Fecal Short‐Chain Fatty Acids of Very‐Low‐Birth‐Weight Preterm Infants Fed Expressed Breast Milk or Formula

Pourcyrous, Massroor; Nolan, Vikki G.; Goodwin, Andrew; Davis, Samantha L.; Buddington, Randal K.

doi:10.1097/mpg.0000000000000515

Cited by 30 publications

(26 citation statements)

References 48 publications

(76 reference statements)

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“…Propanediol was also found in high concentrations in HIGH-ALPHA pigs. Propanediol is a precursor of propionate, a hepatic and intestinal gluconeogenic substrate [65] that may also correlate to lower NEC risk [66]. Together with the higher levels of several other microbial metabolites, this suggests an altered fermentation pattern after supplementation with high amounts of α-Lac, although no association between bacterial families/genera and microbial metabolites were found.…”

Section: Discussionmentioning

confidence: 96%

Alpha-Lactalbumin Enriched Whey Protein Concentrate to Improve Gut, Immunity and Brain Development in Preterm Pigs

et al. 2020

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Human milk is rich in nutritional factors, such as alpha-lactalbumin (α-Lac), and important for neonatal development, but nutrient supplementation may be required for optimal growth. Using a pig model, we hypothesized that α-Lac-enriched whey protein concentrate (WPC) supplementation improves neonatal development. Cesarean-delivered preterm pigs were fed either dilute bovine milk (REF) or REF milk supplemented with WPC with normal (STANDARD-ALPHA) or high (HIGH-ALPHA) α-Lac. Clinical, gut, immune and cognitive endpoints (open field, T-maze) were assessed and tissues collected at Day 19. The growth of STANDARD-ALPHA and HIGH-ALPHA were higher than REF (31 vs. 19 g/kg/d). Most organ weights, gut, immunity and brain variables were similar between WPC groups. HIGH-ALPHA had a higher bone mineral content, colon microbial diversity and an abundance of specific bacteria and microbial metabolites, and tended to show a faster food transit time (p = 0.07). Relative to REF, WPC pigs showed higher relative organ weights, blood amino acids, blood neutrophil function, and microbial metabolites, but lower brush-border enzyme activities and plasma cortisol. Cognition outcomes did not differ among the groups. In conclusion, WPC supplementation of milk improved some growth, gut and immunity parameters in preterm pigs. However, increasing the α-Lac content beyond human milk levels had limited effects on the immature gut and developing brain.

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Section: Discussionmentioning

confidence: 96%

Alpha-Lactalbumin Enriched Whey Protein Concentrate to Improve Gut, Immunity and Brain Development in Preterm Pigs

et al. 2020

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“…Although to date no preventative measures have been established to routinely prevent the expression of NEC, certain approaches have reduced its incidence and severity. If a premature infant weighing less than 1500 grams is given its mother's expressed breast milk, the premature is less likely to develop NEC and if it does the condition is less severe [11]. In addition, in small clinical trials certain probiotics have reduced the incidence and severity of NEC [7,8].…”

Section: Discussionmentioning

confidence: 99%

“…Short chain fatty acids (SCFAs) are produced by intestinal commensal bacteria interacting with a diet rich in complex carbohydrates which cannot be metabolized by enzymes in the small intestine [9]. In the immature human intestine, SCFAs are produced when expressed breastmilk fed to prematures interacts with colonizing bacteria [10,11] for example, Bifidobacteria infantis can produce increased levels of SCFAs (acetate, propionate and butyrate) [12]. A number of studies in mature intestine have shown that SCFAs have anti-inflammatory effects under conditions of intestinal inflammation such as dextran sulfate sodium (DSS) colitis and are in short supply in patients with inflammatory bowel disease and rheumatoid arthritis [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Short chain fatty acids produced by colonizing intestinal commensal bacterial interaction with expressed breast milk are anti-inflammatory in human immature enterocytes

