Babies born with very low birth weight (VLBW), which is defined as less than 1.5 kg at birth, have altered gut microbiota as compared to healthy term babies. This is a risk factor for neonatal growth and slowing/arrest of growth in the hospital.
To correct this, nutrition in hospitals could be designed with appropriate microbial constituents. A new study discusses how fortified human milk changes the gut microbiome in these babies.
Introduction
Breastmilk is the best source of nutrients for all infants, including VLBW. When the mother is unable to fulfill the baby’s milk requirements, donor milk from another lactating mother is used after pasteurization.
This pasteurized donor human milk (PDHM) is fortified with multiple nutrients that are typically derived from bovine milk to support VLBW infant growth. Currently, the use of human-milk-based fortifiers (HMBFs) instead of bovine-milk-based fortifiers (BMBFs) is being explored clinically.
There is little evidence to show how these fortifying milk products affect the infant gut microbiome, despite the fact that BMBFs are extensively used in neonatal intensive care units (NICUs). The current study reports the outcome of using either of these two milk fortifiers in infants born weighing less than 1.25 kg during their hospital stay.
Results
The researchers examined the stool samples of 119 infants to assess the composition of their gut flora. Over 500 of these samples were obtained at a median of five per infant. This yielded about 700 operational taxonomic units (OTUs), belonging to about 130 genera and 9 phyla.
The microbiome contained mainly Enterobacteriaceae, Clostridium sensu stricto, Veillonella, Staphylococcus, Haemophilus, and Enterococcus species, all of which were present in more than 50% of infants. Bacteroides and Streptococcus were also prominent, while almost 20% of samples were positive for Bifidobacterium. Every infant exhibited a different microbial composition that reflected an individual profile.
Conclusion
The current study is the only randomized controlled trial to demonstrate how different fortifiers affect the microbiome of VLBW infants. While changes in microbiome diversity could affect future health outcomes, further work using metabolomics and transcriptomics is needed to better understand the underlying mechanisms by which either type alters the fortifier effect on bacterial genes in a dose-dependent manner.
Source:
https://www.news-medical.net/news/20220824/Fortified-human-breastmilk-alters-the-microbiota-of-low-birth-weight-infants.aspx