Dysbacteriosis in infants: causes, symptoms, diagnosis and treatment

2024 Author: Curtis Blomfield | [email protected]. Last modified: 2023-12-16 20:44

Most parents look forward to the birth of their baby. They prepare for this event by buying diapers, nipples, bottles and other little things. All this is thoroughly washed, washed, ironed, sterilized by mothers and fathers so that their child does not have he alth problems. But, according to statistics, every second family is faced with such a problem as dysbacteriosis in infants. Many are perplexed where this ailment could come from, because the child is carefully cared for, and all the recommendations of the pediatrician are scrupulously implemented. Unfortunately, dysbacteriosis in infants is not always associated with poor hygiene or feeding. An interesting fact is that such a disease does not exist in European countries. More precisely, there is a violation of the functions of the intestine in children, but this is not considered a disease. In the ICD, dysbacteriosis also does not appear. But Russian doctors stubbornly make such a diagnosis for every second baby. If our children have this disease, let's see what affectsits occurrence, how it manifests itself, how to treat it.

Where microbes come from in the child's gastrointestinal tract

The baby's organs begin to form at the stage of the embryo, but during this period they are protected by the placenta and mother's immunity. The first acquaintance with the outside world and the microbes inhabiting it occurs at the moment of birth. It was then that hundreds of microorganisms that live in the vagina of every woman rush into the sterile stomach and intestines of the baby.

But this does not mean that dysbacteriosis will immediately appear in the baby. Among bacteria, there are many "good" ones. They stabilize the process of digestion and assimilation of food in a child, control the number of pathogenic bacteria.

The expansion of microbes that began in the birth canal of a woman does not stop for a second, because the baby is in one way or another in contact with the medical staff of the maternity hospital, breathes hospital air, and undergoes medical procedures. We should not forget about visits to the woman in labor by relatives who come to the ward from the street and previously had contact with different people.

Basically, a sterile baby is defenseless against an avalanche of microscopic creatures seeking to penetrate his body.

They settle in his mouth, esophagus, stomach and intestines. In the first hours, these are simple and facultative (they can live both with and without oxygen) anaerobes. By the first week, their ranks are replenished with archaea and other protozoa. Finally, the process of formation of the microflora of a small person is completed approximately three months after his birth. Athe althy baby in the intestines present:

Bifidobacteria.
Lactobacillus.
E. coli (E.coli).
Klebsiella.
Some mushrooms.

Colostrum

Excellent prevention of dysbacteriosis in infants is the first attachment to the mother's breast. About 30 years ago, in maternity hospitals, babies were brought to women in labor only on the second or third day. Now they are forced to apply babies to the breast already in the first hours after childbirth. As such, women do not yet have milk, only colostrum. This product is rich in beneficial lactobacteria and bifidobacteria, which are very necessary for the child's intestines. Also found in colostrum:

Immunoglobulins.
T-lymphocytes.
Live macrophage lymphocytes.
Neutrophils.
White blood cells (produce interferon).
Oligosaccharides (prevent "bad" bacteria from attaching to the mucous membranes of the digestive tract).
Lactoferrin (helps iron ions to be absorbed by the intestinal walls, depriving pathogenic organisms of the opportunity to develop).
Peroxidase enzymes (destroy bacterial membranes).

Scientists have found that the joint activity of all the above cells and structures successfully resists such microbes:

Clostridia.
Salmonella.
Streptococci.
Bordetella (cause whooping cough).
E. coli (pathogenic).
Vibrio cholerae.
Rotavirus.
Herpes.
Candida mushrooms.
Enteroviruses.
Dysentery pathogens.
Coxsackieviruses, poliomyelitis,hemagglutinating encephalitis, RSV).

Primary and secondary dysbacteriosis

From the above, it can be understood that two hostile "armies" are constantly present in the baby's intestines. One of them is useful cells, proteins and microorganisms. The second is bacteria, fungi and viruses that cause dangerous diseases. Intestinal dysbacteriosis in infants may not begin while the first "army" controls the second, maintaining a certain balance in the microflora.

As soon as it is disturbed, pathogenic microbes instantly begin to multiply, form colonies, penetrate into the mucous membranes, disrupt the normal course of the processes of digestion and assimilation of food.

The amount of beneficial, and especially opportunistic bacteria, should also correspond to the norm. If there are too few or too many of them, the child also begins to have problems with the intestines. An imbalance between beneficial and pathogenic microbes is the main cause of dysbacteriosis in infants. But why is the balance upset? There are already more than a dozen reasons.

Note that there are two types of dysbacteriosis:

Primary (before the onset of intestinal dysfunction, the child was not ill with anything).
Secondary (appears against the background of another disease).

