I told
myself, I told everybody, in fact “WE’VE TRIED PROBIOTICS” Shut up, about the
probiotics. “They don’t help” I would say, through a sigh, to whichever
practitioner happened to be in my grasp at the time. When you haven’t had a
decent night’s sleep in over a year, often being wrenched from your sleep every
45 minutes to feed, sooth or massage a thrashing, kicking, screeching, arching,
grunting and irritable infant, you have little patience for, or faith in,
things that don’t work immediately. You want the cure now, yesterday, 9 months
ago even.
You see, I knew good and well antibiotics kill off the good bacteria in the gut, and Evie was given IV antibiotics immediately following her birth, so probiotics were the first place I had looked for answers. What I didn’t know at the time, however, was the crucial role that probiotics play specifically in gut motility and that the gut takes time to heal. It’s not a one dose miracle, and if you can find the patience, the faith and the memory power to remember several daily doses through the sleepless fog, they might just be the oil strike you have been waiting for.
So what makes me so sure that probiotics can be effective in healing the gut and restore motility, that when sluggish, causes colic, constipation, reflux & excessive vomiting? Research my friends, research. Meticulous, obsessive, relentless, desperate, prop your eyelids open with toothpicks and pray for answers, research. And I can’t take all of the credit of course, a few of the people we saw about Evie’s gut issues did suggest probiotics, but they never bothered to explain to me (maybe because they didn’t know, exactly) WHY they were so important and how long they might take to have the desired effect, the fact that she needed more than the recommended dose on the bottle, which is prescribed for maintenance, and not repair. And I needed more than that. For example, you can tell me oxygen is good and I might believe you and think “That’s good, I must look into that”. But if you tell me HEY OXYGEN IS GOOD BECAUSE YOU CAN NOT, AND WILL NOT, SURVIVE WITHOUT IT – I might start to take oxygen a little more seriously. People try to sell you things all the time in this world that we live in, anyone can make anyone believe that they need any product if they are good enough at persuasion. But as a nurse, I’m a hard sell, I want to see evidenced based, peer reviewed research, so that’s what I went to find.
So, babies are born with a sterile gut [1], [2]. They then acquire their gut’s microflora – throughout the birth process and then from breast milk (if breast fed) and the environment (formula, environmental germs etc) [1], [3]. However, when babies are either born via caesarean section, or receive antibiotics following birth, their gut flora is altered for at least 6 months (the longest period of study), and possibly permanently, if left untreated [1]. The reason that babies whom receive antibiotics following their birth suffer from gut-flora-annihilation is obvious; antibiotics don’t discriminate, they kill both good and bad bacteria, leaving the host depleted. But babies born via caesarean section also receive antibiotics, albeit prior to their birth. Mothers undergoing a caesarean section are routinely given a preventative dose of intravenous antibiotics prior to their birth. This is typically the antibiotic ampicillin. Ampicillin easily crosses the placenta and both Mum and baby will have equal amounts in their systems after one hour of administration [1].
So how did my search for answers about colic & constipation bring me to probiotic treatment? Because
“Bacteria inhabiting the human intestine participate in the maintenance or gut
sensory and motor functions , including the promotion of intestinal propulsive activity…
Intestinal motility represents one of the major control systems of gut microflora…” [4]
So, when my daughter was given IV antibiotics immediately following her birth, her sterile gut was bombarded with bacteria killers that would make achieving a healthy balance all the more difficult in her tiny still-developing little system, from the get go. That balance is crucial to keeping the gut moving, pushing gas and solids in the right direction. Cue 15 months of sleeplessness thanks to our good friend’s colic and constipation.
*I will note here that this study of infants whom were normal vaginal births, without antibiotic administration. One third was formula fed, one third was breast fed, and one third was a formula fed control group whom received no probiotics. This study showed that whilst adding probiotics to the one formula fed group gave them a similar gut health to those whom were breast fed, it actually made no difference to reported gastrointestinal symptoms within the 6 months. This is possibly due to the fact that pretty much all babies struggle with gas, their muscles aren’t as co-ordinated as an adults, their tummy is getting used to being used and they generally all struggle to some degree (albeit much more mildly if not given antibiotics, the problem still exists). Suggestions to deal with normal infant gas can be found here.
You see, you can give as much fibre, laxatives and water as you like – if gut motility is sluggish, your fighting a losing battle. Furthermore, laxatives are not, and nor should they be, a long term option. Why wouldn’t you want to fix the underlying problem? Why would you just want to cover it up and hope it goes away? So, we started Evie on probiotics 3 x a day for 2 days, until her poo turned to green diarrhoea and the gas from this was so intense that the colic came back… Too much. So we pulled it back to just twice a day, and within 7 days she was doing big, soft poos everyday**, napping again during the day, waking less frequently at night and I was so happy I could cry.
You see, I knew good and well antibiotics kill off the good bacteria in the gut, and Evie was given IV antibiotics immediately following her birth, so probiotics were the first place I had looked for answers. What I didn’t know at the time, however, was the crucial role that probiotics play specifically in gut motility and that the gut takes time to heal. It’s not a one dose miracle, and if you can find the patience, the faith and the memory power to remember several daily doses through the sleepless fog, they might just be the oil strike you have been waiting for.
