In the Journals

Antibiotic use in children might weaken benefits of breast-feeding

Recent study findings suggested that antibiotic use in children might negate the long-term benefits of breast-feeding by affecting intestinal microbiota.

Willem M. de Vos

The researchers noted that breast-feeding can reduce the likelihood of childhood infection and becoming overweight in early life. In addition, they hypothesized that antibiotic use, which can alter the microbiota, might be a modifying factor in the relationship between breast-feeding and infant weight gain.

To determine whether early-life antibiotics could weaken the benefits of breast-feeding, the researchers performed a retrospective cohort study of 226 Finnish children aged 2 to 6 years who were participating in a probiotic trial during 2009 and 2010. The researchers assessed fecal microbiota composition in 42 of these children. Afterward, they examined the associations between breast-feeding duration and antibiotic use and later values of BMI.

Among the children who were antibiotic-naive (n = 113) before being weaned off breast-feeding, each month of breast-feeding decreased later antibiotic use by a mean of 5% (95% CI, 2-8) and decreased BMI by an average of 0.08 z score units (95% CI, 0.04-0.11). In the cohort of children who took antibiotics (n = 113), each month of breast-feeding decreased later antibiotic use by 4% (95% CI, 0-7), but did not decrease BMI.

In the 42 children whose fecal microbiota were assessed, children with a breast-feeding duration shorter than 6 months and no early-life antibiotic use had 55% less Bifidobacterium (95% CI, 43-87) and 71% less Akkermansia (95% CI, 28-87) compared with those who had a longer breast-feeding duration. In the same subgroup, children with early-life antibiotic use had 39% less Bifidobacterium (95% CI, 30-68) and 69% less Akkermansia (95% CI, 22-90) compared with those who did not take antibiotics in early life.

The researchers believe these results suggest that the breast milk’s effect on the microbiota leads to long-term metabolic benefits and that these benefits can be disrupted by antibiotic use.

“Our results indicate that short duration of breast-feeding and antibiotic use before weaning are associated with microbiota development toward a composition that may increase weight gain,” the researchers wrote. “Promoting the natural development of the microbiota may be an effective way to improve long-term health in children.” – by Will Offit

Disclosure: The researchers report no relevant financial disclosures.

Recent study findings suggested that antibiotic use in children might negate the long-term benefits of breast-feeding by affecting intestinal microbiota.

“Breast-fed children have better satiety and appetite regulation than formula-fed children, which could be partly due to the differences in microbiota, as the short-chain fatty acids produced by bacteria in the intestine influence gut hormones related to satiety and energy homeostasis,” Willem M. de Vos, PhD, professor of microbiology at the Academy of Finland in Helsinki, and colleagues wrote. “Human milk contains considerable amounts of complex fucosylated and sialylated glycans that are nonnutritious to the host but used as energy sources by Bifidobacterium species, which are abundant in the breast-fed infant’s intestine.”

Willem M. de Vos

The researchers noted that breast-feeding can reduce the likelihood of childhood infection and becoming overweight in early life. In addition, they hypothesized that antibiotic use, which can alter the microbiota, might be a modifying factor in the relationship between breast-feeding and infant weight gain.

To determine whether early-life antibiotics could weaken the benefits of breast-feeding, the researchers performed a retrospective cohort study of 226 Finnish children aged 2 to 6 years who were participating in a probiotic trial during 2009 and 2010. The researchers assessed fecal microbiota composition in 42 of these children. Afterward, they examined the associations between breast-feeding duration and antibiotic use and later values of BMI.

Among the children who were antibiotic-naive (n = 113) before being weaned off breast-feeding, each month of breast-feeding decreased later antibiotic use by a mean of 5% (95% CI, 2-8) and decreased BMI by an average of 0.08 z score units (95% CI, 0.04-0.11). In the cohort of children who took antibiotics (n = 113), each month of breast-feeding decreased later antibiotic use by 4% (95% CI, 0-7), but did not decrease BMI.

In the 42 children whose fecal microbiota were assessed, children with a breast-feeding duration shorter than 6 months and no early-life antibiotic use had 55% less Bifidobacterium (95% CI, 43-87) and 71% less Akkermansia (95% CI, 28-87) compared with those who had a longer breast-feeding duration. In the same subgroup, children with early-life antibiotic use had 39% less Bifidobacterium (95% CI, 30-68) and 69% less Akkermansia (95% CI, 22-90) compared with those who did not take antibiotics in early life.

The researchers believe these results suggest that the breast milk’s effect on the microbiota leads to long-term metabolic benefits and that these benefits can be disrupted by antibiotic use.

“Our results indicate that short duration of breast-feeding and antibiotic use before weaning are associated with microbiota development toward a composition that may increase weight gain,” the researchers wrote. “Promoting the natural development of the microbiota may be an effective way to improve long-term health in children.” – by Will Offit

Disclosure: The researchers report no relevant financial disclosures.