Personalization of the Microbiota of Donor Human Milk with Mother’s Own Milk

Abstract

The American Academy of Pediatrics recommends that extremely preterm infants receive mother’s own milk (MOM) when available or pasteurized donor breast milk (DBM) when MOM is unavailable. The goal of this study was to determine whether DBM could be inoculated with MOM from mothers of preterm infants to restore the live microbiota (RM). Culture dependent and culture independent methods were used to analyze the fluctuations in the overall population and microbiome, respectively, of DBM, MOM, and RM samples over time. Using MOM at time = 0 (T0) as the target for the restoration process, this level was reached in the 10% (RM-10) and 30% (RM-30) mixtures after 4 h of incubation at 37°C, whereas, the larger dilutions of 1% (RM-1) and 5% (RM-5) after 8 h. The diversity indexes were similar between MOM and DBM samples, however, different genera were prevalent in each group. Interestingly, 40% of the bacterial families were able to expand in DBM after 4 h of incubation indicating that a large percentage of the bacterial load present in MOM can grow when transferred to DBM, however, no core microbiome was identified. In summary, the microbiome analyses indicated that each mother has a unique microbiota and that live microbial reestablishment of DBM may provide these microbes to individual mothers’ infants. The agreement between the results obtained from the viable bacterial counts and the microbiome analyses indicate that DBM incubated with 10–30% v/v of the MOM for 4 h is a reasonable restoration strategy.

Human Milk’s Hidden Gift: Implications of the Milk Microbiome for Preterm Infants’ Health

“…Some authors postulate that preterm infants fed DHM or formula are devoid of contact with HMM [79], and for this reason strategies which allow an early exposure of preterm infants to the HMM have been proposed. To this purpose, Cacho et al [80] inoculated DHM with small amounts of MOM from mothers of preterm infants. According to viable cell counts and microbiome analysis, they suggested that DHM incubated with 10% MOM for 4 h was a reasonable restoration strategy.…”

Inherited nongenetic influences on the gut microbiome and immune system

“…Preterm infants fed donor milk had gut microbiomes that more closely resembled infants fed their mother's own milk compared with formula fed infants (Parra‐Llorca et al, ). In addition, some groups have tested the viability of “spiking” donor milk with infants' own mothers milk to inoculate the infants with a personalized microbiome (Cacho et al, ), a concept similar to a recent push to include probiotics in infant formula (Aceti et al, ; Cavallaro, Villamor‐Martínez, Filippi, Mosca, & Villamor, ; Mugambi, Musekiwa, Lombard, Young, & Blaauw, ; Rautava et al, ; Villamor‐Martínez et al, ). These interventions showcase the importance of breastfeeding, or in lieu of breastfeeding, a diet reflecting the myriad of components maternally transferred that support the development of the offspring's immune system and shape gut homeostasis during early life.…”

Mother's Own Milk: How Does It Differ from Donor Milk for the Baby

“…18 A recent study demonstrated that incubation of donor milk with 10% of mothers' own milk for 4-8 hours resulted in microbe levels similar to those seen in mothers' own milk. 18 Alternative pasteurization techniques, such as ultraviolet C radiation, can be developed that help preserve the essential bioactive components that are lost in the processing of donor milk. 19 Because many aspects of donor milk are suboptimal for preterm infants, there is a theoretical rationale for preferring mothers' own milk over banked donor milk; however, well-designed randomized controlled studies are needed to further evaluate the benefits of mothers' own milk and donor milk in preterm infants.…”

“…Compared with donor milk, mothers' own milk has a higher concentration of most microbes and differs in the relative abundance of bacterial genera. 18 Mothers' own milk could potentially be used to personalize the microbiota of donor milk. 18 A recent study demonstrated that incubation of donor milk with 10% of mothers' own milk for 4-8 hours resulted in microbe levels similar to those seen in mothers' own milk.…”

“…18 Mothers' own milk could potentially be used to personalize the microbiota of donor milk. 18 A recent study demonstrated that incubation of donor milk with 10% of mothers' own milk for 4-8 hours resulted in microbe levels similar to those seen in mothers' own milk. 18 Alternative pasteurization techniques, such as ultraviolet C radiation, can be developed that help preserve the essential bioactive components that are lost in the processing of donor milk.…”