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

Background and Significance

As can be seen in the development and increased usage of antibiotics in the 20th century, most microorganism studies had previously focused on invasive and pathogenic features. Fewer studies had examined the benefits and contributions of the microorganisms to a human host until recent years (National Institutes of Health [NIH] Human Microbiome Project [HMP] Working Group, 2009). The breakthrough of the human microbiome research has come following the completion and publication of the human genome sequence in 2000 and 2003 (National Human Genome Research Institute, n.d.). Some researchers argued about the importance of understanding the interactive activities between humans and microorganisms living in and on them to complete the project (Davies, 2001).

As a result of increasing attention, in 2007, the NIH initiated the "Human Microbiome Project" to gain understanding about the characteristics in compositions of the human microbiome and factors that may influence its compositions, and to examine associations between the changes in the human microbiome and health/diseases, especially in certain medical conditions. With recent research efforts and improved gene sequencing technology, scientists started realizing the benefits and contributions from these organisms. These include such elements as the immune maturation and responses, prevention from pathogen overgrowth, regulation of intestinal endocrine functions, neurologic signaling, energy biogenesis, biosynthesis and metabolism of vitamins, neurotransmitters, and several other compounds in a human host (Lynch & Pedersen, 2016; Young, 2017).

On the other hand, dysbiosis of intestinal microbiota could be associated with certain childhood diseases through altering functions of the immune-inflammatory system, physiologic metabolism, and the intestinal-brain axis in their developing organs (Johnson & Versalovic, 2012; McVey Neufeld et al., 2016; Slattery et al., 2016; Stiemsma & Michels, 2018). Interestingly, these conditions are consistent with common chronic health conditions in children and adolescents. For example, the percentage of obese children and adolescents increased by about 15% between 1980 and 2014 (CDD, 2016; Partnership for a Healthier America, n.d.). In the same manner, the incidence of childhood allergies, behavioral problems, and learning disabilities have also increased (Miller et al., 2016; Perrin et al., 2014).

Moreover, several studies discuss that there is a time-sensitive period for the establishment of diversity shifts in the intestinal microbiota in early life, typically the first 3 years, although the microbiota compositions of preadolescents and adolescents are still distinct from these of adults (Johnson & Versalovic, 2012; Lynch & Pedersen, 2016; Stiemsma & Michels, 2018). These studies also describe several factors that affect the establishment of healthy diversity in the intestinal microbiota community, including infants' gestational age, type of delivery, breastfeeding or formula feeding, diet and dietary supplements, infections and antibiotics uses, hereditary influences, and other environmental factors (Chan et al., 2016; Collado et al., 2015; Johnson & Versalovic, 2012). Therefore, it is crucial for pediatric health care professionals to be aware of both interfering and promoting factors for the establishment and sustention of the intestinal microbiota community in children to prevent common chronic health problems and nurture their health.

For this article, the extent of the problem was assessed, and a systematic review of the literature was undertaken to provide the evidence for the disruption of intestinal microbiota in children with previously mentioned common chronic health conditions. Additionally, the evidence for the beneficial approaches using the manipulation of intestinal microbiota to prevent and/or treat these diseases was determined.