Babies and toddlers have very delicate immune systems, and when the immune system is misdirected or underdeveloped, it can manifest in cow’s milk protein allergy, other food allergies, eczema or wheezing.
These tinies also often have a generalised low immune system prone to picking up “every bug going” including colds, bronchiolitis, diarrhoea and vomiting. In the past, much of this has been put down to genetics, as the predisposition to allergies, hay fever, eczema and asthma (collectively known as atopic conditions) are usually passed down through the generations.
In recent years, research has been looking into the role that the balance of gut bacteria plays in the allergies and how the gut microbiome can influence the development and severity of atopic conditions. This article explores this research in more detail and shares how diet and specific probiotic strains might influence the gut bacteria, which in turn helps the immune system to adapt better to its environment. The ultimate goal of this research is to find ways to help make life easier for atopic children which might mean being able to broaden their diet choices or be less dependent on asthma inhalers and eczema creams. And this in turn takes much of the burden and stress off the parents and family life.
How a child’s immune system develops
A baby’s immune system starts to develop very early on in pregnancy. Lymphocytes (white blood cells) develop in the baby’s liver by 9 weeks in utero and are present in the bloodstream and spleen by 12 weeks.
However, after birth is when the baby’s immune system needs to mature and start to adapt to its environment, so that the baby builds resilience against viruses, yeast and bacterial infections. The baby’s immune system doesn’t mature until around 2 to 3 months, so this is why it is important to see a doctor if your baby is unwell during this time, and also why you need to be very careful with hygiene and try to use natural skincare and household cleaners as much as possible.
It is also a window of time when the baby builds oral and gut tolerance to foods and their environment (environmental allergens, chemicals). Research has found that the milk that the baby receives in the first few days of a baby’s life can influence the development of a cow’s milk protein allergy, and babies who receive formula in this short window of time are more likely to develop a milk allergy than those who are exclusively breast fed in the early days.
Since the immune system is still developing in the first few months, milk is the only food that a baby should consume via breast milk or specialist baby milk formula. From around 4-6 months the baby starts to build oral tolerance to other foods which means they can eat foods without being allergic or sensitive to them. This is partly why you need to wait to wean a baby onto solid food until they are at least 17 weeks.
How does a baby’s gut microbiome populate?
We all have billions of gut bacteria which influence our metabolism, immunity and inflammatory response, as well as mood and learning. This gut microbiome starts developing in a baby’s tummy right from birth. A natural vaginal birth will give a baby a head start over a caesarean birth on the microbiome-front as the journey through the birthing canal helps the baby pick up important vaginal bacteria from their mother, which then starts to populate in the gut from day one. A caesarean baby will also build a gut microbiome, and this will be more influenced by the airborne bacteria in their home as well as the way they are fed. So not all is lost if you end up having a c-section birth.
A breast-fed baby has an advantage over a formula fed baby when building a healthy and diverse gut microbiome, as dendritic cells form a channel between the mother’s gut lining and the back of her breasts sending her gut microbes into her breast milk which the baby ingests. If the mum’s microbial balance is therefore reflected in the baby’s gut – if there are plentiful and diverse beneficial prebiotics and probiotic bacterial strains in mum’s gut, then the baby will benefit from these too.
It is thought a healthy maternal gut microbiome can be an important factor for preventing allergies and ameliorating many of the symptoms associated with allergy in small babies such crying, excess gas production, milk regurgitation, very loose or sluggish bowels and skin rashes.
Mum’s microbiome will be influenced by her diet and whether she has needed to take antibiotics or other medications such as proton pump inhibitors like omeprazole for reflux. A diet rich in fruit, vegetables, salads, nuts, seeds, olive oil, oily fish, live yoghurt and fermented foods as well as probiotic supplementation can help build a healthy microbiome, whereas processed convenience foods and using lots of antimicrobial wipes and gels generally do not. Once the baby is weaned onto solid foods, then parents also have the opportunity to build the baby’s microbiome through food.
