Here's an
unidentified flying fact for your consideration: There are 100 trillion (100,000,000,000,000) bacteria - weighing 4 pounds - happily living in your intestines. That's ten times more bacteria than there are cells in your body, more bacteria than the number of stars in our galaxy, more bacteria than the number of humans who have ever lived (estimated, by the way, at 100 billion) ... You get the picture. There are a lot.
Now that I've completely grossed you out, know this: without these guys, you'd be dead. Some scientists even consider our bacterial inhabitants to be an essential body organ because without them your intestines couldn't properly absorb nutrients, the tissues would be thin and easily torn, your immune system would be compromised, you would become vitamin K deficient, you would be unable to digest certain foods. No wonder, then, that most are called "friendly" (probiotic) bacteria.
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Probiotic bacteria and your infant When your baby was born her intestines were was completely free of bacteria. Over the first weeks, as she swallowed milk and saliva, various germs entered her gut and took up residence.
Interestingly, these bacteria are different whether a breast- or bottle-feeder, and whether born by C-section or not. Breast-fed and vaginally-born infants are colonized by more of the friendliest guys of all:
bifidobacteria, while bottle-fed, C-section delivered infants have far fewer. These bifidobacteria seem especially good in promoting intestinal growth and function, helping the immune system to develop, and playing a role in preventing allergies.
By 12-18 months of age, the bacterial flora (as they are picturesquely called) look pretty much the same no matter what the manner of birth or feeding.
Formulas with friendly bacteria? Perhaps another reason "breast is best" is because of this effect. That's why you are now reading about infant formulas containing these "friendly" bacteria. Is it a good idea? Should you buy it?
Although the evidence is pretty thin at this point, I'm saying yes to supplementation (much like a vitamin) in the first year of life with
bifidobateria and
lactobacillus in formula-fed and/or C-section delivered infants. Here's my reasoning:
- Since your infant's intestines are going to become home to lots of bacteria anyway, why not try to duplicate what generally happens in nature (i.e., in a breast-fed, vaginally-born infant).
- Bifidobacteria seem to be very safe; there have been no reports of significant medical problems in infants who ingest them. And there seems to be increasing evidence of their positive role in early infant health.
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Other uses of probiotic bacteria in children? The best evidence for the
therapeutic use of probiotic bacteria is during a diarrheal illness (especially
rotovirus), where they seem to cut down on the severity and duration of the symptoms. Probiotic bacteria have also have been shown to cut down GI disease in sick, premature infants. Other, less proven, uses have included to prevent infections of the genitourinary tract, to treat irritable bowel syndrome, and to help with
preventing and treating eczema in infants.
Again, based on their safety and that it seems to make sense (at least to me), I often recommend using supplements of probiotic bacteria for kids during and after:
- Infectious diarrhea.
- Taking antibiotics for any reason.
- In the care of sick, premature infants (to prevent necrotizing enterocolitis).
- Symptoms of irritable bowel syndrome.
- Cases of severe eczema
- Recurrent urinary tract infections
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Look for supplements containing
bifidobacteria and
lactobacillus. (There is some debate if yogurt alone can do the trick. Personally I'd count more on the supplements you can buy at your drugstore or health food store).
But beware the exorbitant claims made that these bacteria can prevent cancer and cure other illnesses, which seem pretty dubious to me. Here's what the
Harvard Health Letter had to say about this issue (2002):
"Probiotics have been oversold. The claims are that seductive pills, powders, and solutions containing 'friendly' bacteria will boost the immune system, prevent cancer and perform other assorted health miracles...But that doesn't mean it's based on total fiction...The evidence suggests that probiotic therapy could be useful some day as a form of preventive medicine - and not just for diseases affecting the gut."
And since preventive medicine is often best started in infants and children, I'm cautiously coming down on the side of their use, even though the scientific evidence is by no means well established (this is about as "fringey" as I get).
I'm curious: are any of you going down this road? What do your pediatric providers think about this controversial area?
