Dysbacteriosis in newborns. Dysbacteriosis in infants - a real problem or a medical myth

Dysbacteriosis is a fairly common occurrence in infants, but if an adult can tell about health problems, then diagnosing the disease in a child causes some difficulties. What symptoms accompany dysbiosis? How to treat dysbiosis in infants? What signs should you look out for? All these questions must be answered in order to cope with the disease.

What is dysbiosis

Reasons for the development of dysbiosis in an infant

Dysbacteriosis in infants is a common phenomenon. It is usually preceded by one of several of the following reasons:

1. Congenital malformations of the gastrointestinal tract, diseases of the stomach and intestines, infections.
2. Long-term use of antibiotics. They kill not only pathogenic, but also beneficial microorganisms.
3. Violation of environmental conditions.
4. Improper diet, including untimely introduction of complementary foods.
5. Weakening of the immune system.
6. Stressful situations, unhealthy family relationships.
7. Wrong choice of milk formulas when artificial feeding.
8. At the very early stage of a child’s development, the intestinal microflora has not yet established itself within the required norms.

Formation of microflora in a baby

For the entire 9 months that the baby is in the womb, he is surrounded by a sterile environment. At this time, his intestines do not contain any bacteria. Their settlement begins during the passage of the fetus through the mother’s birth canal as a result of the baby’s contact with them.

In the first days of life, the baby's intestines are filled with colonies of various microorganisms. Mother's colostrum contains substances that promote the proliferation of beneficial bacteria. Therefore, it is necessary to put the baby to the breast as early as possible.

At first, completely natural dysbacteriosis may occur, associated with an insufficient number of lacto- and bifidobacteria, in which case treatment is not required. If there are no pathologies in the development of the intestine and there is no infection, then by the 5th day after birth the microflora approaches the required framework, and by the month it is completely stabilized.

If the baby’s well-being does not improve, or if digestion difficulties arise again after a normal state, then we can talk about the appearance of dysbacteriosis. In this case, treatment is required.

Symptoms of dysbiosis in an infant

Diagnosis of dysbiosis and its treatment in an infant has its own characteristics. Unfortunately, it is impossible to ask him about his well-being, so you should proceed from your observations of his condition:

1. Colic. A couple of hours after eating, the child begins to be capricious and “kink” his legs.
2. The child sleeps poorly and does not gain weight well.
3. Curdled lumps of milk appear in the stool.
4. Increased gas formation, which is accompanied by regurgitation and painful release.
5. Change in stool color, up to green.
6. Oral thrush and skin rash.
7. When the condition is neglected, symptoms such as fever, diarrhea and vomiting appear.

If you notice these symptoms, you should immediately consult a doctor, especially if the child has already reached one month of age. Until this moment, mild manifestations of intestinal dysbiosis are not a disease; this is a natural condition of a newborn.

To understand at what point to start sounding the alarm, you need to understand the degrees of dysbiosis and consider the symptoms characteristic of them. Degree of development of intestinal dysbiosis in an infant

Pediatricians divide the development of dysbiosis into several phases:

1. Compressed. The child has a decrease in appetite and instability in weight gain. The color of stool becomes light shades of brown. This condition is usually associated with malnutrition and reaction to complementary foods or allergens. At this stage, the baby’s condition does not cause concern.
2. Subcompensated. Symptoms of this stage are more pronounced: severe abdominal pain, loss of appetite, diarrhea, or, conversely, constipation. The color of the stool is uneven with a greenish tint and clots of food. In this case, when taking a blood test, pathogenic microflora is detected in it.
3. Decompensated. All previous symptoms appear to a much greater extent. The smell of stool is reminiscent of a rotten egg. Such symptoms raise strong concerns for the child’s condition. There is a lack of weight gain, anemia and signs of rickets.
4. 4th degree. The smell of feces acquires putrid shades, there is a stable green color and a liquid consistency. Intoxication of the body begins, which is accompanied by weakness, complete refusal to eat, fever, weight loss. These signs require immediate hospitalization.

Pronounced symptoms should be a signal for immediate medical attention. The doctor will determine the extent of the disease and prescribe appropriate treatment.

