Most parents look forward to the birth of their crumbs. They are preparing for this event by buying diapers, nipples, bottles and other little things. All this, mothers and fathers thoroughly wash, wash, iron, sterilize, so that their child does not have health problems. But, according to statistics, every second family is faced with such a problem as dysbiosis in infants. Many are wondering where this ailment could come from, because the child is carefully taken care of, and all the recommendations of the pediatrician are meticulously followed. Unfortunately, dysbiosis in infants is not always associated with hygiene or feeding. A curious fact is that in European countries such a disease does not exist. More precisely, there is a violation of intestinal functions in children, but this is not considered a disease. In the ICD, dysbiosis also does not appear. But Russian doctors stubbornly make such a diagnosis to every second infant. Since our children have this ailment, let's figure out what affects its occurrence, how it manifests itself, how to treat it.
Where do microbes come from in the baby’s digestive tract?
The baby’s organs begin to form at the stage of the embryo, but during this period they are protected by the placenta and mother’s immunity. The first acquaintance with the outside world and the microbes that inhabit it occurs at the time of birth. It was then that hundreds of microorganisms that inhabit the vagina of every woman rush into the baby’s sterile stomach and intestines.
But this does not mean that dysbiosis will immediately appear in the baby. Among bacteria, there are many "good." They stabilize the process of digestion and assimilation of food in a child, control the number of pathogenic bacteria.
The expansion of microbes, which began in the birth canal of a woman, does not stop for a second, because the baby somehow contacts the medical staff of the hospital, breathes hospital air, and undergoes medical procedures. Do not forget about the visits of women in labor by relatives who are in the ward from the street and before that had contact with different people.
In fact, a sterile baby is defenseless in front of an avalanche of microscopic creatures seeking to penetrate his body.
They settle in his mouth, esophagus, stomach and intestines. In the early hours, these are simple and optional (they can live with and without oxygen) anaerobes. By the first week, their ranks are replenished by archaea and other protozoa. Finally, the process of formation of microflora of a small person ends approximately three months after its birth. In a healthy child in the intestine there are:
- Bifidobacteria.
- Lactobacillus.
- Escherichia coli (E.coli).
- Klebsiella.
- Some mushrooms.
Colostrum
An excellent prevention of dysbiosis in infants is the first application to the mother's breast. About 30 years ago in maternity hospitals, women in childbirth were brought in only on the second or third day. Now they are forced to put babies to their breasts in the first hours after giving birth. As such, women do not yet have milk, only colostrum. This product is rich in beneficial lactobacilli and bifidobacteria, which are very necessary for the intestines of the child. Also found in colostrum:
- Immunoglobulins.
- T lymphocytes.
- Live macrophage lymphocytes.
- Neutrophils.
- White blood cells (produce interferon).
- Oligosaccharides (do not allow "bad" bacteria to attach to the mucous membranes of the digestive tract).
- Lactoferrin (helps iron ions to be absorbed by the intestinal walls, depriving pathogens of the opportunity to develop).
- Peroxidase enzymes (destroy the shell of bacteria).
Scientists have found that the joint activity of all of the above cells and structures successfully resists such microbes:
- Clostridia.
- Salmonella.
- Streptococcus
- Bordetellas (cause whooping cough).
- E. coli (pathogenic).
- Vibrio cholera.
- Rotavirus.
- Herpes.
- Candida mushrooms.
- Enteroviruses.
- The causative agents of dysentery.
- Coxsackie viruses, polio, hemagglutinating encephalitis, RSV).
Primary and secondary dysbiosis
From the foregoing, it can be understood that in the intestines of the baby there are always two hostile “armies”. One of them is useful cells, proteins and microorganisms. The second - bacteria, fungi and viruses that cause dangerous diseases. Intestinal dysbacteriosis in infants may not begin until the first "army" controls the second, maintaining a certain balance in the microflora.
As soon as it is disturbed, pathogenic microbes instantly begin to multiply, form colonies, invade the mucous membranes, disrupt the normal course of digestion and assimilation of food.
The amount of useful, and especially opportunistic bacteria, must also comply with the norm. If there are few or too many of them, the child also begins to have problems with the intestines. Imbalance between beneficial and pathogenic microbes is the main cause of dysbiosis in infants. But why is the balance upset? There are already more than a dozen reasons.
Note that there are two types of dysbiosis:
- Primary (before the appearance of intestinal dysfunction, the child was not ill with anything).
- Secondary (appears against the background of another disease).
It is sometimes difficult to draw a clear line between them, especially if the child does not have an infectious disease. In general, intestinal dysbiosis in infants occurs under such conditions:
- Difficult birth with complications.
- A problem pregnancy, during which a woman was treated with various medications, including antibiotics.
- A woman is taking hormonal drugs and other drugs with milk that enter the baby’s digestive tract.
- Refusal of breastfeeding.
- Early introduction of complementary foods.
- Not suitable specifically for this baby milk mixture.
- Immaturity of the digestive tract of the baby. More common in premature babies.
- Bad ecology.
