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

Practice Implication

Pediatric health care practice includes well infant/child preventive care, prevention and management of common pediatric acute illnesses, as well as chronic health conditions. Therefore, not only pediatric primary health care providers, but all pediatric health care professionals are particularly well-positioned to assess the current chronic health problems associated with intestinal dysbiosis in children and effectively intervene in them. With the present findings, we could identify a high-risk population of intestinal dysbiosis and associated health problems by taking effective birth history, such as who are prematurely bone, born via cesarean section, and who are not breastmilk fed. We should also monitor and assess regular anthropometric measurements and signs and symptoms of previously discussed common childhood chronic diseases, and perform detailed history taking regarding daily dietary intake focusing on healthy food choices, processed food availabilities, and financial and practical conflicts/stress to healthy food consumptions that may influence on the structure and function of intestinal microbiota. Additionally, we could encourage and assist mothers for breastfeeding practice from the new standpoint that it promotes intestinal microbiota establishment and stabilization, which potentially interact with infants' immune system and resulting in increasing resilience to the above childhood common diseases. We can encourage patients and their families to practice daily healthy food choices such as increasing intake of dietary fiber (raw vegetables and fruits, whole grain products), yogurt/kefir, and traditional ethnic fermented foods to promote function of Bifidobacteria and Butyrate-producing microbiota.

Moreover, we should conduct judicious and thoughtful use and choice of antibiotics in early infancy deliberately, for instance avoiding unnecessary, repeated exposure and favored use of narrow-spectrum antibiotics, instead of macrolide or broad-spectrum antibiotics when possible. Further, we should use probiotics to prevent and alleviate severity of antibiotics-associated diarrhea and restore healthy intestinal ecosystem after the antibiotic exposure. Patients and families should also be encouraged regarding adequate intake of probiotic-rich foods and probiotic products. Finally, health care providers may want to consider prenatal, postnatal, and childhood probiotics supplementations and/or prescription when the discussed clinical conditions in otherwise healthy children as adjunction to the current prevention guidelines and standard treatment regimens with patients/families wishes under the safety cautions.