The feasibility of gastrointestinal (GI) microbiome work in a pediatric intensive care unit (PICU) to determine the GI microbiota composition of infants as compared to control infants from the same hospital was investigated. In a single-site observational study at an urban quaternary care children’s hospital in Western Michigan, subjects less than 6 months of age, admitted to the PICU with severe respiratory syncytial virus (RSV) bronchiolitis, were compared to similarly aged control subjects undergoing procedural sedation in the outpatient department. GI microbiome samples were collected at admission (n = 20) and 72 h (n = 19) or at time of sedation (n = 10). GI bacteria were analyzed by sequencing the V4 region of the 16S rRNA gene. Alpha and beta diversity were calculated. Mechanical ventilation was required for the majority (n = 14) of study patients, and antibiotics were given at baseline (n = 8) and 72 h (n = 9). Control subjects’ bacterial communities contained more Porphyromonas, and Prevotella (p = 0.004) than those of PICU infants. The ratio of Prevotella to Bacteroides was greater in the control than the RSV infants (mean ± SD—1.27 ± 0.85 vs. 0.61 ± 0.75: p = 0.03). Bacterial communities of PICU infants were less diverse than those of controls with a loss of potentially protective populations.
Vitamin D supplementation for breastfed infants is recommended due to low levels of vitamin D in human milk and the high prevalence of vitamin D deficiency. The relationship between maternal vitamin D supplementation while breastfeeding and infant serum vitamin D levels is beginning to be described. A literature review was conducted that investigated the impact of maternal supplementation, with at least 4000 IU of vitamin D, on infant serum vitamin D levels. Inclusion criteria were publication between 2016–2022, primary research, exclusively breastfed infants, and mothers taking vitamin D supplements while breastfeeding. Exclusion criteria were publication prior to 2016, review articles, results that did not include infant serum vitamin D levels, and research using participants already included in this review. Over 90% of infants whose mothers took vitamin D supplements while breastfeeding had adequate serum vitamin D levels. The final mean serum vitamin D of all infant participants whose mothers consumed vitamin D supplementation was 66.7 nmol/L, while mean serum vitamin D in those whose mothers did not consume supplements was 33.5 nmol/L. Consumption of vitamin D supplements by lactating women exclusively breastfeeding their infants can lead to adequate serum vitamin D levels in their infants.
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