Treatment of intestinal dysbiosis in an infant

It is important to promptly diagnose intestinal dysbiosis in an infant and begin to treat it. Treatment of advanced stages of the disease takes more time and can have a negative impact on the development of the child. Treatment of intestinal dysbiosis in an infant is carried out in several stages:

1. Optimizing a newborn's diet. The ideal food for a child is breast milk; if for some reason this is not possible, then it is replaced with adapted milk formulas that contain the necessary beneficial bacteria.
2. Suppression of the proliferation of pathogenic bacteria. For this, special immunopreparations are prescribed, which contain bacteriophages that absorb unwanted microorganisms.
3. Colonization of the intestines with the necessary microorganisms. This happens with the help of probiotics.
4. If the child refuses to eat, its deficiency should be filled with sweet tea or solutions that the pediatrician can prescribe.

The best treatment for intestinal dysbiosis is its prevention. Even during pregnancy, the expectant mother should take care of the state of her own microflora, since it is with her that the baby will have to contact when leaving the birth canal. It is also important to put the baby to the breast in the first hours after birth. If everything is done correctly, then there will be no situations when the baby needs treatment.

After discharge from the hospital, you could not get enough of your baby: he was so healthy, cheerful, calm, slept for a long time and ate with appetite. And his stool was the same as it is described in books: in smell and consistency it resembled thick sour cream, but suddenly it became watery, green, pieces of mucus or bloody streaks, streaks of blood are visible in it. Something went wrong with the skin: dryness, peeling, redness appeared. Yes, and the baby sucks badly: a few minutes after the start of feeding, he refuses to breastfeed, cries, bends his legs. What happened? Most likely, the newborn has intestinal dysbiosis.

The thing is that a newborn is born with a sterile intestine, in which there are no bacteria. The colonization of microorganisms begins when passing through the birth canal of the mother.

Then, during the first five to seven days of life, the intestines of all healthy full-term breastfed babies are colonized by bifidobacteria, and by the month of life - by lactobacilli. These two species make up 90 to 95% of the intestinal microflora.

This relationship is not accidental: the child’s body and its environment represent a single ecological system that is in a state of biological equilibrium. Any qualitative and quantitative disturbance of this balance is called intestinal dysbiosis. The absence or deficiency of even one type of bacteria leads not only to intestinal dysfunction, but also to impaired immunity, metabolism, rickets, and food allergies.

SYMPTOMS OF DYSBACTERIOSIS IN NEWBORNS

At the beginning, intestinal dysbiosis may not appear outwardly, but as soon as the body weakens, clinical symptoms appear. The mother should be alerted to the lack of weight gain in the baby, changes in the skin, the appearance of allergic dermatitis, thrush or stomatitis on the mucous membranes, decreased or lack of appetite, constipation, regurgitation, vomiting, putrid breath, increased salivation, flatulence, bloating, pain in the abdomen, increased frequency and change in stool consistency.

All these symptoms allow the doctor to suspect the development of intestinal dysbiosis in the child. However, to make a final diagnosis it is necessary to carry out laboratory diagnostics.

Unfortunately, dysbiosis has become a very common problem, especially among children who are often sick. Most often and most quickly, the normal composition of the microflora is disrupted in children of the first year of life: any intestinal infection in them is usually accompanied by intestinal dysbiosis.

FACTORS CONTRIBUTING TO DYSBACTERIOSIS

1. In newborns:

Maternal health problems
Pathology during childbirth
Late breastfeeding
Long stay in the maternity hospital
Physiological immaturity of intestinal motor function
Presence of small pustular infections
Malabsorption from the intestine
Primary immunodeficiency

2. In infancy and early age:

Unfavorable course of the newborn period
Early artificial feeding
Dyspeptic disorders (vomiting, regurgitation, constipation, intestinal dysfunction)
Frequent acute viral diseases in the first year of life
Phenomena of allergic dermatitis, rickets, anemia, malnutrition
Changes in the psychoneurological status of the child
Infectious or other pathology.

3. In children of preschool and school age:

Poor nutrition
Being in closed groups
Presence of chronic diseases
Frequent acute respiratory viral infections
Allergic reactions, hormonal changes in the body

4. Factors independent of age group:

Intestinal infections
Frequent use of antibacterial drugs
Long-term treatment with hormonal and anti-inflammatory drugs
Surgical interventions
Stress

TREATMENT OF DYSBACTERIOSIS

First of all, treatment of intestinal dysbiosis begins with nutritional correction. If age allows, fermented milk mixtures or fermented milk products are included in the child’s diet. However, the basis of treatment is biologically active preparations containing live bifidobacteria and lactobacilli. These drugs are cultures of normal intestinal microflora, promote its engraftment and reduce intestinal dysbiosis. These same drugs are recommended for use in weakened children for preventive purposes: ten days before and after vaccination.

