We need more evidence about the risks and benefits of giving children faecal microbiota transplants (Jun 2024) FMT

[Michael Harrop]

https://onlinelibrary.wiley.com/doi/10.1111/apa.17339

The available data on FMT in children are sparse.3 The choice of FMT is pivotal, and even more critical, if the patient is a child. Adults exhibit a relatively stable gut microbiome, but the microbial composition in children varies significantly and evolves alongside their immune system and other physiological functions.6 Therefore, selecting an appropriate donor for children is a complex task. The lack of detailed guidelines poses challenges for paediatric practitioners.

The lack of well-designed, large RCTs on FMT treatment for children is problematic. There is potentially a high risk of publication bias from selective reporting of positive outcomes skewing the overall understanding of this intervention. Also, the lack of sham-treated control groups makes it challenging to differentiate between improvements due to FMT and those that would have occurred naturally over time.

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I raised this concern in the past:
Ethics concerns about a Finnish FMT clinical trial giving infants FMT from their mothers. "Main Trial of the Cesarean Section and Intestinal Flora of the Newborn Study (MT-SECFLOR)", Helsinki University Central Hospital. (Nov 2019)

To me, the obvious ethical alternative would be to screen young children/toddlers/infants to be FMT donors

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