Pediatric Food Allergies are on the Rise: Support Your Child’s Microbiome
Julia Getzelman, MD – CEO & Founder Getzwell Personalized Pediatrics
Food allergies are a hot topic, and with good reason. In the past 14 years, there has been a 50% increase in pediatric food allergies! Let’s talk about this alarming shift, because not only do we need to keep our children who have food allergies safe and healthy, but we must do what we can to prevent food allergies from developing in the first place.
“Allergies happen when the immune teams make the mistake of identifying something harmless as dangerous. No one is born with these mistakes” (Lele 14). The chances of the immune system making this kind of mistake–which can be permanent–rises dramatically where the body’s microbiome has been disrupted anytime between birth and three years of age. The sharp increase in pediatric food allergies in many ways reflects how out of whack, or dysbiotic, many children’s microbiomes are.
One vital key to avoiding food allergies and maintaining better health is to support the microbiome. In this article, I discuss what the microbiome is in relation to the immune system, what food allergies are, what common products and practices put the microbiome at risk, and how, at GetzWell, we take a proactive approach to protecting your family’s microbiome and providing supportive care.
The Immune System
First, a quick overview of the immune system.
The skin, gastrointestinal tract, and lungs are the largest organs in the body that are part and parcel of the body’s defense, or immune, system (Lele 7). All three have a huge surface area that is constantly exposed to the “non-self” elements of the environment. These barriers are also called the epithelium; the cells of all the barriers are called epithelial cells (Lele, 8). The epithelial barrier includes epithelial cells, plus proteins or lipids, and in the lungs and gastrointestinal tract, a layer of mucus as well. The epithelial barrier of these three organs is our first line of defense against pathogens (Lele 8). Ideally, these three organs offer a strong and stable barrier that allows some non-self things into our bodies, but not others. For example, when the lungs are healthy they are very attuned to particles of different sizes and allow oxygen into the bloodstream and cause us to exhale other gasses; the intestines when functioning properly differentiate between foreign pathogens and nutrient proteins that are safe; and healthy skin is sensitive to parasites and some chemicals but not others. When non-self things get through these barriers but shouldn’t, the immune system reacts by creating an antibody that is specific to each “invader” or otherwise activates a “fight” response (Lele).
Creation of antibodies is absolutely what we want if the intruder is a virus, parasite, or bacteria that evades the epithelial barriers. But if the “bad guy” is peanut dust, cow’s milk, or egg that enters through a baby’s physiologically thin skin, the body may create a cascade of reactions that will result in an allergic response (Lele).
Each of our epithelial barriers is teeming with microbes–especially mutually beneficial ones which support us in myriad ways while we also help them survive–a symbiotic relationship developed over tens of thousands of years of human evolution (Lele 24). In fact, more than 10,000 different microbial species have been documented as living on or in humans. (Lele 23).
The Skin Microbiome
A single square inch of our skin can have up to 6 billion microorganisms living on it, and the average adult has 3,000 square inches of skin (Lele 23). There is no “correct” microbiome because a ”wide variety of possible combinations of microbes are workable, and an equal number of combinations are dysbiotic” (Lele 27). Dysbiosis (an imbalance) can come from a missing, critical species, too few microbes overall, or too little diversity in the species that are present.
Babies are thought to get their starter skin microbiome from the vaginal canal and then from skin-to-skin contact right after birth. From then on, the things the baby interacts with (clothing, the dust and pet dander at home, dirt and grass at the park, and more) cause the species that make up the microbiome to change (Lele 27). The microbes on the skin make it stronger, and they work together with the skin to kill pathogens and also turn down inflammation as needed.
Dysbiosis of the skin microbiome can cause a breakdown of the skin barrier, allowing pollens, food particles, bacteria, or viruses to cross the skin barrier. These failures can eventually lead to conditions like psoriasis, eczema, food allergies and contact dermatitis (Lele 29).
The Gut Microbiome
The intestinal tract, the big tube that goes through the body from mouth to anus–more commonly known as the gut–is where most of the microbes in the body live (Lele 32). Its surface area is actually much bigger than the skin. Because most pathogens enter the body through the gut, the microbes of the intestine have an enormous effect on the immune system which was “designed” to reject foreigners in the form of pathogens and accept foreigners in the form of food.
A baby gets their starter microbiome during delivery, and it lasts until about six months. Babies who pass through the vaginal canal get the vaginal bacteria as a starter, whereas babies born by C-section tend to get bacteria from the hospital environment plus their mother’s skin. Breast milk feeds the bacteria that form the protective mucous lining of the intestines and make vitamin K, both of which are critical to good health. Then, when a baby starts to eat solid foods and crawl, everything they put in their mouth provides an ongoing series of new microbes as well as fuel for resident microbes (Lele 35).
When the gut microbiome has the wrong species, mix of species or proportion of species, we call this a dysbiosis from which there can be serious consequences, from tooth decay to “leaky gut” and allergies or autoimmune disease (Lele).
What Is Damaging the Microbiome and What Can We Do About It?
Many common practices are damaging our children’s microbiomes, including C-sections, antibiotics, toxins, pesticides, and general pollution. At GetzWell, we work with families to help limit these factors wherever possible, always prioritizing microbiome health.
- C-sections: A baby’s microbiome is seeded at delivery, during its passage through the vaginal canal. As a result, babies born via C-section do not receive at birth a vast array of necessary microbes. While some C-sections are medically necessary and should be performed, many are not and should be avoided. If a C-section is necessary, there are measures GetzWell can advise parents to take to help seed a healthy microbiome in their new baby.
- Antibiotics: Antibiotics are over-prescribed and they don’t discriminate between so-called “good guys and bad guys.” While they are critical in certain circumstances, we need to recognize they also wreak absolute havoc on the microbiome. Additionally, even though antibiotics only kill bacteria, many physicians prescribe them for viral infections, unfortunately. Furthermore, a full 10-day course, even when dealing with a bacterial infection, may be far more medication than is actually necessary. At GetzWell, we discuss with parents whether antibiotics are necessary or if there are better options to support your child. If antibiotics are warranted, we advise you how to help repair your child’s microbiome as quickly and effectively as possible
- Toxins: Toxins are everywhere. We can avoid bringing some of them into our homes by carefully reading labels of soaps and other cleaning agents and comparing them against the EWG databases. GetzWell is eager to provide guidance on problematic products.
- Pesticides: Pesticides disrupt the microbiome by killing certain species. Choose organic when you can, especially for the dirty dozen. Doing so supports not only your family’s health but also the health of the planet.
- General pollution: Exhaust, manufacturing, microplastics–pollution is everywhere: air, water, soil, food. One way to reduce air pollution in your home is by using effective purifiers. Another way of greening your home is by taking shoes off at the door.
Please contact our GetzWell Pediatricians discuss any of these issues—we are eager to support you, your child, and their microbiome!
Lele, Meenal. The Baby and the Biome: How the Tiny World Inside Your Child Holds the Secret to Their Health. Avery, 2022.