If the production and absorption of vitamins, micro- and macroelements is impaired, children should be included in their treatment with multivitamin preparations with mineral supplements in age-appropriate dosages. In some cases, intestinal dysbiosis may not be an independent problem, but only one of the symptoms of a disease. In such a situation, first of all, it is necessary to take care of the treatment of the underlying disease.

PREVENTION OF DYSBACTERIOSIS

An expectant mother can prevent the development of this disease in her child if she eats right and consumes foods containing a lot of fiber: bran, oatmeal, salads dressed with vegetable oil. It is also recommended to introduce into the diet berries and fruits that regulate intestinal function: apples, apricots, grapefruits, black currants.

In children, prevention of intestinal microflora disorders begins with early breastfeeding, natural feeding, and a rational, balanced diet.

Careful observation of the child: the nature of the stool, appetite, body weight, will help you avoid this problem or suspect and treat it at the very initial stages.

Dysbacteriosis is a violation of the healthy composition of the intestinal bacterial flora, which is expressed in loose stools. Dysbacteriosis in a newborn baby causes incomplete absorption of milk (infant formula) and insufficient weight gain in the newborn.

If left untreated, it becomes a serious problem for an infant. How to treat dysbiosis in infants, and what remedies can be used independently, without consulting a doctor?

How to determine dysbiosis

In order to treat effectively, it is necessary to correctly determine the cause of the disease, to be sure that loose stool in a child is only dysbacteriosis, and not a disease of the digestive system, poisoning, or an infectious process.
Dysbacteriosis is diagnosed by the presence of loose stools in a child.

In addition, the stool becomes heterogeneous and contains clots, mucus, grains, and liquid. The stools may appear green, unpleasant smell, foam.

A pungent odor can also come from the baby's mouth. There may be severe regurgitation, a rash on the skin, plaque on the tongue and teeth. The above symptoms are extreme. They appear when the microflora is severely disrupted as a result of poisoning, infections, or taking antibiotics.

Dysbacteriosis can be a consequence of a serious illness, infection, or poisoning. In case of aggravating factors, medical consultation and comprehensive treatment are necessary.

Dysbacteriosis and intestinal flora

At birth, the baby does not have any intestinal bacterial flora. The baby is born sterile and becomes familiar with various microorganisms after birth. With the first feedings, his intestines will become colonized with bacteria. They come from colostrum and mother's milk along with enzymes.

The formation of the intestinal flora of a newborn baby occurs during the first 10 days after birth. If there is an insufficient number of bacteria in the milk, colonization of the intestines occurs slowly and incompletely, and the child develops dysbacteriosis.

The emerging intestinal flora consists of 90% bifidobacteria. The remaining 10% are lactobacilli, Escherichia coli (colibacteria), and Bacillus subtilis. They not only digest proteins, fats and carbohydrates.

They also synthesize enzymes, vitamins, and protect against pathogenic microbes and viruses. The aggressive effect on the intestinal flora of certain medications also causes disturbances in intestinal function. Thus, dysbiosis after antibiotics in infants is a consequence of the death of friendly flora from the aggressive action of the antibacterial component.

After final formation, the intestinal flora consists of a huge number of microorganisms. 1 mg of intestinal contents contains from 500 thousand to 1 million lacto-, bifido- and colinebacteria.

How to treat dysbiosis in infants: breast milk

The reason is a violation of the child’s intestinal flora, its incomplete formation or the death of some bacteria as a result of aggressive influence (external or internal toxins, infection).

In order to cure dysbiosis, it is necessary to replenish the composition of friendly beneficial flora. At the same time, the normal amount of necessary bacteria will take control of pathogenic microorganisms, prevent their further reproduction, and over time, reduce the number of pathogens to the required norm.

In order to normalize the bacterial composition of the infant's intestinal flora, he is given pharmaceutical preparations - so-called probiotics. Or they eat foods that contain lacto- and bifidobacteria, or substances necessary for their life (fiber).

For an infant feeding on mother's milk, the main food is the source of the necessary living flora. Breast milk contains lactic acid bacteria as well as enzymes to digest and absorb food. For example, amylase, protease, lipase, which help break down milk fats and convert them into lactic acids for absorption.

Enzymes and enzymes are not present in dry milk formulas; they are present only in the milk of a nursing woman. When pumping and storing milk, these substances are lost.