- Long stay in the hospital (this increases the risk of catching pathogenic microbes).
- Mom’s diseases (mastitis, bacagnosis, dysbiosis, allergy).
- Diseases of the baby. A lot of them. The main ones include ARVI, rickets, anemia, allergies, bronchial asthma, diabetes mellitus.
- Treating the baby or mother with antibiotics.
Classification
There are four degrees of dysbiosis:
- The first (compensated). Its important feature - the well-being of the child does not cause concern. He eats, awakes without crying, sleeps calmly. At this stage, signs of dysbiosis in infants are unstable weight gain, poor appetite, increased gas formation and colorless (slightly colored) feces. Malfunctioning of mother or child causes such disorders.
- The second (subcompensated). This degree requires treatment with medicines, since it causes the activity of pathogenic microorganisms that have proliferated in the intestine. Analysis of feces at grade 2 reveals the presence of staphylococcus or yeast-like fungi. Sometimes Proteus are also present in it. How is dysbiosis of the 2nd degree manifested in infants? The main symptom is a change in feces. It acquires a green tint and an unpleasant odor. Often, white clumps of undigested milk are noticeable in it. The child is tormented by stomach pains, gas, diarrhea, because of which he becomes moody, refuses to eat, sleeps restlessly. Constipation with this degree of disease is rare.
- Third (decompensated). Most often, it occurs when the parents, at the first appearance of dysbiosis, tried to treat the baby with their own methods and released the situation out of control. All signs of dysbiosis in infants characteristic of the previous stage are amplified: the child experiences abdominal pain, he is tormented by gas, diarrhea. Feces gain a steady green hue and the smell of a rotten egg. They also have fragments of undigested food, a pole, mucus is added, and sometimes streaks of blood. The child is very weak, eats almost nothing. Prolonged diarrhea can lead to dehydration. This is manifested in the skin turgor and in weak muscle activity. For babies, dehydration is deadly. Therefore, a child with diarrhea observed for several days must be hospitalized.
- Fourth. It rarely comes to this stage. Microorganisms from the intestines of the child spread to other organs, causing their inflammation. The patient has vivid signs of intoxication - vomiting, fever, persistent diarrhea (feces almost unformed, mucous-watery). Without urgent resuscitation, the infant dies.
Breast-feeding
Of course, feeding the baby with breast milk is a priority. It contains vitamins, mother's antibodies, which provide the baby with passive immunity.
But even on breastfeeding, dysbiosis in infants is diagnosed quite often. The main reason is the imperfect work of the digestive system, which is fully adjusted months to three. Often the disease occurs due to such reasons:
- Non-compliance with hygiene. Microbes can enter the baby’s body with a dirty nipple, bottle, dummy, toys, and other items that the baby touches. Hygiene should be observed by everyone who comes in contact with the baby. Many microorganisms do not harm adults, since they have already developed immunity. But the child does not yet have a strong immune defense.
- Diseases of the mother or baby. If this happens, doctors try not to prescribe antibiotics. These drugs in the intestines kill both “bad” microorganisms and “good” ones. In infants, dysbiosis after antibiotics is observed in most cases. To prevent this from happening, the child must be prescribed medications that protect the intestinal microflora during the treatment period.
- Poor nutrition mom. Women who are breastfeeding should remember that the well-being of the baby depends on their diet. Therefore, from the menu you need to exclude many, even useful products that can cause disruption of the intestines of the crumbs. This includes plums, apricots, strawberries, grapes, smoked meats, pickles, cucumbers, cabbage, coffee and other products. Very often, a child’s intestinal problems disappear after the mother removes “dangerous” foods from her menu.
Symptoms of dysbiosis in an infant who is breast-feeding may be as follows:
- The feces are foamy in nature. Often there is mucus in it. This is one of the main symptoms manifesting about a problem in the intestines.
- A rumbling in the tummy.
- In the process of feeding or immediately after it, frequent spitting up, sometimes turning into vomiting.
- Weak weight gain or loss.
- Moodiness, anxiety of the child for no apparent reason (the diaper is dry, the baby is fed).
In some children, dysbiosis is accompanied by a rash. It can cover significant areas of the body or look like separate pimples.
Artificial Feeding
In the maternity hospital, nurses and doctors see to it that moms put their babies to their breasts. At home, some parents immediately transfer the child to artificial feeding.
Now the composition of both domestic and imported milk mixtures is made as close as possible to breast milk. They include a balanced complex of vitamins, probiotics, prebiotics, proteins, and other beneficial substances. Therefore, modern children receiving such nutrition grow healthy.
But dysbacteriosis in babies with artificial feeding is diagnosed much more often than in their peers who receive mother's milk. This is due to the fact that so far our technology is not able to accurately reproduce what nature creates. So, mixtures can not serve as a source of many beneficial bacteria that enter the baby with breast milk. The microflora in the intestines of the “artificer” is depleted, since it is only Escherichia coli. This greatly complicates the process of assimilation of food.
The advantage of artificial feeding is only that you can accurately know the volume of what the child ate (on a scale on a bottle), that is, it is better to control weight gain.
