Influence of Feeding Type on Gut Microbiome Development in Hospitalized Preterm Infants

Abstract

Background Premature infants have a high risk for dysbiosis of the gut microbiome. Mother’s own breastmilk (MOM) has been found to favorably alter gut microbiome composition in infants born at term. Evidence about the influence of feeding type on gut microbial colonization of preterm infants is limited. Objective The purpose of this study was to explore the effect of feeding types on gut microbial colonization of preterm infants in the neonatal intensive care unit (NICU). Methods Thirty-three stable preterm infants were recruited at birth and followed-up for the first 30 days of life. Daily feeding information was used to classify infants into six groups (mother’s own milk [MOM], human donated milk [HDM], formula, MOM+HDM, MOM+Formula, and HDM+forumla) during postnatal days 0–10, 11–20, and 21–30 after birth. Stool samples were collected daily. DNA extracted from stool was used to sequence the 16S rRNA gene. Exploratory data analysis was conducted with a focus on temporal changes of microbial patterns and diversities among infants from different feeding cohorts. Prediction of gut microbial diversity from feeding type was estimated using linear mixed models. Results Preterm infants fed MOM (at least 70% of the total diet) had highest abundance of Clostridiales, Lactobacillales, and Bacillales compared to infants in other feeding groups, whereas infants fed primarily human donor milk or formula had a high abundance of Enterobacteriales compared to infants fed MOM. After controlling for gender, postnatal age, weight and birth gestational age, the diversity of gut microbiome increased over time and was constantly higher in infants fed MOM relative to infants with other feeding types (p < .01). Discussion Mother’s own breast milk benefits gut microbiome development of preterm infants, including balanced microbial community pattern and increased microbial diversity in early life.

Formula alters preterm infant gut microbiota and increases its antibiotic resistance load

“…Enterobacteriaceae was the dominant family in 29 of the 46 infants. These observations are in line with a previous report indicating that exposure to formula is associated with increased abundance of fecal enterobacteria 22 . In this study, similar to the ARG load, gestational age tended to be inversely correlated with Enterobacteriaceae abundance (fold change 22 % decrease / week of gestation; quasibinomial GLM:p < 0.1; Supplementary Table 2).…”

“…Formula-fed infants exhibited significantly reduced diversity of microbial communities compared to infants who were not fed formula (Figures 4c and 4d; Supplementary Table 6), which has also been observed previously 22 . Since the formula-fed infants were also enriched in potentially pathogenic species and had more antibiotic resistance genes, it appears to be likely that potentially pathogenic ARG-carrying bacteria can reach dominance the formula-fed infant gut microbiota resulting in a simple community largely consisting of an ARG-carrying pathogen.…”

Patterns of community assembly in the developing chicken microbiome reveal rapid primary succession

“…In another study, the immune system developed concurrently with the microbiome (Crhanova et al, 2011). Bacterial community succession occurs rapidly, and experiments sampling successional microbial systems at a high temporal resolution find that during early colonization, the microbial community may exhibit radical shifts in composition at a daily scale (Cong et al, 2017;Gilbert et al, 2010), in correspondence with bacterial growth cycles and their ecological niches (Barnard, Osborne, & Firestone, 2015). Defining microbial succession in the GIT is critical to understanding gut community assembly, disturbance responses, and disease (Marino, Baxter, Huffnagle, Petrosino, & Schloss, 2014), but they have not been studied at a sufficient temporal resolution to understand the mechanisms behind the observed dynamics, particularly during the first week of development.…”

A pilot study on nutrients, antimicrobial proteins, and bacteria in commerce‐free models for exchanging expressed human milk in the USA

“…Other studies conducted using nonculturing methods suggest that some bacteria are endogenous to human milk and do not originate from contact with the skin (Martín et al, ; Perez, Doré, Leclerc, & Levenez, ). A study of preterm infants fed unpasteurized human milk showed higher diversity within their gut microbiome than preterm infants fed pasteurized human milk or formula, suggesting that bacteria present in raw human milk may contribute to the development of the infant microbiome (Cong et al, ).…”