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What’s Up With the Virgin Gut? Do Babies Really Have an “Open Gut” Until 6 Months of Age?

There is a persistent myth about infant gut development that comes up in nearly every online discussion of starting solid foods. It’s the myth that infants have a “virgin” or “open” gut until around 6 months of age. I’ve received so many emails, Facebook posts, and comments about the virgin gut over the last few years that I thought it was finally time to take a look at the science – and lack thereof – behind this myth.

I have written before, in my book and on my blog, about the controversy around when to begin introducing solid foods to a baby. Some health organizations recommend 6 months of exclusive breastfeeding, while others recommend starting to offer solids between 4 and 6 months, following baby’s cues of readiness as your ultimate guide. Based on my analysis of the most current science, I believe that the second approach is more evidence-based and helps parents to focus on their baby’s unique development rather than the calendar. I also think that it’s just fine to wait until 6 months if that is your preference.

However, whenever I discuss this science, someone lectures me about infant gut development, and they usually send me a link to KellyMom’s page on the topic, which urges parents not to offer solids before 6 months. Here’s what it says:

“In addition, from birth until somewhere between four and six months of age babies possess what is often referred to as an “open gut.” This means that the spaces between the cells of the small intestines will readily allow intact macromolecules, including whole proteins and pathogens, to pass directly into the bloodstream. This is great for your breastfed baby as it allows beneficial antibodies in breastmilk to pass more directly into baby’s bloodstream, but it also means that large proteins from other foods (which may predispose baby to allergies) and disease-causing pathogens can pass right through, too.”

Wow, that does sound scary! I can see how this “open gut” idea would worry parents approaching the transition to solid foods. But here’s the thing: There are no references given to support these statements, and in all my reading of the research literature on readiness for solids, I have not encountered science backing this concern. Yet somehow this idea of the open gut comes up over and over in online discussions, complete with judgment for parents who offer solids before 6 months and non-evidence-based suggestions about how to “heal” a baby’s gut. All of this only serves to increase anxiety in parents, which is the last thing any of us need.

It’s time to get to the bottom of this. Let’s look at some science…

What do we mean when we talk about an “open” or “closed” gut? How do we measure this?

The lining of the small intestine serves a critical role in absorption of nutrients and in immune protection. Food and bacteria from the environment enter the GI tract, and the lining of that tract is what separates it from the body’s bloodstream. It’s important that this lining is selective about letting in the good stuff and keeping out the less desirable elements, as this interface is one of an infant’s most important barriers to infection (1).

The intestinal lining is composed of a single layer of epithelial cells, called enterocytes, arranged in many deep folds that serve to increase the surface area for nutrient absorption. Nutrients are absorbed across the intestinal enterocytes and into the blood stream.

The spaces between the enterocytes are joined by protein complexes, the most important of which are called tight junctions. Despite their name, these junctions are never a complete seal and let some particles through while excluding others, mostly on the basis of size and charge (2).

Researchers use the term intestinal permeability to describe how easily particles can cross the lining of the intestine and into the blood stream. Intestinal permeability is tested in research settings by giving a person an oral dose of two sugars, usually mannitol and lactulose (not to be confused with lactose, which is the major sugar found naturally in milk). Mannitol is the smaller of the two (molecular weight 182) and is absorbed through pores in the intestinal enterocytes. Lactulose is too large to fit through those pores (molecular weight 342), but some of it will sneak through the tight junctions to get into the bloodstream. Once in the blood, neither lactulose nor mannitol are further metabolized; they’re just filtered by the kidneys and excreted in the urine. So, if you give a person (including a baby) a dose of these two sugars and collect their urine, you can measure how much of each was absorbed in the small intestine. Results are usually expressed as a lactulose to mannitol ratio (L/M), with higher values representing greater intestinal permeability and lower values representing less intestinal permeability or a more “closed gut” (3,4).

Does intestinal permeability change in infancy?

Yes, but the timeline is different from KellyMom’s description.

