Children’s Gut Health: Nourishing a Healthy Gut

Children’s gut health is vital to early development and sets a baseline for lifelong health. (4)(12) The gut microbiome, the population of microbes residing in the intestinal tract, begins developing at birth and continues throughout childhood. (4)

The microbiome promotes health by supporting metabolism, nutrient absorption, and immune development, as well as preventing infection by pathogenic microbes. (2)(4) In children and adults, dysbiosis (an imbalanced microbiome) has been associated with conditions including allergy, asthma, irritable bowel syndrome, neurodevelopmental disorders, and obesity. (4)(12)

Several lifestyle changes can help improve your child’s gut health, contributing to their overall health and well-being.

Understanding your child’s gut health

The intestinal microbiome develops from the neonatal to adolescent periods of your child’s life. A healthy gut microbiome is diverse (has a variety of different microbes), rich (has a high number of microbes), and is resistant to environmental factors. (1)

Children’s gut health is influenced by factors including:

• In-utero environment (e.g., amniotic fluid, composition of microbes in the placenta) (4)
• Maternal diet (1)
• Gestational age at birth (i.e., preterm infants and full-term infants have a different intestinal microbial composition) (4)
• Delivery mode (i.e., vaginal birth or Caesarean section (C-section)) (1)
• Extended hospital stays
• Feeding mode (i.e., breastfeeding or formula feeding)
• Early antibiotic treatment
• Exposure to less sanitary environments (i.e., having siblings or household pets is associated with increased microbial diversity and richness) (4)
• Dietary habits (1)

Did you know? The average individual carries about 160 species of bacteria out of over 1,000 that have been identified in the human gut. (1)

Your child’s gut health is closely linked to their physical growth and development, (12) as well as the function of their nervous system, (4)(12) immune system, (4) and metabolism. (4)(14)

Gut health and children’s behavior 

The gastrointestinal (GI) tract communicates with the brain via a nervous system process known as the gut-brain axis. This is a bidirectional relationship, meaning that brain signals can affect functions of the GI tract, and nerve signals from the GI system can affect brain function. (4)

Dysbiosis during childhood can impair a child’s neurodevelopment by impacting the blood-brain barrier, brain immune function, communication between GI nerve cells and the brain, and inflammation of the central nervous system. (12) 

Dysbiosis in children with autism spectrum disorder (ASD) may be associated with the development and severity of autism. (3) However, more research is needed to understand the causes of autism (4) and the effectiveness of targeting children’s gut health as a potential treatment for autistic behaviors. (3)

Gut health and the immune system

The health of the gut microbiome has been shown to influence immune health and a child’s risk of conditions such as allergies and asthma. Studies suggest that infants with GI infections such as Escherichia coli (E. coli) and Clostridium difficile (C. diff) have an increased risk of developing immune reactions such as eczema, recurrent wheezing, and allergic sensitization (increased reactivity to allergens). (4)

Similarly, children receiving antibiotic treatment during the first year of life may have an increased risk of developing asthma. The risk increases as the number of antibiotic treatment courses increase. (4)

Gut health and obesity in children

The gut microbiome is involved in metabolic processes such as regulating growth hormone signaling and how energy is collected from nutrients. (12) The patterns of specific bacteria found in an infant’s microbiome can affect their risk of becoming overweight and obese in childhood. (4)

How to improve children’s gut health

Keep in mind that you can’t change or control some of the factors that influence your child’s microbiome, such as their delivery mode at birth. Consider addressing the modifiable lifestyle factors below to improve your child’s gut health.

Best foods for children’s gut health

Research shows that short- and long-term dietary patterns play a significant role in microbiome diversity and composition (specific microbes present). Mediterranean and plant-based diets have been associated with gut microbiome improvements. (1)

In human and animal trials, certain foods and dietary components have been found to increase microbial diversity and richness, increase beneficial bacteria, and/or decrease pathogenic bacteria. (1) The best foods for children’s gut health include:

• Fermented foods (1)
• Foods high in fiber (e.g., whole grains, nuts, legumes) (1)(3)
• Foods high in monounsaturated and polyunsaturated fatty acids (MUFAs and PUFAs) (e.g., fish, nuts, seeds, avocados, olive oil)
• Fruits and vegetables
• Nuts
• Plant-based protein (e.g., grains, beans, legumes) (1)

The interactions between the gut microbiome and diet depend on the individual’s baseline (starting) microbes, which suggests that dietary changes may need to be personalized. (1) Generally, this is done with the help of an integrative healthcare practitioner, who may use gut microbiome testing to inform dietary recommendations for your child.

Foods to avoid for children’s gut health

Similarly, some foods and dietary components may have a negative impact on the microbiome when consumed in imbalanced amounts, such as:

• Animal proteins (e.g., dairy, eggs, meat)
• Artificial sweeteners (e.g., Sucralose)
• Emulsifiers (e.g., carrageenan, guar gum)
• Saturated fatty acids (e.g., butter, fatty meats, palm oil) (1)

A Western-style diet may reduce microbial diversity, decrease beneficial bacteria, and increase the growth of pathogenic microbes. The imbalances mentioned above are found in Western diets, which are high in processed foods, fried foods, and sugar, and low in plant foods with fiber and polyphenols. (1)

Additionally, certain foods may need to be avoided in children with disorders of gut-brain interaction (DGBIs), such as infant colic, infant regurgitation, and irritable bowel syndrome. Research suggests that removing cow’s milk can help improve infant colic and regurgitation, while a low-FODMAP diet can be beneficial for children with DGBIs. (11)

Reducing antibiotic use

Courses of antibiotics during infancy and childhood are associated with changes in gut microbiome composition, (4) and may be associated with conditions such as asthma, type 1 diabetes, and Crohn’s disease. (8) Speak to your child’s pediatrician about the adverse effects of antibiotics and prudent use of antibiotics for your child. 

Breastfeeding during infancy

Human breast milk has components, such as immunoglobulins and beneficial microbes, that support the development of an infant’s immune system and gut microbiome. (1)(2)(12) Human milk oligosaccharides (HMOs), a type of carbohydrate found in breast milk, act as a prebiotic, which means they are fermented by gut microbes and can promote the growth of good bacteria. (1)(12)

Stress management for a healthy gut

Researchers have found that stress in children and adolescents is related to their gut microbial composition, which may be a result of the gut-brain axis. (10) Strategies to manage stress include meditation, spending time outdoors, and talking to friends and family.

Physical activity and gut health

Regular aerobic activity, particularly higher-intensity or longer-duration aerobic exercise, may support gut health. (7) Aerobic activities for kids include running, hiking, biking, and sports that involve throwing and catching. More research is needed to understand how exercise impacts the gut microbiome in children specifically. (7)

Dietary supplements for children’s gut health

Several supplements have been studied for their effects on the gut microbiome and related health conditions in children, including:

• Digestive enzymes, which may decrease symptoms affecting the digestive system such as abdominal pain, bloating, diarrhea, and flatulence (9)
• Prebiotics, which supply probiotics with food, and have been found to reduce the negative effects of antibiotic treatment on beneficial gut bacteria (13)
• Probiotics, or beneficial bacteria, which may reduce the negative impact of antibiotics on the microbiome and prevent certain infections (6)

Should I give my child a probiotic?

The safety and effectiveness of probiotics and other supplements depends on their appropriate use in your child. Speak to your child’s healthcare practitioner for personalized recommendations based on their health status and needs.

The bottom line

Childhood dietary and lifestyle patterns help establish your child’s gut health and lifelong habits that contribute to their well-being. (1) To support optimal health and development, work with a healthcare practitioner and implement the children’s gut health tips in this article.