Could Your Baby's First Antibiotics Increase Food Allergy Risk Later?

Babies who receive antibiotics during their first week of life may be significantly more likely to develop food allergies later in childhood, according to new Dutch research that followed children for over a decade. The study found that early antibiotic exposure increased the odds of food allergies by more than three times, but surprisingly had no effect on other common allergic conditions like asthma or seasonal allergies.

What Did the Research Find About Early Antibiotics and Food Allergies?

Researchers from the Netherlands tracked 314 children from birth through ages 9-12, building on an earlier study called INCA (Impact of Nutrition on Children with attention-deficit/hyperactivity disorder). Of the original group, 151 babies received intravenous antibiotics in their first week of life to combat potential sepsis, while 285 did not receive any antibiotic treatment.

The results were striking: children who had received early antibiotics showed much higher rates of food allergies compared to those who hadn't. When parents reported food allergies, the antibiotic group had 3.52 times higher odds of developing them. For test-confirmed food allergies specifically, the odds jumped to 6.6 times higher.

Why Might Early Antibiotics Affect Food Allergies Specifically?

The timing of antibiotic treatment appears crucial. Lead researcher Dr. Nora C. Carpay and her team noted that "the most rapid microbiome development occurs in the weeks after birth," making this period particularly sensitive to disruption. The antibiotics used included gentamicin combined with penicillin, amoxicillin, or amoxicillin-clavulanic acid, depending on hospital protocols, with treatment lasting anywhere from 2 to 7 days.

Interestingly, the study found no significant differences between the two groups for other allergic conditions:

• Asthma rates: No increased risk was observed in the antibiotic group compared to children who didn't receive early antibiotics
• Inhalant allergies: Including hay fever and seasonal allergies, these showed no association with early antibiotic use
• Eczema and contact allergies: Despite previous studies finding links, this research showed no significant correlation with first-week antibiotic treatment

The researchers believe food allergies may follow a different developmental path than respiratory allergies. "Food allergies follow a different route of sensitization, via the skin and gastrointestinal tract, while inhalant allergies and asthma typically develop via the respiratory system," the study authors explained.

What Should Parents Know About This Research?

Dr. Jessica Hui, a pediatric allergist and immunologist at National Jewish Health in Denver, found the study valuable for clinical practice. "As an allergist, I am always excited when studies like this are published," Hui told Medscape Medical News. She emphasized that knowing antibiotics are a potential risk factor allows healthcare providers to "reinforce early introduction of allergenic foods so the infants at risk for food allergy can hopefully prevent its development through methods that we know work."

The study included term-born babies from four Dutch hospitals born between August 2012 and January 2015. Parents completed monthly questionnaires throughout their child's first year, tracking feeding practices and health indicators. The research team then followed up when the children reached ages 9-12, surveying parents about their children's allergy status and reviewing general practitioner diagnoses for 246 of the participants.

While these findings add to growing evidence about the gut microbiome's role in allergy development, the researchers noted that more large-scale studies are needed to confirm these patterns. The study's focus on antibiotics given specifically in the first week of life, rather than later in childhood, helps eliminate some of the bias that can occur when antibiotics are prescribed for existing respiratory symptoms.