译文:
你是否应该给你婴儿或孩子喂益生菌呢？
这里有一个让你考虑的到处流存但未经确认的事实：在你的肠子里面快活地活着100万亿个细菌，总共重四磅。这些细菌数量比你全身细胞数量的十倍还要多，比我们银河系里的星星还要多，比这个世界上曾经存活过的人的数量还要多（顺便说，估计这个数字为1000亿）。你可以想象到这数量之大。
现在你是不是感觉作呕呢？不过必须知道：如果没有这些细菌你早就死了。甚至有些科学家把我们身内这些细菌当作是我们的基本身体器观。因为如果没有它们，肠子就不能正常地吸引营养，组织就会变得很薄，容易破；就会危及免疫系统的安全；就会缺乏维生素K，就会消化不了某些食物。这样大部分这种细菌被称为益生菌就不足为奇了。
当婴儿出生的时候肠道里面是完全没有细菌的。在最开始的那几周，随着婴儿吞食牛奶、口水，各种微生物进入了它的内部并开始定居。
有意思的是，那些细菌会因为母乳喂养还是用奶瓶喂养，是自然生产还是剖腹产而有所区别。母乳喂养和自然生产的婴儿会有更多的益生菌寄居，而奶瓶喂养和剖腹产的婴儿则少得多。这些益生菌看起来对促进肠道生长和功能发育，有功于免疫系统成长有特别的功效，并且对防止过敏症状有着很好的作用。
益生菌与婴儿
到8-12月大时，无论是什么方式生产和喂养的，身内的细菌丛（这是它们的特别称谓）都不会有什么区别。
含有益生菌的婴儿食品
也许母乳喂养是最好的另一个理由就是益生菌的影响吧。这也是你现在在读这些关于含有益生菌的婴儿食品的读特物。这是一个不错的想法，你会买吗？
虽然关于这一点的证据是非常之薄弱的，我觉得对奶粉喂养或者是剖腹产的婴儿在产后第一年补充益生菌和乳酸菌（就像补充维他命一样）是值得肯定的。以下是我的理由：
- 既然婴儿的肠道迟早都会成为很多细菌生长的地方，为什么不尝试使它像在自然条件下那样的。（例如像：母乳喂养的，自然生产的婴儿）
- 益生菌是很安全的。从来没有出现过关于喂食益生菌而引起明显的医学上的问题的报告。而且越来越多的证据显示它们在婴儿早期健康中扮演着一个重要角色。
益生菌有用最好的证明是医生在痢疾时使用益生菌，可以明显地缓解症状和持续时间。益生菌也被用在降低患病早产儿的GI值。其他一些未经证实的用途有防止泌尿系统感染；治疗急性肠道综合症；预防和治疗婴儿湿疹。
另外，由于安全并且有效（至少我觉得有效）我经常在小孩患以下病或治愈后建议补充益生菌：
- 传染性痢疾；
- 使用抗生素后；
- 婴儿患病或早产儿（预防防死性结肠炎）；
- 有急性肠道综合症的病征；
- 反复性尿道感染。
寻找含有益生菌和乳酸菌的补品（曾有过辩论说只要酸奶酪就可以了。个人认为从药店或健康食品店购买的补品更可靠）但是要小心那些我觉得非常值得怀疑的荒唐说明：这些菌可以防癌和治疗其他疾病。以下是哈佛健康消息上关于这些事件的说明：
益生菌被过份的吹嘘，很多声称这些含有益生菌的药片，药粉，溶液可以促进免疫系统，预防癌症，产生医学奇迹。不过这些也并不都是虚幻的，有证据表明益生菌治疗有朝一日可以用作预防药品，而不仅仅是肠道感染的药物。
因为预防性的药物最后在婴儿或儿童时期即使用，我非常谨慎地批评使用，即使有明显的科学证据证明。
我想：有几个人会沿着这条路走下去呢？婴儿用品供应商门会如何看待这一有争议的领域呢？