Against the background of breastfeeding “on demand,” dysbiosis in a newborn can go away without additional treatment. If intestinal bowel movements do not normalize and stools do not improve, the baby is given medications with the necessary bacteria.

They populate the intestines and digestive tract, establishing the process of milk digestion. What is used for newborns?

What do pharmaceutical preparations contain

There are three groups of pharmaceutical drugs for the treatment of dysbiosis in children of different ages.

1. Probiotics are a group of pharmaceutical preparations that contain lacto- and bifidobacteria. Their packaging or instructions indicate the names of microorganisms and their concentration in each dose of the drug.
2. Prebiotics are drugs that stimulate the activity of probiotics (bacteria).
3. Symbiotics are complex preparations that contain pro- and prebiotics.

Probiotics can supply the body with live cultures of bacteria or their lyopholized form (dried, frozen, inactivated). They are included in various complex preparations.

When it enters the body’s liquid medium, the lyopholysate becomes active within 4-5 hours, populates the intestinal cavity and begins to displace pathogens. Probiotics can contain various microorganisms. More often than others, they contain lacto- and bifidobacteria.

1. Lactobacilli - are included in the complex pharmaceutical preparations Linex, Acepol, Acelact. When treating dysbiosis, lactobacilli are given first because they remove and replace pathogenic flora. In case of complex treatment, together with taking other lactic acid bacteria, Lactobacterin is given to the baby in the morning.
2. Bifidumbacteria - included in the complex preparations Bifidumbacterin, Linex. Promote the growth of intestinal flora. Since bifidum bacteria favor the growth of any intestinal flora, drugs containing them are given to the child not at the beginning of treatment, but only after the number of pathogens in the intestines has been reduced to normal (after several days of taking drugs with lactobacilli).

Some pharmaceutical preparations that are used to treat dysbiosis in newborn babies do not contain bacteria, but their metabolic products.

Namely, vitamins and acids that are produced in the intestines for food digestion and immune protection. An example of such a drug is Hilak Forte, which is also prescribed to newborns for dysbiosis.

How to treat dysbiosis in children: list of remedies

We list the most commonly prescribed anti-dysbacteriosis medications for newborns:

• Acipol - contains lyopholized (inactivated, dried, but preserved alive) pieces of lactobacilli and kefir fungus. When added to water, milk, lyopholized bacteria come to a living, active state within 4-5 hours. That is, once they enter the intestine, they begin to multiply and populate its cavity. In this composition, kefir grains are a prebiotic - a substance on the basis of which lactobacilli multiply.
• Acylact – contains lyopholized lactobacilli. Available in powder form for dilution.
• Linex - contains lacto-, bifidobacteria and a small amount of streptococci.
• Bifilin, Bifiform + bifiform baby - contain bifidobacteria.
• Bifidumbacterin forte – contains bifidum bacteria on activated carbon. Shows additional detoxifying effect
• Biosporin - contains spores of living microorganisms - Bacillus subtilis and so-called Marine bacteria.
• Primadophilus - contains lactobacilli, Primadophilus Bifidus - contains a complex of lactobacilli and bifidobacteria.
• Bactisuptil is dried spores of microorganisms, also kaolin and calcium carbonate. This is a complex-action drug that, in addition to populating the intestines with beneficial flora, removes toxins (creolin - clay, a natural detoxifier) ​​and prevents rickets, which often accompanies long-term dysbacteriosis. According to the instructions, this drug is given to children over 5 years of age. However, doctors often prescribe it for children under one year old and newborns.

Folk remedies for dysbacteriosis

Chamomile is a natural antiseptic and detoxifier. In addition, it has a carminative effect, which helps cope with flatulence in newborns. To treat and prevent dysbiosis in newborns, chamomile is brewed in a weak concentration - 0.5 liters of water - 0.5 teaspoon of dried flowers.

The resulting light yellow solution is given to the baby before each bottle feeding. After that, after 10-15 minutes, when the child feels hungry again, they give a breast.

- is a supplier of lactic acid bacteria. When treating dysbiosis in a newborn or infant during the first months of life, kefir is used for enemas. It is necessary to introduce a small amount of kefir into the baby’s intestines (at the rate of 10 g for each kilogram of his weight). Number of procedures – 2-3.

Dysbacteriosis in infants is not a disease, but a consequence. It is necessary to find out the root cause of the disruption of normal intestinal microflora and only then treat the child. First of all, it is important to adjust the nutrition of the baby and the nursing mother. If necessary and as prescribed by a doctor, you can take probiotics and prebiotics.