To draw a clear line between them is sometimes difficult, especially if the child does not have an infectious disease. In general, intestinal dysbacteriosis in infants occurs under the following conditions:

Difficult labor with complications.
Problem pregnancy during which the woman was treatedvarious medications, including antibiotics.
A woman taking hormonal drugs and other drugs that enter the baby's digestive tract with milk.
No breastfeeding.
Early introduction of complementary foods.
Inappropriate formula for this baby.
Immaturity of the digestive tract of the baby. More common in premature babies.
Bad environment.
Long stay in the hospital (this increases the risk of catching pathogenic microbes).
Mother's diseases (mastitis, bacteriosis, dysbacteriosis, allergies).
Baby diseases. A lot of them. The main ones include SARS, rickets, anemia, allergies, bronchial asthma, diabetes mellitus.
Treating baby or mother with antibiotics.

Classification

There are four degrees of dysbacteriosis:

First (compensated). Its important feature - the well-being of the child does not cause concern. He eats, stays awake without crying, sleeps peacefully. At this stage, signs of dysbacteriosis in infants are unstable weight gain, poor appetite, increased gas formation and colorless (weakly colored) feces. Such disorders are caused by malnutrition of the mother or child.
Second (subcompensated). This degree requires treatment with medicines, as it is caused by the activity of pathogenic microorganisms that have bred in the intestines. Analysis of feces at grade 2 reveals the presence of staphylococcus or yeast-like fungi. Sometimes it contains proteins. How does it manifest itselfinfants dysbacteriosis 2 degrees? The main symptom is a change in feces. It acquires a green tint and an unpleasant odor. Often there are white lumps of undigested milk in it. The child is tormented by pain in the tummy, gas, diarrhea, because of which he becomes capricious, refuses to eat, sleeps restlessly. Constipation is rare in this grade.
Third (decompensated). Most often, it occurs when parents, at the first appearance of dysbacteriosis, tried to treat the baby with their own methods and let the situation get out of control. All signs of dysbacteriosis in infants, characteristic of the previous stage, are intensified: the child experiences abdominal pain, he is tormented by gases, diarrhea. The feces acquire a stable green tint and the smell of a rotten egg. They also contain fragments of undigested food, a pole, mucus is added, and sometimes streaks of blood. The child is very weak, eats almost nothing. Prolonged diarrhea can lead to dehydration. This is manifested in skin turgor and weak muscle activity. For babies, dehydration is deadly. Therefore, a child with diarrhea that has been observed for several days must be hospitalized.
Fourth. This stage is rarely reached. Microorganisms from the child's intestines spread to other organs, causing them to become inflamed. The patient has clear signs of intoxication - vomiting, fever, incessant diarrhea (fecal masses are practically unformed, muco-watery). Without urgent resuscitation, the infant dies.

Breastfeeding

Of course, breastfeeding is a priority. It contains vitamins, mother's antibodies, which provide the baby with passive immunity.

But even on breastfeeding, dysbacteriosis in infants is diagnosed quite often. The main reason is the imperfect work of the digestive organs, which is fully adjusted by three months. Often the disease occurs due to such reasons:

Poor hygiene. Microbes can enter the baby's body with a dirty nipple, bottle, pacifier, toys, and other items that the child touches. Hygiene must be observed by everyone who comes into contact with the baby. Many microorganisms do not harm adults, as they have already developed immunity. But the child does not yet have a strong immune defense.
Diseases of mother or baby. If this happens, doctors try not to prescribe antibiotics. These drugs in the intestines kill both the "bad" microorganisms and the "good" ones. In infants, dysbacteriosis after antibiotics is observed in most cases. To prevent this from happening, the child must be prescribed drugs that protect the intestinal microflora during the treatment period.
Mom's poor nutrition. Women who are breastfeeding should remember that the well-being of the baby depends on their diet. Therefore, many, even he althy foods that can cause disruption of the intestines of the crumbs, must be excluded from the menu. These include plums, apricots, strawberries, grapes, smoked meats, pickles, cucumbers, cabbage, coffee and other products. Very often atthe child's bowel problems disappear after the mother excludes "dangerous" foods from her menu.

Symptoms of dysbacteriosis in a breastfed baby may be as follows:

Feces of a frothy nature. It often contains mucus. This is one of the main signs that manifests a problem in the intestines.
Tummy growling.
In the process of feeding or immediately after it, frequent regurgitation, sometimes turning into vomiting.
Weak weight gain or loss.
Crankiness, restlessness of the child for no apparent reason (the diaper is dry, the baby is fed).

In some children, dysbacteriosis is accompanied by a rash. It can cover large areas of the body or look like individual pimples.

Artificial feeding

At the maternity hospital, nurses and doctors make sure that mothers put their babies to the breast. At home, some parents immediately transfer the child to artificial feeding.

Now the composition of both domestic and imported milk formulas is made as close as possible to breast milk. They include a balanced complex of vitamins, probiotics, prebiotics, proteins, and other useful substances. Therefore, modern children who receive such nutrition grow up he althy.

