Q&A: What pharmacists should know about gut health

AJP speaks with pharmacist John Bell about the latest in children’s gut health and related allergies

1. What do pharmacists need to know about cows’ milk allergy and kids?

Cows’ milk allergy (CMA) is one of the most common food allergies, with between one baby in 20 to one baby in 50 in Australia and New Zealand being affected.

CMA can be difficult to diagnose, with the symptoms often quite varied. Symptoms can include vomiting diarrhoea, skin rash and respiratory issues, but usually become evident early in childhood. CMA is more common in babies with a family history of allergy or eczema.

2. How can pharmacists best support parents who come into the pharmacy with questions about their kids’ gut health?

Most people in the community now have an awareness of the importance of the microbiome and its influence on gut health and health more generally, but research findings show that parents feel they need more information.

Moreover most parents believe that pharmacists are highly knowledgeable about gut health and specifically that pharmacists should be the key provider of information about CMA.

So, we have responsibility to be able to meet these expectations – to be able to explain how best CMA can be identified and managed. Importantly we should reassure parents that with appropriate management strategies there should be no long-term adverse effects for their child and that they will most likely outgrow the condition by the age of three.

3. What do parents need to know about the differences between prebiotics and probiotics?

There is often some confusion about probiotics and prebiotics, what they are and how they work. As pharmacists we have an opportunity to explain the differences and the respective benefits.

Put simply we can describe probiotics as live beneficial bacteria sometime present in yoghurt or other fermented foods. Prebiotics can be described as fertilisers for the good bacteria in our gut.

From a dietary point of view, they are the non-digestible fibrous components of our food, generally found in fruit, vegetables and wholegrains. As oligosaccharides they are present in human breast milk and are included in some specific infant formulas.

4. What other warning signs are there of gut health issues that pharmacists should look out for in children?

So-called functional gastrointestinal disorders (FGIDs) are common in children; primarily colic, constipation and regurgitation (reflux). Parental reassurance is important as these conditions are generally self-limiting with no adverse consequences for the child.

As with CMA, evidence-based nutrition advice is considered the first line management option.

Referral should be considered if the child has ongoing respiratory problems, has problems gaining weight, arches the back after most feeds or is routinely unhappy between feeds.

The research cited above has been provided by Edelman Intelligence.

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