During intrauterine development, the gastrointestinal tract (GIT) of the fetus is sterile. The first colonization of the mucous membrane and skin of a newborn by bacteria and microbes occurs when moving through the mother’s birth canal. Then there will be breastfeeding, contact with the mother and medical staff, the equipment of the delivery room, water when washing, etc. This process is inevitable. Gradually, the baby develops an individual and unique composition of microflora. In this case, the percentage of bacteria is determined at the genetic level and is transmitted from mother to child. About 400 species of bacteria must coexist in his intestines without “quarreling” with each other. What influences the combination of beneficial and opportunistic bacteria in the intestines? How to help if a failure occurs and there are symptoms of dysbiosis in the baby?

Is dysbiosis possible in a newborn?

This diagnosis is often made in newborns and children in the first month of life. In what cases is this justified?

• Late breastfeeding. Breast milk is a source of bifidobacteria and the best prevention of dysbacteriosis. About a week after the first breastfeeding, about 95-98% of beneficial milk bacteria are found in the newborn's intestines. If for some reason breastfeeding begins later or does not begin at all, the intestines become colonized with opportunistic bacteria. It cannot be said that dysbacteriosis immediately develops. Rather, the preconditions are being created for further disruption in the microflora.
• Forced use of antibiotics. Unfortunately, there are situations when a baby cannot do without antibiotics. Then you have to choose the lesser of two evils - side effects during treatment with antibacterial drugs. Broad-spectrum antibiotics are the most destructive to the newborn's microflora. If antibiotic therapy is carried out while breastfeeding, the intestinal microflora is restored much faster. One conclusion can be drawn: a woman should try to maintain breastfeeding for at least six months.

All other reasons are not significant and do not deserve attention. Mom has so much trouble and worry that she shouldn’t bother herself with a non-existent diagnosis.

Signs of microflora disturbance

How does dysbacteriosis manifest in infants? Short-term digestive disorders in an infant are normal. But if symptoms recur and get worse, it may indicate a more persistent imbalance in the gut.

• Baby's anxiety. Poor sleep, refusal to eat, weight loss or poor gain.
• Watery, greenish diarrhea. It may contain mucus impurities, foam, white lumps, particles of undigested food when complementary foods are introduced, and the stool has a putrid odor.
• Frequent constipation. A breastfed baby may poop once every 3 days. And this will be a variant of the norm if the process of defecation occurs independently, without discomfort. Formula-fed children should have a bowel movement at least once a day.
• Unstable chair. Diarrhea can be replaced by prolonged constipation and vice versa.
• Increased gas formation, colic. This symptom can be judged by the child’s behavior: he wiggles his legs, pulls them towards his tummy, and bothers the gas.
• Vomiting after every meal. Most babies experience regurgitation, so it is recommended to keep them upright for about 10 minutes after eating. With dysbacteriosis, regurgitation is profuse and can turn into vomiting.

Dysbacteriosis is not determined by clinical signs alone. It is necessary to pass the appropriate tests.

What analysis will definitely confirm dysbiosis?

Usually a bacteriological research method is prescribed - bacterial culture of stool for the presence of pathogenic microflora. However, it does not give a clear picture, because it does not reveal the parietal microflora of the small intestine. In addition, part of the pathogenic microflora dies if the timing of the analysis is violated and if it comes into contact with air. It is impossible to judge the microflora of the entire intestine from stool.

A biochemical analysis of stool is considered more reliable. It is based on the determination of fatty acids in stool, which are secreted by pathogenic bacteria. The spectrum and quantity of fatty acids indicates the presence of a specific pathogenic microflora and its location. Biochemical analysis also makes it possible to identify lactase and other enzyme deficiency, colitis, irritable bowel syndrome, and determine liver dysfunction.

Most common causes in infants

Too often, all digestive problems are associated with a violation of the intestinal microflora. And the answers sometimes lie on a different plane. Much depends on the nature of the baby’s diet.