The sugar absorption test has been used to measure the process and timing of gut closure in infants. Contrary to the KellyMom’s claims that this critical process happens between 4 and 6 months, studies show that the most important gut closure actually happens in the newborn period. For example, one study measured intestinal permeability in 72 healthy newborns on days 1, 7, and 30 of life and found that the biggest drop occurred within that first week of life (5).

Intestinal permeability is high at birth but quickly drops within the first week of life. (Data from Catassi et al. 1995)

Intestinal permeability is high at birth but quickly drops within the first week of life. (Data from Catassi et al. 1995)

Does whether an infant is breastfed or formula-fed affect intestinal permeability? Maybe a little, but the difference doesn’t last long. The study shown in the graph above found no difference in intestinal permeability in exclusively breastfed and formula-fed babies on day 1 or day 30. On day 7, intestinal permeability was slightly lower in breastfed compared with formula-fed infants, indicating that formula-feeding may slow the process of gut closure (5). It’s possible that this may contribute to the increased incidence of GI illness observed in formula-fed infants. But again, this difference is transient. By one month and beyond, there is no difference in intestinal permeability between breastfed or formula-fed infants (6).

Preterm infants have greater intestinal permeability at birth but have similar values as term infants by 3-6 days of life.7 The process of gut closure is delayed when preterm infants are fed only by IV rather than via the gastrointestinal tract (oral or tube-feeding), and at least partial human milk feeding rather than exclusive formula-feeding improves gut closure in these vulnerable babies (8,9).

What about later in infancy? Studies on this question show a very gradual decline (if at all) in intestinal permeability over the first several years of life. There is no gut closure door slamming shut on the 6-month birthday. In the graph below, I’ve plotted intestinal permeability by age from two studies (10,11).

Over the first few years of life, a very gradual process of gut closure occurs. Some fine print about this figure: The Noone study actually used a different sugar absorption test, so these values may not be directly comparable, but you can see the same trend in both studies. The data from Noone are individual children, and those from Kalach are averages given in a group of children in each age group.

Over the first few years of life, a very gradual process of gut closure occurs. Some fine print about this figure: The Noone study actually used a different sugar absorption test, so these values may not be directly comparable, but you can see the same trend in both studies. The data from Noone are individual children, and those from Kalach are averages given in a group of children in each age group.

Another study (3) established a reference value for normal intestinal permeability measured by the sugar absorption test (lactulose/mannitol) among healthy children as 0.033 (average of 30 children with mean age of 5 years), and you can see that most of the babies in the above graph actually reached that degree of gut closure by 3 months. The reference value for intestinal permeability in adults established in the same study was just a tad lower at 0.027.

In other words, when it comes to readiness for solid foods, gut closure is probably irrelevant. It happens long before today’s parents are offering bites of banana or oatmeal.

KellyMom also claims that an infant’s “open gut” allows breast milk antibodies to pass directly into the bloodstream. That actually doesn’t happen in human infants – except for maybe in the first few days of life when intestinal permeability is truly high (and the evidence isn’t clear on that point). Instead, human babies get maternal antibodies (IgG) into their bloodstream when they cross the placenta during pregnancy. These include IgG developed by the mother in response to infection or immunization, and this is why maternal immunization for pertussis and flu during pregnancy is so effective at protecting babies from infection after birth. This is different from many other species of animals, in which IgG can’t cross the placenta and are instead transferred to baby via milk (especially colostrum) after birth (12,13).

The most important antibody type in human milk is secretory IgA, which coats mucosal surfaces such as the lining of the GI tract and can protect against infection in that way. However, IgA can’t be absorbed into the blood in human babies. This post on The Scientific Parent explains how this works in humans in more detail: Passive Immunity 101: Will Breast Milk Protect My Baby From Getting Sick?

What IS important for gut readiness for solid foods?

When infants start eating solid foods, they are shifting from the relatively simple diet of easy-to-digest breast milk and/or formula to a more complex diet with a variety of foods (with milk still being an important one). These foods require more work to digest, which means greater activity of a suite of digestive enzymes. In addition, the kidneys have to work a bit harder to excrete metabolites from these foods. How do we know that infants have the capacity to adapt to a more complex diet by 4 months of age?

