardless of antibiotic treatment or not. When researches compared immediate antibiotic treatment to a “wait and see approach", there was no improvement in pain associated with the ear infection at follow up visits and no difference in ear abnormalities or symptom recurrence.

    •    Antibiotics were most useful in children under 2 years of age with bilateral (both) ear infections and discharge.

    •    Otitis media which means ear “inflammation” (itis = inflammation) not ear “infection” can be caused by food allergies and food sensitivities. Treating them with antibiotics can worsen gut health and actually further increase the risk of food intolerances.

    •    Only 20% of sore throats are caused by bacteria (group A B haemolytic streptococcus) otherwise most sore throats will clear up on their own.

    •    Asthma prevalence was almost half as likely to develop in children who had received antibiotics during their first year of life than those who didn’t.

    •    Antibiotic use in pregnancy and in early life has been associated with increased risk of food allergies.

    •    Use of antibiotics in early life increases a person’s risk of being overweight in later life.

    •    Due to the gut flora, early life appears to be a critical time of development of a persons metabolism and immune system.

Now don’t get me wrong - the purpose of this article is not to say that antibiotics ARE BAD or that they shouldn't be used to treat bacterial infections. They have a time and a place and can be LIFE SAVING. But they are also not harmless and have a wide range of consequences on gut health, metabolism, allergies, intolerances and inflammation. And we are only at the very beginning of understanding the impact this is having on our health and our children's health.

Always speak and have a discussion with your medical doctor if you are concerned about your child’s health.

If you feel like you are stuck in a constant rut of recurrent childhood illness’s with or without recurrent scripts for antibiotics maybe you need to consider concentrating on building a strong robust immune system. This isn’t possible without having a healthy gut.

Healthy little guts = less need for childhood antibiotics and strong, vibrant humans for life! WIN WIN.

Let’s beat the super bugs by raising super humans! 

Love Chantel.

GUT HEALTH : HOW TO REBUILD WITH PROBIOTICS AND PREBIOTICS

The importance of Gut Health has really exploded. Probiotics are a household name and prebiotics won’t be far behind them. And to be fair, rightly so. There pretty much isn’t a single condition that in some way can’t be linked back to the health of the gut.

My recent little bout of “Welcome to Byron Bay” gastro bug, reminded me of how important building gut health up is and hence I decided to share a little how to guide that turned out to be not so little. So feel free to skip ahead to the, Love Your Guts Banana Omelette recipe….

Just incase you haven’t heard the word on the street or you missed this blog: , let’s do a little recap.

• We are finally starting to develop a deep appreciation for the trillions of microbes that inhabit our small and large intestines.
• Most of these little guys have co-evolved with humans, relying on us for their survival and we relying on them for health and wellbeing
• We feed them nutrients through the foods we eat (or we should) and in return they digest carbohydrates that would otherwise be indigestible to us and make vitamins and other important substances like short chain fatty acids (butyrate, propionate) that we otherwise cannot make. Microbes protect us against infections, regulate metabolism, and host the majority of the immune cells in our body.
• This symbiotic relationship is what makes up a persons microbiome. If all is well this hopefully harmonious collection of microorganisms looks after so many vital functions in our body.
• So hence, unless you have been living under a rock for the past several years, I am sure you have heard that a disrupted gut microbiome is associated with an overwhelming large amount of common conditions.
  To name a few: acne, antibiotic associated diarrhoea, asthma/allergies, autism spectrum disorder, autoimmune disease, cancer, dementia, dental cavities, depression and anxiety, diabetes, eczema, fibromyalgia, gastric ulcers, heart disease, inflammatory bowel disease, neurological disorders, parkinson disease. This is a partial list and new ones are added almost monthly.

I would go as far as saying that gut dysfunction is one key underlying mechanisms that contributes to almost all disease. Hence, supporting it’s diversity and abundance will make you more resilient against infection and disease.

How do we support gut diversity and abundance ?

Probiotics? Yes certainly this is a good starting place otherwise supplement companies would not be creating new products with different strains and different combinations of microorganisms everyday.

It’s difficult not to notice how many different brands of probiotic supplement are available on the market today ? All claiming to have a zillion times more live cultures than the next. I can remember when it was just good old “Have you had your Inner Health Plus today?” and that was it. Times are a changing.

The important things to know about probiotics are:

• Most probiotics do not quantitatively change the composition of the gut microbiome over time. That means that if you take a capsule of a zillion Lactobacillus acidophilusone day, then on the second day another zillion, you don’t increase to two zillion. Feeling a bit ripped off? Not so fast
• Probiotics do however play a primary role in immune regulation , helping to regulate and balance the immune system (remembering that over 70% of our immune cells reside in our gut) AND reduce inflammation in the gut. Two very important factors for health.
• A good strategy with probiotics is to take a wide spectrum of microorganism like lactic acid producing bacteria (Primal Defense Ultra by Garden of Life), soil based organisms (Prescript Assist) and beneficial strains of yeasts (Saccharomyces boulardii) . And rotate them.
• The best and most cost effective way to get a diversity of beneficial microorganisms is to become a fermenting extraordinaire or seek out locations that sell fermented foods (Byron Bay is winning in this departments). And again the key word being “diversity” so ensure you are getting the full spectrum of fermented foods; kefir, sauerkraut, kombucha, beet kvass etc.
• For example, if you look at the content of the amount of beneficial microbes in a glass of kefir, it is far greater than any commercial probiotic you can get. Mother nature will always win out.

What about abundance?