Infant milk formulas are catching up and many brands such as Hipp, Kendamil, Piccolo, Aptamil, SMA Pro, Cow & Gate, and Similac add cow’s milk Galacto-Oligosaccharides (GOS) to their formulas which feed the baby’s gut microbiome with prebiotics. GOS is very similar in nature to the prebiotics in breast milk and helps in a generalised fashion to feed and cultivate beneficial bacteria in a little one’s intestines. If your baby’s formula does not contain GOS and they can tolerate small amounts of dairy, then it is worth trialling supplementing them with a GOS based prebiotic.
Specific strains for allergic babies
There are specific probiotics strains that have been researched extensively regarding food allergy prevention and treatment and more research is in the pipeline. Lactobacillus rhamnosus GG and Bifidobacteria lactis are the two key probiotic strains found to help with babies and toddlers who have food allergies, a generalised low immune system and are gassy, regurgitate or have painful tummies.
Lactobacillus rhamnosus GG was patented over 30 years ago and its research is very far reaching. This specific probiotic strain has been found to be helpful in a wise range of situations from gastrointestinal infections and diarrhoea, irritable bowel syndrome, respiratory tract infections and allergy.
Nutramigen LGG is a hypoallergenic milk formula which is often prescribed by paediatricians when a baby has a cow’s milk protein allergy. This contains Lactobacillus rhamnosus GG, whereas Neocate and SMA Alfamino do not. It may therefore be prudent to trial a baby with severe cow’s milk protein on allergy on Neocate and SMA Alfamino with a separate Lactobacillus rhamnosus GG probiotic supplement grown on a dairy free medium. Lactobacillus rhamnosus GG is not added to any other milk formulas either, so you can supplement whilst they are drinking these. Supplementation is also suitable for an exclusively breast-fed baby or mixed-fed baby.
Bifidobacteria lactis has been used in over 400 studies and use has been associated with softer and more frequent bowel movements as well as shorter and fewer episodes of loose stools. It is also linked to less excessive crying and fussing in babies, fewer episodes of respiratory discomfort, better immune system support as well as less red, dry, and scaly skin in babies. I haven’t found this probiotic strain added to any infant milk formulas yet, and this may be a helpful addition to a baby or toddler if their gut health and immune system is compromised.
Research on a baby’s immune system and gut health has been carried out combining these two strains together which are classed as symbiotics. They can also be found as a blend commercially in probiotic supplements. These do not guarantee any specific outcome and it is not known exactly how long these need to be taken to make a difference, but since they are such important strains for overall gut health and immunity, it is worth giving them a go for a few months and observe any changes in your little one’s gut, skin health or food tolerance.
If you have a baby or toddler with food allergies or other atopic conditions and would like to discuss their gut health and immunity in more detail, then arrange a time to speak to one of our dedicated baby and toddler nutrition clinical team.
- Formula supplementation remains a risk for cow’s milk allergy in breast‐fed infants
- Primary Prevention of Allergic Diseases: The Role of Early Exposure to Cow’s Milk Formula
- Health benefits of Lactobacillus rhamnosus GG and Bifidobacterium animalis subspecies lactis BB-12 in children
- Towards a better understanding of Lactobacillus rhamnosus GG – host interactions
- Lactobacillus rhamnosus GG-supplemented formula expands butyrate-producing bacterial strains in food allergic infants
- Lactobacillus rhamnosus GG (ATCC 53103) for the Management of Infantile Colic: A Randomized Controlled Trial
- Probiotics in late infancy reduce the incidence of eczema: A randomized controlled trial
- Bifidobacterium lactis Ameliorates the Risk of Food Allergy in Chinese Children by Affecting Relative Percentage of Treg and Th17 Cells
- Safety of Bifidobacterium animalis subsp. lactis (B. lactis) strain BB-12®-supplemented yogurt in healthy children