Here’s the opinion of European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHN; PDF):

“The available data suggest that both renal function and gastrointestinal function are sufficiently mature to metabolise nutrients from complementary foods by the age of 4 months. With respect to gastrointestinal function, it is known that exposure to solids and the transition from a high-fat to a high-carbohydrate diet is associated with hormonal responses (eg, insulin, adrenal hormones) that result in adaptation of digestive functions to the nature of the ingested foods, by increasing the maturation rate of some enzymatic functions and/or activities. Thus, to a large degree gastrointestinal maturation is driven by the foods ingested.” (14)

This is a recurring theme in nutritional biology – that it is only by exposure to a type of food that the GI tract can actually become efficient at digesting it. This is one reason why the transition to solids may give you some interesting diapers, from very messy to very solid, as the GI tract adapts to digesting these new foods. That’s good reason to introduce new foods gradually and in small quantities at the beginning, but it isn’t a good reason to avoid feeding them at all.

m and marble rye

OK, maybe not the best choice for a baby new to solid foods, but this guy really thinks he’s ready to try some marble rye.

If a baby’s GI tract was really too immature to handle solids by 4 months, we would also expect to see more GI illness and food allergies developing in babies starting solid foods at that age. However, this is not what we observe. Most studies find no difference in risk of GI infection whether babies start solids between 4 and 6 months or after 6 months (15-17).

When it comes to risk for food allergies, recent research suggests that introducing solids, including common allergens, between about 4 and 6 months may actually reduce the risk of food allergies. (I give more details on this, with lots of references, in this post.) A study just published found that babies who start solid foods at 4 or 5 months have significantly lower risk of eczema compared with babies exclusively breastfed for 6 months (18). (Eczema in infancy is often associated with later development of allergies (19).) The development of a baby’s digestive and immune systems are interwoven processes, and exposure to food proteins during the 4-6 month period seems to help steer the immune system towards tolerance of foods rather than reactivity to them.

All of this doesn’t mean that you need to rush your baby to start solid foods. It just means that you can cross the open gut off your list of things to worry about. Anytime in the 4-6 months range is a great time to try offering your baby solid foods, following your baby’s signs of developmental readiness and interest in eating solids as your guide.

I ran across this video when I was looking for images to accompany this post. It’s a little off-topic, but it made me laugh a little, because I don’t think I could ever call M’s gut “virgin,” whatever that means. And I don’t think that’s a bad thing. (Please rest assured that M and our dog have a mutual appreciation for this licking ritual.)

Corrections (5/6/16): The information about IgG passed from mother to fetus during pregnancy was updated to emphasize that those IgG can develop in response to infection and immunization of the mother. The previous version just focused on immunization. In addition, I deleted a paragraph about “leaky gut syndrome” as a cause and potential target for cures for autoimmune diseases. Response from readers indicated that paragraph was distracting from the rest of the post, and I felt it wasn’t relevant to this post on infants. In general, there is a lot of pseudoscience in information about the leaky gut, especially if it is coming from folks trying to sell cures. (See here, here, and here for more info.) However, it is an active area of research and may be one of the things mediating the development of autoimmune diseases. Whether or not that information will eventually lead to any progress in prevention or treatment of these disease is debatable.

References:

