Should kids under one take antibiotics?: “There are increasing reasons not to”

Antibiotics are a life-saving medication that have dramatically improved the survival rates of infants – but overusing them is potentially doing “more harm than good”.

In Australia, two-thirds of babies have already received antibiotics by the time they’re 12 months old, and this trend is on the rise. But is it really safe for our little ones?

Why would you give antibiotics to a child under one?

“I think it’s really important to say upfront that antibiotics are a critical medicine and can be lifesaving,” says Dr Penelope Bryant, a consultant in paediatric infectious diseases and medical lead at the Royal Children’s Hospital.

“There are a number of infections caused by bacteria in young children under the age of one, for which antibiotics are absolutely necessary.”

For example, when it comes to treating severe infections like pneumonia, bloodstream infections and meningitis, Penelope says antibiotics are “absolutely lifesaving”.

Listen to Dr Penelope Bryant on Feed Play Love:

Overuse is having an impact 

But as parents are becoming more health aware, there has been an increase in the use of antibiotics in children under one.

“We know that there’s a lot of antibiotic use that is unnecessary and … is something that we’re thinking is actually causing more harm than good,” says Penelope.

“Using lots and lots of antibiotics increases your chance of developing a resistant bacteria,” Penelope explains. “So what that means is a bacteria that causes an infection that’s then very hard to treat or sometimes impossible to treat.”

“That’s been recognised for the past couple of decades, and there’s been a lot of work trying to make sure people are aware of that risk.”

Why are antibiotics being overused?

As any parent will tell you, seeing your child sick is their worst nightmare, and if giving them antibiotics helps, then they’ll do that. 

“We’re much more protective of our children,” says Penelope. “But I think it’s because people recognise the risks: people understand what severe pneumonia and meningitis and bloodstream infections are, and they want to make sure that their child isn’t going to get those.”

As for the notion that parents are pressuring GPs for prescriptions, Penelope says that isn’t true.

“Parents are often coming in asking, ‘Does my child need an antibiotic?’ Rather than thinking that their child definitely needs an antibiotic. And I think there’s a mismatch between what GPs are thinking parents want and what parents are actually wanting.”

What about probiotics?

Maybe.

“There’s no evidence that the probiotics make children more robust,” says Penelope. “They mostly don’t do any harm on occasion.”

“People are now trying to research if you have had antibiotics, does giving probiotics reset your microbiome?”

While we don’t have any definitive answers yet, Penelope hopes this will soon change. 

“I think it’s a really important area of research, and I think in five years we’ll hopefully know the answer to that, but it’s not very helpful for us today.”

Weighing up the risks

The decision between an unwell baby now, or a potentially sick baby in the future is a hard decision to make. 

“There are increasing reasons not to use antibiotics as viral infections become more prominent in our young baby cohort than bacterial infections, particularly those who are immunised,” says Penelope.

“And as we are increasingly recognising the potential effects [overusing antibiotics will have] down the track, it’s always very hard to weigh up the risk between my child becoming severely unwell today and my child potentially having a risk that we don’t really know everything about in five years.”

“It’s a very difficult balance.”

If you are concerned about your baby’s health, talk to your GP.