Navigating the Pediatric Microbiome: Emerging Evidence and Clinical Implications

There is emerging interest in the ability of the intestinal microbiome—the collective genome of resident microbes—to impact host function. Given the dynamics of development, the pediatric microbiome is of particular importance as alteration of microbial communities (microbiota) early in life may deeply influence long-term health and disease. This review explores the current understanding of the establishment and evolution of the microbiome in early life. It then discusses the evidence for three key spheres of microbiome-mediated disease in pediatrics: inflammatory bowel disease, obesity and atopic disease. The role of microbiota-derived therapeutics is also examined through the lens of future care for children. Probiotics and fecal microbiota transplant, a novel therapy to restore the microbiome, are explored and the rationale for caution outlined for infants and children. Ultimately, there is potential for research born out of the field to alter our paradigm of pediatric disease and its treatment. © 2014, Springer Science + Business Media New York.