Well it turns out there is a second part to the story, enter, the new (but not so new) kid on the block; prebiotics . Prebiotics are a food source for beneficial bacteria that already live in our gut and DO increase the number of beneficial microorganisms significantly over time.

A simple way to look at it is – Probiotics and fermented foods which contain them are the bugs themselves, and prebiotics are the food the bugs need to survive and multiply. In technical terms, they are indigestible carbohydrates (note indigestible to us humans) that make their way intact to the colon (large intestines) where they selectively feed beneficial bacteria (which is what we want).

Note that ONE of the side effects of a long term low carbohydrate diet, where people limit the amount of starchy vegetables, fruits, white rice, and other grains, is that it can potentially starve off beneficial bacteria in the colon. This can give rise to a host of gastrointestinal symptoms (namely constipation or diarrhoea) and actually cause issues when the person tries to reintroduce these foods back into the diet. Often the reintroduction issues are mistaken as “not able to tolerate” those foods as oppose to lack of those foods being the problem of the distress in the first place.

What and where are prebiotics found?

In short in a variety of plant foods.

1. Fermentable fibers such as resistant starch (eg. unmodified potato starch, green banana flour or plantain flour)
2. Non-starch polysaccharides such as inulin, FOS, FODMAPS, pectin, cellulose
3. Soluble fiber (psyllium husk, acacia fibre, glucomannan, guar gum)

Food sources of prebiotics include:

1. Resistant Starch:

• Cooked and cooled potatoes, sweet potatoes and yams
• Cooked and cooled parboiled rice
• Cooked and cooled properly prepared (soaked or sprouted) legumes
• Dehydrated plantain chips

***** Allow these foods to cool completely in the fridge or freezer. They can be warmed up for eating, but the temperature should stay below 130 degrees in order to provide the beneficial prebiotics.

Resistant starch has been touted as the next big weight loss supplement. It does have some impressive health benefits such as improved insulin sensitivity, decreased blood glucose levels in response to meals, reduced appetite and reduced fat storage in fat cells. Move over Garcinia Cambogia.

2. Non Starch Polysaccharides:

• asparagus, garlic, Jerusalem artichoke, chicory root, onions, radishes, leeks, tomatoes, turmeric, pears, kiwis

3. Soluble fibre

• carrots, winter squash, potato, sweet potato, turnips, parsnips, beets

Eating a combination of uncooked (usually has more prebiotic fibre) and cooked versions of the above.

Examples of supplemental powders to increase your prebiotics intake:

• Prebiogen: Start with 1/8 scoop daily and increase to 1/2 to 1 full scoop
• Unmodified potato starch (Bob’s Red Mill All Natural) or Green Banana Flour (Mt. Uncle’s brand): Start with 1/4 teaspoon daily and gradually increase over the course of a couple of months to 1-3 tablespoons
• Glucomannan powder (Now brand): Start with 1/8 teaspoon once daily mixed in 30ml of water and very slowly increase up to 1/2 teaspoon daily
• Psyllium husk powder (Now brand): behind with 1/4 teaspoon mixed in 30ml of water and gradually increase to 1 to 3 teaspoons taken at separate dosesor Acacia Fibre

Just like with fermented foods, different types of fibre stimulates the growth of different beneficial bacteria, so getting a variety and rotating them will be key.

A BIG CAUTION:

• In the case of starting prebiotics, MORE is not better. It is SO important to start with a really small dose and very slowly work your way up as tolerated
• Know that some gas and bloating is expected, particularly as you begin taking prebiotics (as it is stimulating the growth of bacteria in the colon). However people have been hospitalised from taking too much too soon, so start super small.
• Prebiotics are best AVOIDED if you have Small Intestinal Bowel Overgrowth (SIBO), fungal overgrowth or a parasite infection. Hence, if you are getting a lot of gastrointestinal symptoms and haven’t found out why, consider getting a stool test done before experimenting with prebiotics.
• If you have noticed after reading this that you get a lot of gastrointestinal complaints after eating foods rich in prebiotic fibres that may be sign that you need to do some investigating.

So next time you do the shopping, make sure you are thinking about feeding your now known “extended family”.

If you’ve got their back, they will have yours. If not, expect some disharmony. I warned you here first ;).

Symbiosis (from Greek “together” and “living“) is close and often long-term interaction between two different biological species.

Now for the long awaited recipe.

LOVE YOUR GUTS BANANA OMELETTE

It’s “gut loving” cause I pimped it with some prebiotic fibre to feed the little guys and some gelatin to support a healthy gut lining.

What you need for omelette : 

1 x banana
2 x eggs
1 tsp cinnamon powder
1 tsp maca powder
1/4-1/2 tsp Mt. Uncle’s banana flour
1 Tblsp Great Lakes Gelatin Powder

What to do:

1. Smash the banana with a fork in a bowl.
2. Add 2 eggs and mix together.
3. Add cinnamon and Gelatin powder to the mix.
4. Heat butter on a pan on a medium to high.
5. Once the pan is heated, add mixture to pan.
6. Allow it to seal on one side, sprinkle banana flour onto the mixture, and then flip in half and allow it to further cook though
7. Garnish with kefir/yoghurt and nuts and seeds.

****Original version of this recipe is courtesy of the talented @theholisticnutritionist. You know it’s a good recipe when it’s still a staple meal some four years on.

Gut Loving Banana Omelette with goats milk kefir and Eros brand activated nut and seed mix

Hope you enjoy it for years to come too.

Love Chantel x