Human milk feeding enriches beneficial microbiota in very low birth weight pre-term infants
Year: 2015
Type: article
Study design: Observational Study
Abstract: In the United States, nearly 500,000 infants are born pre-term each year.These infants are at high risk of serious complications, including necrotizing enterocolitis (NEC), sepsis, and death.While hospitalized these infants routinely receive multiple doses of broad-spectrum antibiotics, which can have profound and lasting effects on the composition of the intestinal microbiome.Microbiome composition, in turn, can impact a variety of health outcomes including NEC and sepsis.We were interested in determining how feeding strategies impact microbiome composition in infants receiving large doses of antibiotics.The standard of care in Cincinnati is for hospitalized pre-term infants to receive human milk (either mother's own milk or pasteurized donor milk) for the first 14 days of life.After that point they may receive formula, milk, or a combination of milk and formula.We hypothesized that infants who continue to receive predominantly human milk in week three of life would have greater microbiome diversity characterized by increased Bacteroides and Bifidobacteria and decreased Clostridia.We examined the intestinal microbiome of 71 infants from two Cincinnati NICUs.Our experimental cohort consisted only of infants born <32 weeks gestation, with birth weight between 850 and 1500 grams.All infants were free of congenital abnormalities, did not display overt feeding difficulties, survived free of NEC or sepsis, and had stool samples in weeks one, two, and three of life.We examined the effect of heavy antibiotics (≥5 days treatment) and light antibiotics (1-4 days treatment) versus no antibiotics.We then examined the effect of feeding predominantly human milk versus formula in week three of life within each category of antibiotics treatment.Stool samples were collected, 16s rRNA extracted, and microbiome data analyzed for alpha diversity and beta diversity.Microbiome composition was determined by LEfSe.We determined that in all categories, including heavy antibiotics, infants receiving human milk had more Bacteroides.While not significant, a trend toward greater Bifidobacteria and decreased Clostridia was noted with more human milk feeding.Intriguingly, heavier antibiotic use resulted in significantly increased Bacteroides in human milk-fed infants.This preliminary study shows that human milk feeding of pre-term infants has a beneficial effect on microbiome composition even when the infant is receiving broad-spectrum antibiotics.i I gratefully acknowledge the support of my mentor, Dr. Ardythe Morrow, for her unwavering help and constant encouragement as I followed my own path
Author: Olivia Ballard
Institution: University of Cincinnati
Language: English
Topic: Infant Nutrition and Health
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2618063885