• Overfeeding. If the mother chooses the path of feeding on demand, you need to remember an important point: with a sufficient volume of milk, the baby may become hungry only after 2.5–3 hours. Too frequent application can lead to digestive problems, which is explained by the immaturity of enzymes and their insufficient quantity. The food is not completely broken down, the fermentation process begins in the intestines, which causes bloating, colic, and anxiety in the baby.
• Underfeeding. If a baby sucks only foremilk with an excess of lactose and a low fat content, he may develop characteristic digestive symptoms - bloating, green loose stools. Therefore, it is so important that the baby sucks out hindmilk, rich in fats and the enzyme lactase. To do this, it is not recommended to offer another breast until the baby has emptied the first one.
• Switching to another mixture. When artificially feeding, problems with the baby's digestion may arise when the formula is replaced. The baby’s body needs time to produce enzymes for the specific composition of the mixture. The most common cause of digestive problems is lactase deficiency. Lactase deficiency causes the baby's digestive system to be unable to digest and break down lactose. In this case, you need to switch to low-lactose mixtures. It is not recommended to change mixtures too often, and their replacement should be done gradually, with the old mixture being replaced with a new one within a week. Also, a sharp transition from breastfeeding to artificial feeding can lead to dysbacteriosis.
• Early introduction of complementary foods. The most common cause of dysbiosis in infants. If a child drinks fruit juices before 6 months, his diet contains vegetables and fruits, and meat dishes are introduced too early - this is a direct path to gastrointestinal dysfunction. At the first symptoms, they begin to treat dysbacteriosis, and not to revise the diet of the baby. Complementary foods should be introduced gradually, according to the age and individual characteristics of the child's body.

Symptoms of intestinal dysbacteriosis in infants disappear on their own if the wrong approach to nutrition is eliminated. A more serious cause of microflora disturbance is acute intestinal infections caused by pathogens such as E. coli, Staphylococcus aureus, rotavirus, salmonella and others. In this case, dysbacteriosis is delayed for a longer period. And the younger the child, the slower the process of self-regulation goes.

4 degrees of dysbacteriosis

In the medical literature you can find a description of 4 degrees of dysbiosis.

• First. Bifidobacteria and lactobacilli predominate significantly. There are only two types of opportunistic bacteria in the feces that do not make the weather in the intestines. In essence, this is a healthy state of the body. Usually no symptoms appear, nothing bothers the baby. The first stage is called a dysbacterial reaction - a short-term violation of the microflora. It can occur during breastfeeding, when the mother ate something wrong, when introducing complementary foods, switching to a new mixture. These failures do not require intervention, the body independently regulates and restores the composition of the microflora.
• Second. Dysbacteriosis of the 2nd degree in an infant is a more active suppression of normal microflora, when the percentage of beneficial and harmful bacteria is equalized. Hemolyzing and lactose-negative Escherichia coli are found in the stool. This leads to bloating, colic, and diarrhea. The baby may experience slight weight gain. At this stage, the pediatrician may prescribe treatment or suggest reviewing the nutrition of the nursing mother and the bottle-fed baby.
• Third. Opportunistic microflora begins to dominate in the intestines. Staphylococci, Proteus, Serration, Klebsiella and other bacteria are found in large quantities. This leads to a prolonged inflammatory process in the intestines, abdominal pain, and prolonged diarrhea with particles of undigested food. The doctor will recommend mandatory treatment for such a clinical picture.
• Fourth. Rapid growth of pathogenic microflora. Symptoms intensify, intoxication of the body begins, and with prolonged diarrhea, weight loss is observed, which is dangerous for the health of the baby. At this stage, dysbiosis can become chronic and provoke intestinal infections. Then it will be much more difficult to cope with the problem.

Most pediatricians of the new generation treat information about the degrees of dysbiosis as a relic. Just ten years ago, these data seemed serious and completely justified. Today, doctors are in no hurry to treat dysbiosis, giving the microflora the opportunity to regenerate itself.

Features of treatment

Most often, in case of acute intestinal infections and after taking antibiotics, the doctor prescribes therapy with special drugs - probiotics and prebiotics.

Probiotics

Probiotics (eubiotics) are a group of living microorganisms that are beneficial to humans. The most important: various types of bifidobacteria and lactobacilli, yeast fungi, beneficial enterococci, E. coli. The task of probiotics is to balance the intestinal microflora, displace pathogenic bacteria and normalize digestive processes. Probiotics come in dry and liquid forms. These drugs are also classified according to the time of creation. Today there are five generations of probiotics.

Table - The most famous probiotics

Probiotic group	Peculiarities	Drug name
One-component	Only one strain of bacteria	"Bifimbacterin", "Lactobacterin", "Biobakton"
Multicomponent	Several strains of one bacterium	"Acilact", "Linex", "Acipol"
Symbiotics (combined)	Several strains of one bacterium, several types of different bacteria	"Bifiform", "Bifiliz", "Hilak forte"
Sorptive	With the addition of enterosobrents	"Bifidumbacterin forte", "Probiform", "Florin forte"

Only a doctor can prescribe probiotics. The duration of therapy depends on the severity of dysbiosis and the type of drug. For example, for minor gastrointestinal dysfunctions, first generation probiotics are prescribed. The child drinks them for a month. And for acute intestinal infections and poisoning, it is recommended to take probiotics of the third and fourth generations for a week.