  1. Battersby, A. J. & Gibbons, D. L. The gut mucosal immune system in the neonatal period. Pediatr. Allergy Immunol. 24, 414–421 (2013).
  2. Odenwald, M. A. & Turner, J. R. Intestinal permeability defects: is it time to treat? Clin. Gastroenterol. Hepatol. Off. Clin. Pract. J. Am. Gastroenterol. Assoc. 11, 1075–1083 (2013).
  3. van Elburg, R. M. et al. Repeatability of the sugar-absorption test, using lactulose and mannitol, for measuring intestinal permeability for sugars. J. Pediatr. Gastroenterol. Nutr. 20, 184–188 (1995).
  4. Corpeleijn, W. E., van Elburg, R. M., Kema, I. P. & van Goudoever, J. B. Assessment of intestinal permeability in (premature) neonates by sugar absorption tests. Methods Mol. Biol. Clifton NJ 763, 95–104 (2011).
  5. Catassi, C., Bonucci, A., Coppa, G. V., Carlucci, A. & Giorgi, P. L. Intestinal permeability changes during the first month: effect of natural versus artificial feeding. J. Pediatr. Gastroenterol. Nutr. 21, 383–386 (1995).
  6. Colomé, G. et al. Intestinal permeability in different feedings in infancy. Acta Paediatr. 96, 69–72 (2007).
  7. Van Elburg, R. M., Fetter, W. P. F., Bunkers, C. M. & Heymans, H. S. A. Intestinal permeability in relation to birth weight and gestational and postnatal age. Arch. Dis. Child.-Fetal Neonatal Ed. 88, F52–F55 (2003).
  8. Rouwet, E. V. et al. Intestinal permeability and carrier-mediated monosaccharide absorption in preterm neonates during the early postnatal period. Pediatr. Res. 51, 64–70 (2002).
  9. Taylor, S. N., Basile, L. A., Ebeling, M. & Wagner, C. L. Intestinal Permeability in Preterm Infants by Feeding Type: Mother’s Milk Versus Formula. Breastfeed. Med. 4, 11–15 (2009).
  10. Kalach, N., Rocchiccioli, F., Boissieu, D., Benhamou, P.-H. & Dupont, C. Intestinal permeability in children: variation with age and reliability in the diagnosis of cow’s milk allergy. Acta Paediatr. 90, 499–504 (2001).
  11. Noone, C., Menzies, I. S., Banatvala, J. E. & Scopes, J. W. Intestinal permeability and lactose hydrolysis in human rotaviral gastroenteritis assessed simultaneously by non-invasive differential sugar permeation. Eur. J. Clin. Invest. 16, 217–225 (1986).
  12. Van de Perre, P. Transfer of antibody via mother’s milk. Vaccine 21, 3374–3376 (2003).
  13. Udall, J. N. & Walker, W. A. The physiologic and pathologic basis for the transport of macromolecules across the intestinal tract. J. Pediatr. Gastroenterol. Nutr. 1, 295–301 (1982).
  14. Agostoni, C. et al. Complementary feeding: a commentary by the ESPGHAN Committee on Nutrition. J. Pediatr. Gastroenterol. Nutr. 46, 99–110 (2008).
  15. Cohen, R. J., Brown, K. H., Dewey, K. G., Canahuati, J. & Landa Rivera, L. Effects of age of introduction of complementary foods on infant breast milk intake, total energy intake, and growth: a randomised intervention study in Honduras. The Lancet 344, 288–293 (1994).
  16. Dewey, K. G., Cohen, R. J., Brown, K. H. & Rivera, L. L. Age of introduction of complementary foods and growth of term, low-birth-weight, breast-fed infants: a randomized intervention study in Honduras. Am. J. Clin. Nutr. 69, 679–686 (1999).
  17. Quigley, M. A., Kelly, Y. J. & Sacker, A. Infant feeding, solid foods and hospitalisation in the first 8 months after birth. Arch. Dis. Child. 94, 148–150 (2009).
  18. Turati, F. et al. Early weaning is beneficial to prevent atopic dermatitis occurrence in young children. Allergy (2016). doi:10.1111/all.12864
  19. Dharmage, S. C. et al. Atopic dermatitis and the atopic march revisited. Allergy 69, 17–27 (2014).

 

29 Comments
  1. Thank you! The misinformation given to new parents is insane.

    Liked by 1 person

    May 3, 2016
  2. Echoing the above thank you! My gut feel (sorry) has always been that the “leaky gut” was not based in science, but I hadn’t spent the time to learn what the real science was.

    KellyMom is such a prominent breastfeeding resource—I wish she didn’t draw from pseudoscience.

    Like

    May 3, 2016
    • I have to say, it was hard for me to single out KellyMom here, because I do think it is a valuable resource for practical breastfeeding advice. But I do think this kind of misinformation is confusing and potentially harmful to parents, and this was the source readers pointed me to again and again.