et al. 2020

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Necrotizing enterocolitis (NEC) is a devastating intestinal emergency that affects ten percent of very low birth weight premature babies and costs society in both expense and heartache. It is probably caused by an inappropriate interaction of colonizing bacteria with an immature intestine. A possible preventative measure is to feed prematures their mother's expressed breast milk in conjunction with a probiotic. This synbiotic prevention reduces the severity and incidence of this condition. This study was designed to determine the mechanism of the synbiotic effect in human and mouse fetal intestine. Breast milk interacting with a NEC preventative probiotic such as Bifidobacterium infantis can produce increased levels of short chain fatty acids (acetate, propionate and butyrate) (SCFAs). SCFAs are known to be anti-inflammatory in mature enterocytes and immunocytes. Very little is known about their role in immature intestine. When exposed to a human fetal cell line, fetal intestinal organoids and fetal mouse intestine, these SCFAs were anti-inflammatory. Their mechanism of antiinflammation differed from those reported for mature cells by involving the G-protein coupled receptor (GPR 109A) and inhibiting histone deacetylase 4 and 5. These bacterial metabolites may help explain the synbiotic anti-inflammatory effect of breast milk and probiotics given to premature infants at risk for NEC.

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“…While this study did not find differences in Bacteroides colonization over time as a result feeding, we know from other studies that feeding, specifically feeding with human milk, provides many advantages to the preterm infant’s early intestinal colonization. 14 For preterm infants born via Cesarean section, we may consider introducing human milk feedings as early in the neonatal period as possible as a strategy to promote an optimal intestinal microbiome. Along these lines, future consideration may be given to the administration of a specific probiotic that is targeted at influencing the pattern of Bacteroides colonization following Cesarean birth.…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, preterm infants fed human milk had greater levels of total short chain fatty acids, and specific fatty acids including acetate, propionate, and chloride. 14 …”

Section: Background and Significancementioning

confidence: 99%

Mode of Birth Influences Preterm Infant Intestinal Colonization With Bacteroides Over the Early Neonatal Period

Gregory

LaPlante

Shan

et al. 2015

Advances in Neonatal Care

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Background Intestinal colonization during infancy is important to short and long term health outcomes. Bacteroides, an early member of the intestinal microbiome, are necessary for breaking down complex molecules within the intestine and function to assist the body’s immune system in fighting against potentially harmful pathogens. Little is known about the colonization pattern of Bacteroides in preterm infants during the early neonatal period. Purpose This study measured Bacteroides colonization during the early neonatal period in a population of preterm infants based on clinical factors including mode of birth, antibiotics, and nutrition. Methods Bacterial DNA was isolated from 144 fecal samples from 29 preterm infants and analyzed using quantitative real time polymerase chain reaction (PCR). Analyses included liner mixed models to determine which clinical factors affect Bacteroides colonization of the infant gut. Results We found that infants born via vaginal canal had a higher rate of increase in Bacteroides than infants born via Cesarean section (p<.001). We did not find significant associations between antibiotic administration and differences in nutritional exposures with Bacteroides colonization. Implications for Practice These findings highlight the significant influence of mode of birth on Bacteroides colonization. While mode of birth is not always modifiable, these study findings may help develop interventions for preterm infants born via Cesarean section aimed at overcoming delayed Bacteroides colonization. Implications for Research Greater study of the intestinal microbiome and the clinical factors relevant to the preterm infant is needed so that interventions may be developed and tested, resulting in optimal microbial and immune health.

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Fecal Short‐Chain Fatty Acids of Very‐Low‐Birth‐Weight Preterm Infants Fed Expressed Breast Milk or Formula

Abstract: Diets fed to VLBW preterm infants influence fecal SCFA profiles, and hence the metabolism of the GI bacteria, and potentially the health of preterm infants. The responses of bacterial metabolism to diet are influenced with postnatal age and gestational age at birth.

Cited by 30 publications

References 48 publications

Alpha-Lactalbumin Enriched Whey Protein Concentrate to Improve Gut, Immunity and Brain Development in Preterm Pigs

Alpha-Lactalbumin Enriched Whey Protein Concentrate to Improve Gut, Immunity and Brain Development in Preterm Pigs

Short chain fatty acids produced by colonizing intestinal commensal bacterial interaction with expressed breast milk are anti-inflammatory in human immature enterocytes

Mode of Birth Influences Preterm Infant Intestinal Colonization With Bacteroides Over the Early Neonatal Period

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