Prebiotics

Prebiotics are organic substances that can stimulate the growth of beneficial bacteria. By their chemical nature, these can be proteins, carbohydrates and vitamins. Prebiotics are made from natural raw materials: soybeans, whey, sugar beets, sugar cane, cereals, mushrooms, algae.

Table - The most famous prebiotics

Prebiotics for infants are available in different dosage forms: granules, syrups, powders. Their main functions:

• suppressing the growth of pathogenic microflora and enhancing the growth of beneficial ones;
• elimination of mucus and increased gas formation;
• healing of the walls of the large intestine;
• eliminating constipation, improving intestinal motility;
• stimulation of the synthesis of vitamins B and K;
• maintaining normal acidity levels;
• stimulation of the immune system.

Probiotics and prebiotics are often prescribed together for greater therapeutic effect. There are drugs called “synbiotics” that contain both types of drugs. The most famous of them is “Maxilak”.

How to treat dysbiosis in infants? Most often, treatment consists of eliminating factors that influence microflora disturbances. Many modern pediatricians, especially foreign ones, believe that it is impossible to interfere with the formation of the intestinal microflora of an infant. There is also an opinion that most of the beneficial bacteria in the preparations die in the stomach and do not enter the child’s intestines.

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Dysbacteriosis is a violation of the qualitative and quantitative balance of bacteria inhabiting the intestinal walls. According to the ICD, it is not considered a disease, but a condition that occurs as a result of certain pathological processes in the body. The imbalance of microflora must be eliminated, because it negatively affects the well-being of the newborn. Let's figure out how dysbiosis manifests itself in infants, and also find out its causes.

Risk factors

The intestinal microflora is formed in the first months of a child’s life. During this period, transient dysbiosis occurs, which does not need to be treated. But under the influence of negative factors, the balance between beneficial and pathogenic organisms on the mucous membranes of the gastrointestinal tract is significantly disrupted. This condition requires attention from parents.

Causes of dysbiosis:

1. Complete absence of breastfeeding or early transition to an adapted diet. , which are consumed by bottle-fed babies, have a balanced composition, but unlike mother’s milk, they do not help the process of microflora formation.
2. Use of antimicrobial agents. After a broad spectrum course, not only pathogenic agents die, but also lacto- and bifidobacteria. After antibiotics taken by a nursing mother, there is also a deterioration in the functioning of the baby's intestines.
3. Premature entry. Until six months, a baby’s gastrointestinal tract is not able to digest solid food; introducing adult foods ahead of time leads to a significant disruption of the digestion process. The same negative effects occur after eating whole cow's milk or up to a year.
4. Intestinal infections. After them, inflammation of the intestinal mucosa occurs, and conditions are created for the growth of pathogenic bacteria.
5. . A child’s gastrointestinal tract is very sensitive; allergens easily damage the cells of its epithelial membranes, as a result of which their functioning is impaired.
6. Frequent illnesses, poor nutrition, environmental pollution and other factors that provoke a general decrease in immunity.

Clinical picture

Symptoms of dysbiosis after antibiotics or infections are varied. The most commonly found signs are:

• problems with defecation – liquid stool, irregular bowel movements, unusual type of bowel movements
• bloating and associated pain
• profuse regurgitation
• loss of appetite - reduction in portions, refusal to breastfeed
• poor weight gain
• moodiness, sleep disturbance
• rash on the body
• symptoms of general intoxication – fever, weakness

The most striking manifestation of dysbiosis in a newborn is considered to be disturbed stool. Let's look at all the symptoms in more detail.

Diarrhea

The frequency and consistency of bowel movements in infants is determined by the nutrition they receive. While breastfeeding, stool can be observed from 1 to 12 times a day (after each meal). The stool looks like a yellowish paste and has a cheesy odor.

Formula-fed babies poop 1-2 times a day. The stool is thick brown with a characteristic aroma.

With dysbiosis after taking antibiotics or under the influence of other factors, children experience diarrhea. Its symptoms:

• sudden increase in the frequency of bowel movements - feces more often than 8-12 times a day
• watery texture
• presence of mucus
• Strong smell

Frequent liquid stool is dangerous because after it the child may develop dehydration.