But dysbacteriosis in formula-fed infants is diagnosed much more often than in their peers who receive mother's milk. This is due to the fact that while our technologies are not able to accurately reproduce whatnature creates. So, mixtures cannot serve as a source of many of the beneficial bacteria that get to the baby with breast milk. The microflora in the intestines of the "artificial" turns out to be depleted, since it is represented only by E. coli. This greatly complicates the process of assimilation of food.

The benefit of artificial feeding is only that you can know exactly the amount of what the baby ate (on the scale on the bottle), that is, it is better to control weight gain.

Symptoms of dysbacteriosis in infants growing on formula milk:

Problems with stool. Some babies have diarrhea. The stool becomes watery and colorless. Other children suffer from constipation and increased gas formation. For this reason, they often, as they say, start screaming, kicking their legs, arching. According to mothers who refused to breastfeed, constipation in their babies is much more common than diarrhea.
Regurgitation, even if the baby is held in a “column” after feeding.
Further development of the disease can cause fever and a rash on the body.

Complementary food

Often, dysbacteriosis in infants, both breastfed and bottle-fed, begins due to premature introduction of complementary foods:

Fruit juice and puree.
Fermented milk products.
Eggs.
Vegetables.
Meat.

All these products are very useful, rich in vitamins and microelements, but the child's body should get acquainted with them when his digestive system is already strong enough and able to absorb a newfood.

timing of the introduction of complementary foods

On all food products for children offered in the distribution network, not only the expiration date and composition are indicated, but also the age at which they can be introduced into the diet. It is necessary to observe these terms, and also to understand that the body of each person - large or small, has individual characteristics. So what works great for one child may cause bowel dysfunction in another.

Diagnosis

When a child develops diarrhea, as a rule, pediatricians prescribe an analysis for dysbacteriosis. In infants, parents collect feces from a diaper and take the biomaterial to the laboratory.

Bacteria culture can identify about 25 types of bacteria, including beneficial and opportunistic species, as well as determine the percentage of each type of microorganism present in the baby's intestines.

Also, in the results of the analysis for dysbacteriosis in infants, the ratio of "good" and "bad" microorganisms is indicated, the resistance of the latter to antibiotics is revealed.

In addition to bakposev, another analysis is performed - a coprogram. It is used to determine whether there is inflammation in the intestines, as well as the degree of digestion of food fragments present in the feces.

The main disadvantage of bakposev is the duration of the preparation of this analysis, which is at least 7 days (bacteria must grow and multiply). During this time, the baby has time to undergo treatment. Therefore, the results are often out of date.

Another shortcoming of this analysis isthat it gives an idea of the microflora of the lower intestine only, without showing what is happening in the whole organ.

Excretory breath test is now being performed in some medical centers. It is based on deciphering the chemical elements exhaled by the child. This is done using gas-liquid chromatography. The fact is that each type of microbe in the process of life releases substances peculiar only to it into the environment. They are determined in the exhaled air. The test result is prepared in just a few hours. It shows whether or not a child has microbes in the gastrointestinal tract, what types and in what quantity. Such an analysis is expensive, but it helps to immediately begin treatment of dysbacteriosis in infants. Feedback from parents about this research method is mixed. Its advantages are painless and short waiting time for the result. As disadvantages, the test is not informative (errors often occur) and the difficulty of conducting it for infants.

Bakposev is desirable to repeat after the end of treatment, in order to know how much the microflora in the intestines of the crumbs has recovered. Biomass is taken 12 or more hours after taking an antibiotic, and in case of prebiotic therapy - a month after its end.

Treatment of dysbacteriosis in infants

Therapeutic activities for young patients are always carried out in a complex. The child is prescribed the following medications:

"Bacteriophage". The drug is produced for each microbe separately. He includes in hiscomposition of polyvalent bacteriophages that destroy only dangerous bacteria and do not touch beneficial ones.
Sorbents (to remove microbial waste products from the body). Drugs of choice: Karbofan, Polysorbent, Smecta, Mycosorb, Enterosorb.
Enzymes. Their role is to help establish normal digestion. Drugs of choice: Panzinorm, Oraza, Pancreatin, Festal, Cholenzim.
Antibiotics. Appointed strictly according to indications. Drugs of choice: Diflucan, Macropen, Chlorophyllipt, Erythromycin, Meksaz.
In parallel with antibiotics, children are prescribed "Dialact", "Lactobacterin", which protect the beneficial intestinal microflora from destruction by antibiotics.
Probiotics. They restore the disturbed balance in the intestines. Preparations: "Lactobacterin", "Enterol", "Lineks", "Bifikol".
Prebiotics. They activate the production of the necessary bacteria in the body. Preparations: "Lactose", "Lactulose".

When treating dysbacteriosis in infants, doctors can prescribe physiotherapy, herbal and vitamin therapy.

It is recommended during this period not to give the baby any new foods, not to change the mixture, to observe hygiene, often walk with the child, as fresh air and sunlight help to strengthen the immune system and renew the cells of the intestinal mucosa.