Intestinal Microbiota and Child Health

A Review of the Literature

Mikoto Nakamichi, MSN, RN; Dina Madi, PhD, RN


Pediatr Nurs. 2020;46(3):125-137. 

In This Article

Abstract and Introduction


This systematic literature review was conducted to explore the current research evidence for the disruption of intestinal microbiota in children with specific chronic health conditions, as well as to identify the effective approach to promote health through healthy intestinal microbiota in children. Of the initial 180 identified articles, 25 articles were reviewed for the synthesis, and three overarching themes emerged: 1) intestinal microbiota and immuno-inflammatory regulation, 2) intestinal microbiota and metabolic balance, and 3) intestinal microbiota and nervous system: gut-brain axis. Findings repeatedly suggested the protective function of Bifidobacteria and butyrate-producing intestinal microbiota in the development of common childhood chronic health problems across the three themes. Additionally, there were consistent findings of the critical windows of significant interactions between the intestinal microbiota and developing organs/physiologic systems of children. Although much research remains to be done to further understand complex interactions between the intestinal microbiota and human physiology. The present literature review revealed the association between dysbiosis of the intestinal microbiota and common childhood diseases. Based on this evidence, increasing awareness of the influence of intestinal microbiota and implementing practice to promote healthy intestinal microbiota by pediatric health care professionals could be critical for improving health and well-being in children.


It has been known for many years that the human body is colonized by and is a host of many different microorganisms, which are purported microbiomes. Human microbiomes are composed of bacteria, fungi, archaea, viruses, and protozoa, and a majority of them are located in the skin, gastrointestinal tracts, respiratory tracts, and urogenital tracts (Versalovic, 2013). With the advanced genome technology and increased attention on human microbiome research over the past few decades, there is a growing body of studies demonstrating that changes in the number, compositional diversity, and functions of the microbiome are associated with both development of diseases and promotion of health in a human host (Lynch & Pedersen, 2016; Versalovic, 2013; Young, 2017). The intestinal microbiota is considered to be the most diverse and largest community of microorganisms, and is recognized as critical for physiological metabolism, immune-inflammatory responses, and disease susceptibility/resistance of human individuals.

Recent research revealed evidence for microbiome changes related to specific health conditions in infants and children, such as necrotizing enterocolitis, sepsis, colic, malnutrition, atopy/eczema, asthma, allergy, inflammatory bowel disease (IBD), diabetes mellitus and obesity, liver disease, and cognitive behavioral disorders, among others (Johnson & Versalovic, 2012; Kan et al., 2019; Stiemsma & Michels, 2018). On the other hand, the number of children and youth in the United States with chronic health conditions has gravely increased over the last few decades. Approximately 30% of children and adolescents in the United States are affected by chronic health conditions, which further influences their health, social, and academic outcomes, as well as quality of life (Centers for Disease Control and Prevention [CDC], 2017; Miller et al., 2016). Additionally, these illnesses and related negative impacts may persist into adulthood (American Academy of Pediatrics [AAP], 2016; Miller et al., 2016; Perrin et al., 2007). Although the current situation among chronic health conditions in children is immensely concerning, there could be a great deal of potential benefits from interventions of intestinal microbiota research.