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GUT SCIENCE | DEVELOPMENT OF THE
PEADIATRIC GUT MICROBIOME

What is GUT flora and why should you care?
The human intestine harbours trillions of microbial cells which form a symbiotic (mutually beneficial) relationship with the host and play a vital role in both health and disease.1
These microbes, also known as microflora, play important roles in:
• Maintaining homeostasis
• Providing essential nutrients
• Dietary fibre metabolism
• Proper development of the immune system
• Early postnatal life development
Therefore, the gut microbiota is considered a crucial factor for proper early life development and lifelong health. The microbiome also affects the general health status of the infant or child.1
GUT flora development during infancy, childhood and adolescent
There is evidence that microbial colonisation of the infant gut may begin prior to birth as the presence of microbes have been found in the placenta, amniotic fluid and the umbilical cord.
Similarities between the unique microbiota composition of the placenta and amniotic fluid to that of the infant meconium (earliest baby stool) suggests a microbial transfer from mother to child during pregnancy.1
During the first year of an infant’s life, the relatively simple neonatal microbiome matures and develops into a more complex microbiome, with a composition and functionality more representative of an adult gastrointestinal tract.1
While some studies have suggested that the paediatric microbiome reaches a relatively stable, adult-like configuration within the first 3 years of life, other studies have demonstrated continued development through childhood into the teenage years.1
What factors influence the development of normal GUT flora?
In addition to potential in utero environmental influences, many factors have been found to contribute to early intestinal colonisation, such as:
  • Gestational age at birth.1
  • Infant diet1
  • Antibiotic treatment1
  • Environment1

Gestational age at birth.1

Studies have shown that the intestinal microbiota of preterm infants differs from that of healthy term infants. Prematurity is associated with a high risk for neonatal complications and can lead to significant disease and death rates. These premature neonates are often exposed to prolonged hospitalizations, antibiotics, and formula feeding which may all disrupt the maturation of health-associated microbial communities. Importantly, alterations in the microbiome of preterm infants have been correlated with increased risk for complications such as necrotising enterocolitis (NEC) and late-onset blood or systemic infection.

Infant diet1
Breast-fed infants have microbiota enriched with beneficial flora such as Lactobacillus, Staphylococcus, and Bifidobacterium, as compared to formula-fed infants who have greater quantities of microbes associated with inflammation, with a more rapid maturation of their microbiome toward that of an adult-type composition.
Antibiotic treatment1
The use of antibiotic in early life has profound effects on the development of the gut microbiota.
Environment1
Exposure to less sanitary environments Including contact with household pets and siblings, may have a significant effect on the developing microbiome. The number of older siblings positively correlates with bacterial diversity and richness at 18 months of age.
What are potential diseases associated with GUT flora imbalance?
When the balance of the intestinal microbiota becomes disrupted, alterations can lead to:1
• immunologic dysregulation (immune system dysfunction)
• the development of diseases such as Clostridium difficile infection
• inflammatory bowel disease
• irritable bowel syndrome (IBS)
• asthma
• obesity
• neurodevelopmental disorders such as autism
For more information refer to your healthcare provider.

DEVELOPMENT OF THE
PEADIATRIC GUT MICROBIOME

What is GUT flora and why should you care?
The human intestine harbours trillions of microbial cells which form a symbiotic (mutually beneficial) relationship with the host and play a vital role in both health and disease.1
These microbes, also known as microflora, play important roles in:
• Maintaining homeostasis
• Providing essential nutrients
• Dietary fibre metabolism
• Proper development of the immune system
• Early postnatal life development
Therefore, the gut microbiota is considered a crucial factor for proper early life development and lifelong health. The microbiome also affects the general health status of the infant or child.1
GUT flora development during infancy, childhood and adolescent
There is evidence that microbial colonisation of the infant gut may begin prior to birth as the presence of microbes have been found in the placenta, amniotic fluid and the umbilical cord.
Similarities between the unique microbiota composition of the placenta and amniotic fluid to that of the infant meconium (earliest baby stool) suggests a microbial transfer from mother to child during pregnancy.1
During the first year of an infant’s life, the relatively simple neonatal microbiome matures and develops into a more complex microbiome, with a composition and functionality more representative of an adult gastrointestinal tract.1
While some studies have suggested that the paediatric microbiome reaches a relatively stable, adult-like configuration within the first 3 years of life, other studies have demonstrated continued development through childhood into the teenage years.1
What factors influence the development of normal GUT flora?
In addition to potential in utero environmental influences, many factors have been found to contribute to early intestinal colonisation, such as:
  • Gestational age at birth.1
  • Infant diet1
  • Antibiotic treatment1
  • Environment1

Gestational age at birth.1

Studies have shown that the intestinal microbiota of preterm infants differs from that of healthy term infants. Prematurity is associated with a high risk for neonatal complications and can lead to significant disease and death rates. These premature neonates are often exposed to prolonged hospitalizations, antibiotics, and formula feeding which may all disrupt the maturation of health-associated microbial communities. Importantly, alterations in the microbiome of preterm infants have been correlated with increased risk for complications such as necrotising enterocolitis (NEC) and late-onset blood or systemic infection.

Infant diet1
Breast-fed infants have microbiota enriched with beneficial flora such as Lactobacillus, Staphylococcus, and Bifidobacterium, as compared to formula-fed infants who have greater quantities of microbes associated with inflammation, with a more rapid maturation of their microbiome toward that of an adult-type composition.
Antibiotic treatment1
The use of antibiotic in early life has profound effects on the development of the gut microbiota.
Environment1
Exposure to less sanitary environments Including contact with household pets and siblings, may have a significant effect on the developing microbiome. The number of older siblings positively correlates with bacterial diversity and richness at 18 months of age.
What are potential diseases associated with GUT flora imbalance?
When the balance of the intestinal microbiota becomes disrupted, alterations can lead to:1
• immunologic dysregulation (immune system dysfunction)
• the development of diseases such as Clostridium difficile infection
• inflammatory bowel disease
• irritable bowel syndrome (IBS)
• asthma
• obesity
• neurodevelopmental disorders such as autism
For more information refer to your healthcare provider.

Babies and
children

* NEC – Necrotizing enterocolitis (NEC) is a medical condition where a portion of the bowel dies.
References:
  1. Ihekweazu D, Versalovic J. Development of the Pediatric Gut Microbiome: Impact on Health and Disease. The American Journal of the Medical Sciences, 2018;356(5):413-423.
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