For some reason I believed the article had been shared by the "I F***ing Love Science" Facebook page, a source that I deem fairly reputable and reliable (though I don't always share the same opinion as the author on every topic). So when I began reading that a study proved that use of antibiotics early in life leads to food allergies, I immediately knew that was the answer I'd been looking for. After all, it sounded logical-- antibiotics kill a naturally-occurring batcteria in our gut that helps prevent food allergies-- and it made sense with my experience. Though I did use antibiotics both while pregnant with Drew and while nursing him, I didn't use nearly as many as I did with James. I had a different doctor when I had James and since I was struggling with keeping up my lung function, he had reassured me that the antibiotics I was already taking (many of which I stopped when pregnant with and nursing Drew) were actually safe during pregnancy and breastfeeding. I also went through three bouts of mastitis that required antibiotics with James, and did IV antibiotics while nursing him (that I was assured were safe) to treat a CF exacerbation. It seemed to make sense and answered that always-lurking question of, "what did I do wrong?"
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The article also dangled a gleaming carrot in front of me- a special (not on the market yet) probiotic that would CURE James' allergies!
Wait... sounds too good to be true usually means too good to be true, right? I looked back to find the source that had shared this article and found that it wasn't the Facebook science page, it was a "crunchy mom blog". I have nothing against crunchy mom blogs (especially seeing as my own blog leans in that direction), but it definitely wasn't the source I had thought it was. Thankfully I have a sister that not only does medical research, but happens to work in the field of immunology, which deals with allergies and asthma, who I could turn to to ask questions about the validity of the information presented in the article.
I've been seeing this article floating around a lot since I read it (who wouldn't be excited if they or their kids have allergies!?), so I asked Laura if she'd mind if I shared her email response to me about its validity and claims. Her response has a lot of helpful information in it, not only in relation to this specific article, but also in terms of how we interpret "medical research data" that is presented to us. I have shared publicly before that I am easily swayed by "data" when it comes to anything "natural"; I have a somewhat subconscious bias against doctors, medicine, and "unnatural chemicals" (which is kind of ironic given that I literally survive off doctors, medicine, and their "unnatural chemicals"), so it helps to be reminded that science has a method and a purpose.
This was Laura's response to the article:
Hi Diane,
I'm really glad you emailed me about this, as this is my particular field of expertise. This is a legitimate science paper in a mostly reputable journal, but both the article and the blog are grossly overstating what the data shows. The data supports the idea that antibiotics change the microbiome present in the gut, and that changes in the microbiome correlate with changes in allergen sensitivities. This is very different from saying "scientists may have discovered how to stop your peanut allergies for good." They did not develop a cure for allergies, and they did not discover the cause of allergies.
Keep in mind that allergies and asthma have a very strong genetic component, so the fact that both you and Jason have allergies, even if they're not food allergies, mean that both Drew and James were at high risk for developing allergies anyways. It sucks that James developed food allergies, but based on just this paper I don't think you should assume that James' food allergies developed as a result of antibiotics.
Some notes about the paper, that might help you determine your position on it:
1) The journal that this article is in, Proceedings of the National Academy of Sciences (PNAS), is a decent journal, but has a particularly weird form of publishing. If the author is in the National Academy of Sciences, or if they know someone who is in it, they can do a "direct submission" and choose one "reviewer" for their paper. That is exactly what happened with this paper. They did a direct submission and chose their reviewer, who is in the National Academy of Sciences, and happens to be at the same institution. This doesn't mean the paper is wrong, or that it doesn't have merits, but it does mean that fewer people were able to check the author's claims on what the data says before it was published. Time will tell if this paper stands up against critics.
2) Mice are not people. The systems we use to give mice "allergies" are very contrived. While they are a good place to start, and can help us figure out some mechanisms of development of allergies, they definitely have their faults. The microbes that colonize the mouse gut are completely different from people. Also, the dose of antibiotics they give to mice is far higher than people would generally receive. All of these things mean that, although the paper might have accurate data in their mouse models, the hypotheses have to be tested in people before conclusions can be drawn.
3) The authors claim a "conflict of interest", because they put in a patent, probably for the particular combination of microbes to put in probiotics. This probably led to their exaggerated claims on the importance of their findings.
All that being said, I don't think that trying probiotics is a bad idea. There haven't been any negative effects shown yet, and it has become very obvious that altering the gut microbiota can lead to changes in the immune system, which is what is responsible for allergies. However, I don't think you should spend a ton of money or time on it when there hasn't yet been a clinical trial testing the effects of probiotics on the development or treatment of allergies or asthma.
Most importantly, please don't second guess giving the kids antibiotics when they're needed [emphasis mine]. You should make sure you have a pediatrician that doesn't just prescribe antibiotics for any little ailment, but they are incredibly important tools for treating infectious diseases. Also, your use of antibiotics was necessary for your health, and still is, so take them when you need to.
Basically, what you should take away from the above article is this:
1) Yes, the study is somewhat valid, but it does not meet the claims of discovering the cause of allergies or presenting a cure for them.
2) Probiotics may help, but it's not worth an extreme monetary or time investment at this point.
3) DO NOT FEAR antibiotics. They should be used judiciously, but they are important for treating and preventing spread of some diseases.
And the overall takeaway from Laura's message, for me anyway, is this:
Ask questions. Who said it, what did they say, why did they say it, how did they come to that conclusion, where did they publish it...? As a non-scientist, it is easy to believe information that is presented in what seems to be a logical, data-supported manner, especially if it fits with my preconceived notions. But it is important to question the validity of the information before making large (and especially possibly harmful) changes to your behaviors, diet, or routine. Yes, I'm about to make my own deodorant because I've read claims that antiperspirants cause cancer (or Alzheimer's?) and that preventing the body from sweating isn't "natural", but in my opinion homemade deodorant isn't going to harm me (it's made of foods we eat) or anyone else (except maybe their noses if it doesn't work as well as it's supposed to). Choosing not to use antibiotics (or vaccines or sunscreen...) could harm me or my children. I'm not trying to start a debate with or criticize anyone who has a strong opinion on one of these topics; I simply would like to share that it is important to make sure you trust your information. Thankfully I have a sister I can rely on for that. ;)
EDIT: I found this information fairly easily when I clicked the link in the article to the study. Even without having to read the stuff that doesn't make sense to me, simply scrolling to the footnotes showed:
- Conflict of interest statement: A provisional US patent application (61/937952) was filed on February 10, 2014.
- *This Direct Submission article had a prearranged editor.