So what makes me so sure that probiotics can be effective in healing the gut and restore motility, that when sluggish, causes colic, constipation, reflux & excessive vomiting? Research my friends, research. Meticulous, obsessive, relentless, desperate, prop your eyelids open with toothpicks and pray for answers, research. And I can’t take all of the credit of course, a few of the people we saw about Evie’s gut issues did suggest probiotics, but they never bothered to explain to me (maybe because they didn’t know, exactly) WHY they were so important and how long they might take to have the desired effect, the fact that she needed more than the recommended dose on the bottle, which is prescribed for maintenance, and not repair. And I needed more than that. For example, you can tell me oxygen is good and I might believe you and think “That’s good, I must look into that”. But if you tell me HEY OXYGEN IS GOOD BECAUSE YOU CAN NOT, AND WILL NOT, SURVIVE WITHOUT IT – I might start to take oxygen a little more seriously. People try to sell you things all the time in this world that we live in, anyone can make anyone believe that they need any product if they are good enough at persuasion. But as a nurse, I’m a hard sell, I want to see evidenced based, peer reviewed research, so that’s what I went to find.
So, babies are born with a sterile gut [1], [2]. They then acquire their gut’s microflora – throughout the birth process and then from breast milk (if breast fed) and the environment (formula, environmental germs etc) [1], [3]. However, when babies are either born via caesarean section, or receive antibiotics following birth, their gut flora is altered for at least 6 months (the longest period of study), and possibly permanently, if left untreated [1]. The reason that babies whom receive antibiotics following their birth suffer from gut-flora-annihilation is obvious; antibiotics don’t discriminate, they kill both good and bad bacteria, leaving the host depleted. But babies born via caesarean section also receive antibiotics, albeit prior to their birth. Mothers undergoing a caesarean section are routinely given a preventative dose of intravenous antibiotics prior to their birth. This is typically the antibiotic ampicillin. Ampicillin easily crosses the placenta and both Mum and baby will have equal amounts in their systems after one hour of administration [1].
So how did my search for answers about colic & constipation bring me to probiotic treatment? Because
“Bacteria inhabiting the human intestine participate in the maintenance or gut
sensory and motor functions , including the promotion of intestinal propulsive activity…
Intestinal motility represents one of the major control systems of gut microflora…” [4]
So, when my daughter was given IV antibiotics immediately following her birth, her sterile gut was bombarded with bacteria killers that would make achieving a healthy balance all the more difficult in her tiny still-developing little system, from the get go. That balance is crucial to keeping the gut moving, pushing gas and solids in the right direction. Cue 15 months of sleeplessness thanks to our good friend’s colic and constipation.
*I will note here that this study of infants whom were normal vaginal births, without antibiotic administration. One third was formula fed, one third was breast fed, and one third was a formula fed control group whom received no probiotics. This study showed that whilst adding probiotics to the one formula fed group gave them a similar gut health to those whom were breast fed, it actually made no difference to reported gastrointestinal symptoms within the 6 months. This is possibly due to the fact that pretty much all babies struggle with gas, their muscles aren’t as co-ordinated as an adults, their tummy is getting used to being used and they generally all struggle to some degree (albeit much more mildly if not given antibiotics, the problem still exists). Suggestions to deal with normal infant gas can be found here.
You see, you can give as much fibre, laxatives and water as you like – if gut motility is sluggish, your fighting a losing battle. Furthermore, laxatives are not, and nor should they be, a long term option. Why wouldn’t you want to fix the underlying problem? Why would you just want to cover it up and hope it goes away? So, we started Evie on probiotics 3 x a day for 2 days, until her poo turned to green diarrhoea and the gas from this was so intense that the colic came back… Too much. So we pulled it back to just twice a day, and within 7 days she was doing big, soft poos everyday**, napping again during the day, waking less frequently at night and I was so happy I could cry.
Hallelujah!
As for how long she will be on them, I will wait for the current bottle to run out and then see how she goes. I will know immediately if her gut isn't done healing and will quickly get her back on them at the first sign of any kind of upset in the future (including sickness or eczema etc).
By now you might be thinking, that’s great for you lady, but my child has never had antibiotics and was not a caesarean birth! To which I would say: it doesn’t matter. The real point here is the crucial role that probiotics can play in enhancing gut motility. Furthermore, there are numerous factors that can throw out a child’s gut balance including, but certainly not limited to; the diet of the pregnant and breastfeeding mother [5] , the diet of the child[1] and being formula fed[1].
For us, I feel as though probiotics played the key role in getting back on track. But they were, in fact one of many steps! So stay tuned for parts 4 & 5 of The Poo Diaries, coming up in the following weeks!
For those that are interested, I also found a great study (one of many, no doubt) that suggests the use of probiotics in infants can prevent the development of allergies, click here to view.
**When I say doing big soft poos everyday, this was aside from when she was withholding due to the fact that, after 15 months of constipation, she was now too afraid to go and doing her darndest to hold it all in, which I will address in a later blog (parts 4 & 5)!
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