How to help a baby to get a normal flora, what probiotics work for infants, what babies after a C-section and formula-fed ones need. Microbiologist Karina POKUSAEVA told Olena ISLAMKINA.
Microbiologist Karina Pokusaeva has already told Cilantro about microbiota which is a symbiont, ‘second brain’, the ‘forgotten organ’. 10 trillion of useful bacteria inhabit our intestine helping us digest food, participating in the immune system, influencing the mood. The point is to take care about your microbiota as early as possible. Previously amniotic fluid was thought to be sterile; according to new data both good and bad microorganisms can get through all barriers. A child gets the main dose of probiotics from his/her mother passing through the birth canal.
NATURAL BIRTH AND BREASTFEEDING
CILANTRO: How to prepare for pregnancy and what to do to give a baby a normal flora?
KARINA: To have healthy and diverse microbiota we should feed it with vegetables, fruit, fiber, bran. Bacteria will ‘eat’ what we can’t digest. Probiotics will enrich mother’s microflora and get into breastmilk afterward.
Are there any specific probiotics for pregnant and breastfeeding mothers?
They may appear in a few years, I think. They don’t exist now, but we know specific bacteria breastmilk includes which are very useful for newborns. Lactobacillus reuteri, for instance. It’s worth taking them. It’s highly possible that they get in amniotic fluid, breastmilk and colonize the infant’s gut.
Passing through the birth canal a baby swallows up, inhales the microbiota of the vagina. How does it refer to the intestine’s bacteria?
A lot of lactobacilli live in the vagina as well as in the intestine.
Is colonization during breastfeeding the next stage?
Yes. The most important group of useful bacteria for newborns is Bifidobacteria. Their DNA has 20-40 genes systems producing 20-40 protein-clinging enzymes to break down prebiotics. To break down cow milk lactose only 4 genes are needed, for instance.
How long do you need to breastfeed your baby to form his or her gut flora?
Immunoglobulins are largely concentrated in breast milk for the first 6 months of baby’s life. The American Academy of Pediatrics recommends breastfeeding for this period. From a microbiologist point of view, one year is an optimal term to stabilize the microbiota
Does the breastmilk contain both probiotics and prebiotics?
Those bacteria colonizing baby’s gut are able naturally to digest prebiotics from mother’s breast milk.
Prebiotic oligosaccharides of breast milk are so complex and unique that scientists have only started identifying molecules and describing their structures. Only one laboratory at the University of California is able to synthesize them in quantities hardly enough for laboratory research. It means there is no formula containing prebiotics of mother’s breast milk
Can we freeze mother’s breast milk to save some useful bacteria?
No. There are protocols for human milk storage at low temperatures. It’s impossible at home. Probiotics can survive for 5 days in a refrigerator, while freezing kills them. However, prebiotics can survive after freezing.
C-SECTION AND FORMULA FEEDING
What can we do for microbiota in a case of a C-section?
Nothing. There are a few clinics in the US swabbing C-section babies with mother’s vaginal fluid. It’s logical, but scientifically it’s not proved. The more technological decision may appear later.
Are probiotics necessary for formula-fed babies?
Despite a large number of clinical researches, it’s not common to prescribe them. I consider it to be necessary. There are some drops, premix, and pulvis with Lactobacillus reuteri. These bacteria are well studied (here, for instance). Baylor College of Medicine, a medical school where I’d got my Ph.D. degree, published a report concerning Lactobacillus reuteri helping children with autism socialize.
What other bacteria strains, apart from Lactobacillus reuteri, are good for babies?
Bifidobacteria. There are a lot of them, but Bifidobacterium infantis mainly. They are needed to digest complex oligosaccharides.
Can probiotics form the microbiota of a C-section and/or formula-fed babies same as naturally born and breastfed babies have?
These babies will not have the same microflora. The microbiota forms and changes in a lifetime. A baby doesn’t get stable microbiota after the birth and breastfeeding. Babies have Bifidobacteria mainly; people between 20 and 40 have more lactobacillus. Elderly people have other components. The age is very important while choosing probiotics.
CONSTIPATION AND COLIC
How can a mother understand that a baby has problems with microbiota?
It’s an interesting question. Some mothers worry about bowel movements’ colors. However, colors may vary in first months since the flora has not been formed yet. The baby used to get nutrition through the amniotic fluid and blood and then he or she has to drink milk that changes depending on the mother’s menu.
Some of our readers were asking about the reasons of babies’ constipation.
It rarely happens while breastfeeding. It’s necessary to define what the constipation is. Breast milk is well digested, and this can result in rare bowel movements – once in one or two weeks but of normal consistency. American pediatricians consider it an ordinary case. Real constipation happens while giving solid food, especially if it’s early and baby’s intestine is too young, not ready for the new food. In this case, baby feels bad, refuses the breast.
So, is baby’s mood the main indicator?
If the baby is happy there is nothing to worry about. A baby usually cries no more than 2 hours per day, it’s a standard. If the baby is in a bad mood, it’s all about colic bothering all of them but differently. Some of them just arche their backs, pass wind, groan. These are good signs. Gas is the indicator that bacteria work. The microbiota is not formed yet. In 2-3 months it becomes normal, babies become calmer.
SOLID FOOD AND STERILE ENVIRONMENT
How to start solid foods in terms of microbiota? When to start and what solids should be introduced?
In my opinion, the right time is when baby’s intestine is formed more or less; he or she can sit and shows interest in solids. It happens around 6 months. I give my 6-months old daughter fruit and vegetables.
Do you mash them or slice?
There are two ways. In the US it’s recommended starting with cereals and then give 1 fruit or vegetable in 3-5 days to see the reaction. The second way widespread in England is baby led weaning which means a baby feeds him/herself, studies the structure, control the amount. I have chosen the second one, but can’t give such recommendations.
Should baby’s environment be sterile?
You shouldn’t give a newborn to all strangers. However, boiling bottles and dummies, ironing everything is also too much. Dishes are sterilized once when were bought and then only washed with water and soap. The soap kills 98% of bacteria. The same with clothes. To stimulate the immune system, the baby should face bacteria. The majority surrounding us are not dangerous.
What about pets?
It’s proved that babies living with cats and dogs have a stronger immune system. They interact with more bacteria than those who don’t have pets. Their bodies react to bacteria diversity.
Is tetanus immunization necessary to protect a baby from dangerous bacteria?
Being a microbiologist, I think that it’s necessary. Doctors are unanimous that immunization is necessary. I’m a scientist, not a doctor, and I think that there are too many immunizations and too early. The EU has a better system. We have survived owing to immunizations, got rid of terrible epidemics.
And the main question: can a child eat sand and run across the puddles?
All of us have done it and it’s not bad. With open wounds, it’s better to avoid mud of course. On the whole, it’s the right environment for a baby to face. Playing in the mud and jumping in puddles is good, but you have to be cautious.