      Like

      May 3, 2016
      • I’m glad you did. Speaking as a mother who breastfed for over a year, I have very mixed feelings about KellyMom. I felt like it promoted a certain parenting worldview along with the breastfeeding advice, a worldview that didn’t jive with my own.

        Like

        May 3, 2016
        • Yes, I feel the same way. It’s too bad!

          Liked by 1 person

          May 3, 2016
          • I meant to put this in the post, but will put it here instead. I did email the KellyMom site a few weeks ago to say that I was researching this question for a post and finding information that contradicted the article on their site. I asked if they had other references that perhaps I was missing. Nobody replied to my email.

            Liked by 3 people

            May 3, 2016
  3. A #

    Thanks for making the time to post. I loved your blog and book when I was pregnant and continue to appreciate them both during this first year.

    Like

    May 3, 2016
  4. Danielle #

    Do you think that perhaps gut permeability has to do with the growth rate of babies? That it’s more permeable in the beginning because of rapid growth, but it seems to become less permeable on the charts in association when the average growth rate of babies starts to slow down. Is there any evidence or research on this possibility?

    Like

    May 3, 2016
    • I don’t think so…. and I’ve never seen any research on this. Breast milk is already highly digestible, so I don’t think greater intestinal permeability would necessarily mean greater absorption of nutrients. And the big drop in permeability actually happens in that first week or so, when there actually isn’t a ton of growth because it takes a few days for milk to come in. But I don’t know – I can only speculate:)

      Like

      May 3, 2016
  5. I loved KellyMom as a breastfeeding resource, but stopped trusting them when it was time for solids.

    Breastfeeding advocates treat solids as a necessary poison that needs to be introduced as late as possible. In a “when to introduce solids” advice post that I saw on the Breastfeeding USA fb page recently, an ICBLC advised parents to wait until “baby can sit unsupported for 10 mins.” Why? Nobody gave me a satisfactory answer.

    Liked by 1 person

    May 3, 2016
    • Yeah, I don’t understand this attitude about solids. It’s food! And the world is full of wonderful food, and it’s a beautiful thing to share with family. Beginning to offer solids to a baby who is showing all the signs of readiness and physiologically ready to digest food doesn’t take anything away from the breastfeeding relationship except the very *natural* and *gradual* transition towards more solids and less breast milk. I don’t know why there is such hesitation to accept new evidence about timing for solids from breastfeeding advocates. I think it is in part about history – parents did used to introduce solids too soon, and now the pendulum has swung the other way. Maybe it is meant to counter the well-meaning grandparents who might push a breastfeeding mother to introduce “real foods” too soon. But anyway, I prefer to just be honest about what the science does and doesn’t say and go from there:)

      Liked by 1 person

      May 3, 2016
      • Barel #

        Actually before those pushy grandparents, there were the very intuitive and natural way to feed.
        I think it is important to go back to our intuitions and let the nature speak. In less industrialized countries you will see the babies attaches to their mother’s boobs and till they reach a point where they can reach to food themselves (either by sitting up right by themselves or having a couple of tooth) nothing is introduced…There must be a reason, no?
        Looks to me that we are so industrialized that we are eager to push that baby out, everybody is looking for a way to”induce” naturally because they are feed up at 36 weeks of pregnancy. Just let the baby grow…
        Same thing for propping, we prop them to sit, to hold their heads, to walk, to stand, to eat… Eventually they will manage in their own time. Hence the “natural gross motor development”!!!
        Same think for sleeping, we expect babies to seep 12 hours at 3 weeks?! Even adults are intuitively not sleeping 12 hours straight. We wake up to pee, to eat, to drink, to cuddle!
        I believe in miles stones and natural gross motor development and the 4th trimester out of the womb. We are the only species that try to do everything to prop and make little adults of their babies way too soon…
        Those babies who are that small and defenceless and needy only a couple of months, not even a year… Let’s just cherish those moments…
        To each their own, then again, that’s how I see things and wanted to share:)
        Cheers!

        Like

        September 14, 2016
  6. Maureen #

    That is a cute baby. Wow!