Constipation

The destruction of beneficial bacteria in the intestines after taking antibiotics often leads to the fact that digestion slows down and feces move more slowly through the gastrointestinal tract, that is, constipation occurs. Its signs:

• no stool for more than 3 days in breastfed children, more than 1 day in children receiving adapted nutrition
• before defecation, the child groans, blushes, cries
• feces come out in the form of dark-colored balls with a putrefactive odor

Appearance of stool

Dysbacteriosis is not always accompanied by a change in the frequency of bowel movements. In some cases, there is an uncharacteristic appearance of stool, namely:

• the stool is green or almost black
• feces contain particles of undigested food, mucus, foam and streaks of blood (if the mucous membrane is damaged)
• The discharge has a strong, unpleasant smell of “rotten eggs”

Frequent loose stools may be followed by constipation.

Normally, your baby's stool may contain lumps of undigested milk and a small amount of mucus. You should worry if the volume of foreign inclusions is large.

Flatulence

The deterioration of food digestion due to dysbiosis leads to the fact that its particles remain in the intestines, and fermentation begins, the side effect of which is increased (flatulence).

The baby's tummy swells, becomes tense, and you can hear rumbling and seething in it. Excess air stretches the intestinal walls and causes pain to the baby. He cries and pulls his legs up to his tummy. After the gases pass, the baby’s well-being improves.

The situation gets worse if the baby has rare stools or, conversely, diarrhea. Other reasons for increased flatulence:

• maternal malnutrition - the presence of gas-causing foods in the menu
• your baby drinking a lot of foremilk
• the mixture is too thick or incorrectly selected
• swallowing air while feeding or crying
• overfeeding

Dermatitis

Inflammation of the intestinal mucosa, fermentation of food debris, lack of beneficial bacteria - all these are reasons for insufficient absorption of vitamins and minerals in the gastrointestinal tract. As a result, the condition of the child’s skin worsens – a rash, dry and flaky areas appear.

Most often, irritation occurs on the outside of the elbows, knees and cheeks. Sometimes the corners of the mouth crack. Unlike allergic dermatitis, the rash due to dysbacteriosis does not itch.

It can become damaged by rubbing against clothing and become inflamed. Such a rash must be treated, but not with antihistamines, but with moisturizers and antiseptics.

Other manifestations

Other symptoms of dysbiosis:

1. bad breath - it occurs due to a violation of the microflora of the nasopharynx, often it is colonized by Candida fungi, and the baby develops
2. restless behavior - it is associated with disturbances in the gastrointestinal tract that cause pain and discomfort, including infrequent or frequent bowel movements, as well as flatulence
3. poor weight gain or loss due to decreased appetite and diarrhea

Stages of dysbiosis

Depending on the clinical picture, four degrees of dysbiosis in children are determined. In the first (compensated) degree the baby:

• appetite worsens
• weight gain slows down
• stool changes
• flatulence is observed

In addition, rashes, decreased immunity, and brittle nails may occur.

Signs of the second (subcompensated) degree:

• constipation or diarrhea
• stomach pain due to gas
• stool with mucus and undigested food

The third degree is characterized by the average severity of the child’s condition. Its symptoms:

• weakness
• nausea
• diarrhea
• stop weight gain
• anemia
• slight increase in body temperature

Manifestations of severe dysbacteriosis:

• very frequent bowel movements - more than 10-12 times a day
• weight loss
• hyperthermia (above 38 °C)

Symptoms of microflora imbalance increase gradually. The most severe symptoms occur due to the spread of pathogenic microorganisms and general intoxication.

When to see a doctor?

Even at the first symptoms of mild dysbiosis, it is worth visiting a doctor. Seeking medical help is mandatory if complications occur. Their signs:

1. child refusing to eat
2. underweight or weight loss
3. frequent watery stools
4. severe abdominal pain
5. temperature increase
6. vomit
7. symptoms of dehydration - lack of tears, rare urination, sunken fontanelles

Many pediatricians believe that dysbiosis in infancy is a normal phenomenon. If a baby receiving natural nutrition has loose and frequent stools with a small amount of mucus, but he feels great, do not panic. Obvious symptoms of trouble (diarrhea, constipation, fever, regurgitation, abdominal pain) are a reason to consult a doctor. The doctor will be able to determine what is happening to the baby and give advice regarding its treatment.