Symptoms of dysbiosis in infants growing on milk formulas:
- Stool problems. Some babies have diarrhea. The feces become watery and colorless. Other children suffer from constipation and increased gas formation. For this reason, they often, as they say, call in, scream with their legs, bend. According to reviews of mothers who refused to breastfeed, constipation in their babies is much more common than diarrhea.
- Regurgitation, even if after feeding the baby is kept "column".
- Further development of the disease can cause fever and a rash on the body.
Lure
Often, dysbacteriosis in infants who are both breastfed and artificially fed begins because of premature feeding:
- Fruit juices and mashed potatoes.
- Sour-milk products.
- Eggs
- Vegetables.
- The meat.
All these products are very useful, rich in vitamins and minerals, but the child's body should get acquainted with them when his digestive system is already strong enough and is able to absorb new foods.
All food products for children offered in the distribution network indicate not only the expiration date and composition, but also the age from which they can be introduced into the diet. You must comply with these terms, and also understand that the body of each person - large or small, has individual characteristics. Therefore, what is perfect for one child can provoke a violation of the intestines in another.
Diagnostics
When a child develops diarrhea, pediatricians usually prescribe an analysis for dysbiosis. In infants, feces are collected from the diaper by the parents and the biomaterial is taken to the laboratory.
Bakseeding can identify about 25 types of bacteria, including useful and opportunistic species, as well as determine the percentage of each type of microorganism present in the intestines of the baby.
Also, the ratio of “good” and “bad” microorganisms is indicated in the results of an analysis for dysbiosis in infants, and the resistance of the latter to antibiotics is revealed.
In addition to back sowing, another analysis is performed - a coprogram. With its help, it is determined whether there is inflammation in the intestine, as well as the degree of digestion of food fragments present in the feces.
The main disadvantage of bacterial seeding is the duration of the preparation of this analysis, which is at least 7 days (bacteria must grow and multiply). During this time, the baby has time to conduct treatment. Therefore, the results are often irrelevant.
Another drawback of this analysis is that it gives an idea of the microflora of only the lower intestine, without showing what is happening in the whole organ.
Now, in some medical centers, an excretory breath test is performed. It is based on the decoding of chemical elements exhaled by a child. Do this using gas-liquid chromatography. The fact is that each type of microbe in the process of life releases into the environment its inherent substances. They are determined in exhaled air. The test result is prepared in just a few hours. It shows whether or not the child has germs in the digestive tract, what species and in what quantity. Such an analysis is expensive, but it helps to immediately begin treatment of dysbiosis in infants. Parents' feedback on this research method is mixed. Its advantages are called painless conduct and a short waiting time for the result. The lack of information of the test (mistakes often occur) and the complexity of its conduct for infants are noted as disadvantages.
It is advisable to repeat Bakseeding after the end of treatment in order to know how much microflora in the intestines of the crumbs has recovered. Biomass is taken 12 or more hours after taking the antibiotic, and with prebiotic therapy, a month after its completion.
Treatment of dysbiosis in infants
Therapeutic measures for young patients are always carried out in a complex. The following medications are prescribed to the child:
- "Bacteriophage". The drug is available for each microbe separately. It includes polyvalent bacteriophages, which destroy only dangerous bacteria and do not touch the beneficial ones.
- Sorbents (to remove microbial waste products from the body). Drugs of choice: Karbofan, Polysorbent, Smecta, Mikosorb, Enterosorb.
- Enzymes. Their role is to help establish normal digestion. Drugs of choice: Panzinorm, Oraza, Pancreatin, Festal, Cholenzym.
- Antibiotics. Appointed strictly according to indications. Drugs of choice: Diflucan, Macropen, Chlorophyllipt, Erythromycin, Mexase.
- In parallel with antibiotics, children are prescribed “Dialact”, “Lactobacterin”, which protect the beneficial intestinal microflora from destruction by antibiotics.
- Probiotics They restore disturbed balance in the intestines. Preparations: Lactobacterin, Enterol, Linex, Bifikol.
- Prebiotics. They activate the production of the necessary bacteria in the body. Preparations: “Lactose”, “Lactulose”.
In the treatment of dysbiosis in infants, doctors can prescribe physiotherapy, phyto- and vitamin therapy.
It is recommended during this period not to give the baby any new food, do not change the mixture, observe hygiene, often walk with the child, as fresh air and sunlight help strengthen immunity and renew the cells of the intestinal mucosa.
Prevention
Caring for the baby's health starts at the time of the decision to conceive. A woman is required to undergo examination, to cure all her diseases.
Being pregnant, she should regularly take all tests, follow the doctor's recommendations, monitor her diet and daily routine.
For infants, the prevention of dysbiosis is:
- Breastfeeding in the first hours after birth.
- Hygiene.
- Breast-feeding.
- Walking on the street.
- Proper nutrition and health of mom.
- Daily bathing (strengthen immunity).
- Timely introduction of complementary foods.
By following these recommendations, you can significantly reduce the risk of dysbiosis.