    Like

    May 3, 2016
  7. there is always gonna be debate for feeding babies too early or leaving it too late even

    Like

    May 4, 2016
    • Someone here decided to breastfeed only (no solids!) for a year because she was… wait for it… worried her kid might be allergic to foods. This was last year- there was already plenty of good evidence to the contrary! So…. counterproductive and anti-science! Now she’ll congratulate herself on it not being worse if the kid develops any allergies, when in fact SHE most likely made it worse.

      There’s a reasonable range, and then there’s ridiculous, is what I’m saying.

      Like

      May 6, 2016
  8. Jen #

    What are your thoughts on the idea that introducing solids too early can lead to obesity?

    Like

    May 6, 2016
    • There are studies that show that introducing solids before 4 months is associated with increased risk of obesity. After 4 months, there is no correlation with later body weight or BMI.

      Like

      May 6, 2016
  9. Hello. Thank you for this article. My son had a bad case of bronchiolitus at 3-4 months old. It ended in an ear infection, which he took amoxicillin for. Then a few weeks later, another ear infection and another round of amoxicillin. I’ve read things here and there talking about how important a healthy mixture of gut bacteria is (linking it to so many conditions/diseases down the road), and was worried these early doses of antibiotics could do long-term damage to his gut composition. I asked my pediatrician and she said not to worry, but when I asked more questions, she said some say early antibiotics could lead to IBD, leaky gut, etc down the road. I was wondering what your take is on early antibiotics and long-term health effects.

    Like

    May 8, 2016
    • It’s definitely an active area of research right now – determining the effects of early antibiotics. We know enough to know that we should only use antibiotics when they are definitely needed, and with every antibiotic prescription, you’re weighing those risks and benefits. The risks of antibiotics are a little fuzzy and unknown right now. We know that you’re going to dramatically alter the microbiome, but I think we know much less about microbiome recovery and long-term effects. In the meantime, we do really need to treat some of those bacterial infections because there could be very serious and well-known short-term effects, so sometimes antibiotics are absolutely the right choice. It’s good to stop before every antibiotic prescription and ask if it might be reasonable to wait a few days to see how things progress. Sometimes the answer is no, we are certain this is a bacterial infection that needs to be treated, and other times, a “wait and see” approach might be more reasonable. In the case of your son, I think it isn’t worth worrying about since it has already happened, and at this point, the long-term effects that we’re seeing in the research are *correlations* at a population-level, so that doesn’t mean they will happen in your son. A high-fiber diet with lots of fruits and vegetables and whole grains is your best bet for promoting a healthy microbiome, and that is something that has many benefits (although may be easier said than done with a kiddo:). Hope this helps.

      Like

      May 11, 2016
  10. I have cited evidence about this if you care to look at it. Kelly is an amazing resource for moms and professionals as she scored the highest ever on the iblce exam. She’s incredibly knowledgeable.

    Like

    May 11, 2016
    • Hi Miranda,
      Yes, please do send me any relevant studies on gut readiness for solids that you think I may have missed. I’m always happy to look at more science. This post is not meant to be a personal attack against Kelly in any way. I just think it is imperative that we are providing accurate information to parents, and many were confused or misled about this open gut idea.

      Like

      May 11, 2016
  11. Both my children were 9lb + and were breastfed. They were both on small amounts of solids prior to 4 months, when THEY were ready for it, both are healthy with no food allergies, no asthma or eczema. No mother should have to make her child scream with hunger because someone somewhere says you shouldn’t give solid before 6 months, your baby will tell you when they need solids, you just have to listen to them instead of all the armchair experts with internet access. I’m so glad my children were born before the internet and the whole culture of “mum shaming”

    Like

    May 18, 2016
  12. Miranda Buck #

    Anecdote: my little one is highly allergic to cow’s milk protein. If milk splashed her skin she would blister. If I ate even one teaspoon of yoghurt she would come up in hives when I breastfed. At 5 she’s slowly coming more tolerant to cooked dairy. I believe in exposure so I kept trying dairy all through the early months. She came up in hives when I breastfed after eating yogurt (and screaming and green frothy poo and ezcema flare up) until about six months of age. Like magic suddenly I could breastfeed and eat dairy. Funnily enough, by about two she could eat dairy too without a flare up. Until I stopped breastfeeding at three – at which point she again became again unable to tolerate dairy.

