Early Life Antibiotic Exposure and Weight Development in Children.

OBJECTIVE: To examine the timing, frequency, and type of antibiotic exposure during the first 10 years of life in association with (over)weight across this period in a cohort of 979 children. STUDY DESIGN: Within the Child, Parents and Health: Lifestyle and Genetic Constitution Birth Cohort Study, antibiotic exposure record was obtained from general practitioners. Anthropometric outcomes (age- and sex-standardized body mass index, weight and height z-scores, and overweight) were measured repeatedly at 7 time points during the first 10 years of life. Generalized estimating equations method was used for statistical analysis. RESULTS: After adjusting for confounding factors, children exposed to one course of antibiotics compared with none in the first 6 months of life had increased weight- (adjusted generalized estimating equations estimates [adjß] 0.24; 95% CI 0.03-0.44) and height (adjß 0.23; 95% CI 0.0002-0.46) z-scores; exposure to ≥2 courses during the second year of life was associated with both increased weight (adjß 0.34; 95% CI 0.07-0.60), and height z-scores (adjß 0.29; 95% CI -0.003 to 0.59). Exposure later in life was not associated with anthropometric outcomes. Associations with weight z-scores were mainly driven by exposure to broad- (≥2 courses: adjß 0.11; 95% CI 0.003-0.22) and narrow-spectrum ß-lactams (1 course: adjß 0.18; 95% CI 0.005-0.35) during the follow-up period. Specific antibiotic used was not associated with body mass index z-scores and overweight. CONCLUSIONS: Repeated exposure to antibiotics early in life, especially ß-lactam agents, is associated with increased weight and height. If causality of obesity can be established in future studies, this further highlights the need for restrictive antibiotic use and avoidance of prescriptions when there is minimal clinical benefit.

Factors influencing the composition of the intestinal microbiota in early infancy

Objective: The aim of this study was to examine the contribution of a broad range of external influences to the gut microbiotic composition in early infancy...

Breastfeeding and infant eczema in the first year of life in the Koala birth cohort study: a risk period–specific analysis

We studied the association between breastfeeding and eczema, taking into account the possible influence of reverse causation, with risk period-specific analyses...

Breast-feeding duration and infant atopic manifestations, by maternal allergic status, in the first 2 years of life (KOALA study).

OBJECTIVE: To investigate the potential effect of modification by maternal allergic status on the relationship between breast-feeding duration and infant atopic manifestations in the first 2 years of life. STUDY DESIGN: Data from 2705 infants of the KOALA Birth Cohort Study (The Netherlands) were analyzed. The data were collected by repeated questionnaires at 34 weeks of gestation and 3, 7, 12, and 24 months postpartum. Total and specific immunoglobulin E measurements were performed on venous blood samples collected during home visits at age 2 years. Relationships were analyzed using logistic regression analyses. RESULTS: Longer duration of breast-feeding was associated with a lower risk for eczema in infants of mothers without allergy or asthma (P(trend) = .01) and slightly lower risk in those of mothers with allergy but no asthma (P(trend) = .14). There was no such association for asthmatic mothers (P(trend) = .87). Longer breast-feeding duration decreased the risk of recurrent wheeze independent of maternal allergy (P(trend) = .02) or asthma status (P(trend) = .06). CONCLUSIONS: Our findings show that the relationship between breast-feeding and infant eczema in the first 2 years of life is modified by maternal allergic status. The protective effect of breast-feeding on recurrent wheeze may be associated with protection against respiratory infections.