Source of human milk (mother or donor) is more important than fortifier type (human or bovine) in shaping the preterm infant microbiome

Shreyas V Kumbhare; William-Diehl Jones; Sharla Fast; Christine Bonner; Geert 't Jong; Gary Van Domselaar; Morag Graham; Michael Narvey; Meghan B Azad

doi:10.1016/j.xcrm.2022.100712

Source of human milk (mother or donor) is more important than fortifier type (human or bovine) in shaping the preterm infant microbiome

Cell Rep Med. 2022 Sep 20;3(9):100712. doi: 10.1016/j.xcrm.2022.100712. Epub 2022 Aug 26.

Authors

Shreyas V Kumbhare¹, William-Diehl Jones², Sharla Fast³, Christine Bonner⁴, Geert 't Jong⁵, Gary Van Domselaar⁶, Morag Graham⁶, Michael Narvey⁵, Meghan B Azad⁷

Affiliations

¹ Manitoba Interdisciplinary Lactation Centre (MILC), Winnipeg, MB, Canada; Children's Hospital Research Institute of Manitoba (CHRIM), Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.
² Children's Hospital Research Institute of Manitoba (CHRIM), Winnipeg, MB, Canada; Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada.
³ Department of Nutrition and Food Services, Health Sciences Centre, Winnipeg, MB, Canada.
⁴ National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada.
⁵ Children's Hospital Research Institute of Manitoba (CHRIM), Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.
⁶ National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada; Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada.
⁷ Manitoba Interdisciplinary Lactation Centre (MILC), Winnipeg, MB, Canada; Children's Hospital Research Institute of Manitoba (CHRIM), Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada. Electronic address: [email protected].

Abstract

Milk fortifiers help meet the nutritional needs of preterm infants receiving their mother's own milk (MOM) or donor human milk. We conducted a randomized clinical trial (NCT03214822) in 30 very low birth weight premature neonates comparing bovine-derived human milk fortifier (BHMF) versus human-derived fortifier (H2MF). We found that fortifier type does not affect the overall microbiome, although H2MF infants were less often colonized by an unclassified member of Clostridiales Family XI. Secondary analyses show that MOM intake is strongly associated with weight gain and microbiota composition, including Bifidobacterium, Veillonella, and Propionibacterium enrichment. Finally, we show that while oxidative stress (urinary F2-isoprostanes) is not affected by fortifier type or MOM intake, fecal calprotectin is higher in H2MF infants and lower in those consuming more MOM. Overall, the source of human milk (mother versus donor) appears more important than the type of milk fortifier (human versus bovine) in shaping preterm infant gut microbiota.

Keywords: calprotectin; gut inflammation; gut microbiome; human donor milk; human milk fortifiers; mother’s own milk; oxidative stress; very low birth weight infants.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Animals
Cattle
F2-Isoprostanes
Female
Humans
Infant
Infant Formula*
Infant, Newborn
Infant, Premature
Leukocyte L1 Antigen Complex
Microbiota*
Milk, Human*
Mothers

Substances

F2-Isoprostanes
Leukocyte L1 Antigen Complex

Associated data

ClinicalTrials.gov/NCT03214822