    Like

    May 25, 2016
  13. Christy Coyle #

    Thank you! This post is timely for me as my little guy is 4 months old and I’ve been researching this topic lately. I had a feeling that the stuff I’ve read about holding off until 6 months was made up out of the writer’s own biases, but I sincerely appreciate you digging into the actual science.
    I’m sure little man will appreciate it too, as I plan to introduce some yummy baby food as soon as we get the ok from his doctor on Friday. He’s been giving me the, “Hey, where’s mine?” look at mealtimes for weeks now. 🙂

    Like

    June 15, 2016
  14. Mel #

    Thank you for the informative post!

    I laugh a bit every time people say that humans have leaky guts to promote immunoglobulin transfer for months because my husband is a dairy farmer. Cattle are born with a completely blank immune system with no prenatal transfer of immunoglobulins and have a neat digestive system trick for shunting antibodies in colostrum into the calf’s blood supply. This neat trick is functional for a whopping 24 hours maximum since the dangers of having bacteria cross into the bloodstream are simply too high.

    If leaky gut was so dangerous, I’d expect that cattle would have evolved calves that show an aversion to eating grass, hay, twigs. etc., for a few weeks after birth at least. That hasn’t happened. Even though a calf’s rumen won’t be fully active for months, I’ve seen calves less than 12 hours old start to attempt to graze and get pieces of grass and straw in their mouth.

    Like

    June 28, 2016
  15. delta_mummy #

    Hi Alice – can you comment/clarify on another aspect of the “virgin gut” theories that are out there in the blogosphere? (Maybe this is a topic for another blog). It’s often said that “just one bottle” of formula in the early days can permanently damage a baby’s gut, eg:

    http://www.thealphaparent.com/2011/07/virgin-gut-note-for-parents.html
    http://www.health-e-learning.com/articles/JustOneBottle.pdf
    http://drjaygordon.com/breastfeeding/supplement.html

    The idea being that the addition of even small amounts of formula in the early days can cause a permanent shift of the microbiota of the gut from a breastmilk-fed type of pattern to a formula-fed type of pattern (I assume it’s not really clear yet what the long term health outcomes of the microbiome patterns actually are).

    In trying to look into this I tried to track down the original studies cited although do not have great access to the relevant journals, so this was tricky. However I could not identify from the studies mentioned in the above links, any that actually look at primarily breastfed infants who have received small amounts of supplementation, in comparison with exclusively BF infants. The original studies I saw seemed to look at exclusively FF vs exclusively BF and their microbiomes.

    I think this is an important topic because the “virgin gut” theory seems to have penetrated mums’ consciousness and I have encountered cases of mums feeling desperately guilty (or alternatively, very reluctant about) formula supplementation in the early days, even when it’s medically indicated eg for hypoglycaemia, hypernatremia, etc. Have also heard about mums wanting to avoid using recommended medication or vitamins because they believe these too might permanently mess up the baby’s gut.

    (Caveat: imho this is a separate issue from the desire to avoid supplementation if possible, because of its potential impact on establishing milk supply, and good suckling technique at the breast (both of which would be critical for long term success in BF). But I feel it’s essential to avoid misinformation about the real points about supplementation and if it’s necessary, not to add any guilt in cases where supplementation really is needed to get the baby fed in the early days.)

    Do you know more about this and if there really is any solid factual data from original studies to enlighten the “just one bottle” meme?

    Thanks.

    Like

    July 24, 2016
  16. teweesa #

    Thank you for writing this. Any and every article I have read about virgin gut has just left me reeling with the guilt that I was unable to breastfeed and therefore have ruined my son’s insides with formula. I no longer feel like a failure. Thank you.

    Like

    October 27, 2016
  17. charlisunfish #

    Thanks for this interesting information, it’s nice to see a parenting resource actually using science 🙂 And my dog and baby are exactly the same together 😛

    Like

    January 5, 2017

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