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Antibiotics Before Age 2 Can Lead to Chronic Conditions, Study Finds

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  • Antibiotics are frequently prescribed for common childhood illnesses like sinus and ear infections.
  • In some cases, like bacterial infections, antibiotics are critical in order for babies to get well again.
  • However, a study shows using antibiotics too much during the first two years of life may be associated with an increased risk of certain chronic health conditions.

Antibiotics are widely used to treat a host of childhood illnesses quickly and effectively. But new research indicates that antibiotic use in the first two years of life could lead to other health conditions.

A recent study published in the journal Mayo Clinic Proceedings highlights the risks of using antibiotic medication on kids under the age of two. The study finds that these medications can increase the prevalence of health conditions like asthma, allergies, celiac disease, and obesity later in life.

While the exact cause is unknown, it’s assumed that the gut changes brought about by antibiotic use are to blame. According to the study, the findings are consistent with the hypothesis that the composition of the microbiome—the trillions of beneficial microorganisms that live in and on our bodies—plays a critical role in the early development of immunity, metabolism, and behavior.

It's important to note that the results of the study are far from conclusive in showing causation, and many underlying factors could contribute to the increased risk of developing certain conditions.

Risks of Avoiding Needed Antibiotics Are Far Greater

While this may sound alarming, it’s important to note that the risks of foregoing antibiotics when they’re truly needed far outweigh these potential complications. Daniel Ganjian, MD, a pediatrician at Providence Saint John’s Health Center in Santa Monica, California says, “Physicians have to be careful in identifying viral versus bacterial causes of illnesses and only prescribe antibiotics for the latter. But if a child is very sick with a bacterial infection, we should treat the child with antibiotics before it progresses and gets worse.”

Daniel Ganjian, MD

Physicians have to be careful in identifying viral versus bacterial causes of illnesses and only prescribe antibiotics for the latter. But if a child is very sick with a bacterial infection, we should treat the child with antibiotics before it progresses and gets worse.

— Daniel Ganjian, MD

Conditions like pneumonia, sepsis, meningitis, and even wound infections can quickly turn deadly, especially in babies. In cases like these, where a child is gravely ill, there’s no time to fret about possible complications; antibiotics are clearly the best route. 

But what this study encourages parents and physicians to cut down on is casual overuse of antibiotics. Overall, this is already less of a problem than it once was. Since the discovery of strains of antibiotic-resistant bacteria in 1995, the proportion of children under four that used at least one antibiotic during the year decreased from 47.9% in 1996 to 38.1% in 2000. 

Using the 'Wait and See' Approach

In an effort to cut down on overprescribing antibiotics, doctors may recommend that parents take a “wait and see” approach, even for a child who is obviously ill. That’s because many times, it can be extremely difficult to distinguish between a viral illness, which can’t be helped by antibiotics, and a bacterial one, where the use of antibiotics would be the appropriate course of action.

"Parents can ask their pediatrician about natural remedies like honey (for children over 12 months old), nasal saline, and use of a vaporizer," says Ganjian. "Or you can ask if you can wait a few days before deciding whether the child can fight the infection without medications. You can then start the antibiotics if there is no improvement by then, or start the antibiotics immediately if your child is getting worse," he says.


This is especially true in the case of an ear infection, (the number one cause of antibiotic prescriptions in children, according to the CDC). It’s always a good idea to see if things resolve on their own without an antibiotic, especially if your child has recurrent ear infections. 

Age Matters 

The study also found that when antibiotics were prescribed for kids under the age of six months, the prevalence of certain health issues increased further. The risk of atopic dermatitis and overweight increased for both sexes, the risk of asthma increased for girls, and the risk of food allergy increased for boys. That’s a strong argument for keeping young babies inside for as long as possible after birth and enforcing good hygiene practices, like washing hands before handling the baby and asking sick people to avoid visiting. 

What This Means for You

It’s important to note that this study did not look at additional variables that may affect infant health, such as diet or prescriptions for additional medications. Further research is required to determine if there is a cause-effect relationship between antibiotic use in babies and an increased prevalence of childhood diseases such as asthma and allergies.

When your child is sick, especially if they’re under two, it’s a good idea to work closely with your child’s doctor to determine whether an antibiotic is truly needed or whether it’s being prescribed as a “quick fix.” A watchful waiting approach is recommended by most health experts today as a way to ensure this course of action is required in order to restore your little one to health.

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4 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Aversa Z, Atkinson EJ, Schafer MJ, et al. Association of infant antibiotic exposure with childhood health outcomesMayo Clin Proc. 2020. doi:10.1016/j.mayocp.2020.07.019

  2. Centers for Disease Control and Prevention. Be antibiotics aware: smart use, best care. Updated November 17, 2020.

  3. Agency for Healthcare Research and Quality. Statistical Brief #35: Trends in Antibiotic Use Among U.S. Children Aged 0 to 4 Years, 1996-2000.

  4. Centers for Disease Control and Prevention. Pediatric treatment recommendations. Updated February 1, 2017.