Key message: Children that take antibiotics and antacids for bloating in the first six months after birth are twice as likely to develop allergies.
Background: Allergies in children are increasing. More and more children in the USA are given proton pump inhibitors and other antacids. Even antibiotics are being used more frequently for infections. Taking medication within the first few months of life causes a long-lasting change to the microbiome. The question is whether there is a correlation between the increase in allergies at an early age and the intake of medication.
Design: A retrospective cohort study was conducted between 2001 and 2013 involving almost 800.000 children of US-soldiers. The children were included in the study from the 35th day after birth and accompanied until they reached Kindergarten.
Results: Within the first half year after birth, 7.6% of the children received an H2-receptor-antagonist at least once, 1.7% a proton pump inhibitor and a whopping 16.6% an antibiotic!
Children that received an antacid developed twice as many food allergies until the age of four and a half in comparison to other children. The Hazard Ratio for H2-receptor-antagonists was 2.18 and 2.59 for proton pump inhibitors. Medicine allergies were between 1.70 and 1.84 times more common. Even diseases such as allergic asthma, neurodermatitis and contact dermatitis were more prevalent.
The correlation between the use of antibiotics and allergies is also very evident. The Hazard Ratio for allergic asthma was 2.09, 1.75 for allergic rhinitis followed by the occurrence of anaphylaxis (1.51) and allergic conjunctivitis (1.42).
Clinical impact: Medicine should only be used for burping children when the children suffer a lot or when other methods such as thickening the food and lying on the left-hand side after a meal show no effect, according to guidelines. The present data even urges for restraint.
Concerning the use of antibiotics, infants should only receive an antibiotic prescription if a bacterial infection is confirmed and whether the use of antibiotics in a confirmed case is actually justifiable.