A Pilot Study Exploring Temporal Development of Gut Microbiome/Metabolome in Breastfed Neonates during the First Week of Life

Imad Awan; Emily Schultz; John D Sterrett; Lamya'a M Dawud; Lyanna R Kessler; Deborah Schoch; Christopher A Lowry; Lori Feldman-Winter; Sangita Phadtare

doi:10.5223/pghn.2023.26.2.99

A Pilot Study Exploring Temporal Development of Gut Microbiome/Metabolome in Breastfed Neonates during the First Week of Life

Pediatr Gastroenterol Hepatol Nutr. 2023 Mar;26(2):99-115. doi: 10.5223/pghn.2023.26.2.99. Epub 2023 Mar 7.

Authors

Imad Awan¹, Emily Schultz², John D Sterrett³, Lamya'a M Dawud³, Lyanna R Kessler³, Deborah Schoch⁴, Christopher A Lowry³, Lori Feldman-Winter⁴, Sangita Phadtare²

Affiliations

¹ Department of Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA.
² Department of Biomedical Sciences, Cooper Medical School of Rowan University, Camden, NJ, USA.
³ Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA.
⁴ Cooper Medical School of Rowan University and Cooper University Hospital, Camden, NJ, USA.

Abstract

Purpose: Exclusive breastfeeding promotes gut microbial compositions associated with lower rates of metabolic and autoimmune diseases. Its cessation is implicated in increased microbiome-metabolome discordance, suggesting a vulnerability to dietary changes. Formula supplementation is common within our low-income, ethnic-minority community. We studied exclusively breastfed (EBF) neonates' early microbiome-metabolome coupling in efforts to build foundational knowledge needed to target this inequality.

Methods: Maternal surveys and stool samples from seven EBF neonates at first transitional stool (0-24 hours), discharge (30-48 hours), and at first appointment (days 3-5) were collected. Survey included demographics, feeding method, medications, medical history and tobacco and alcohol use. Stool samples were processed for 16S rRNA gene sequencing and lipid analysis by gas chromatography-mass spectrometry. Alpha and beta diversity analyses and Procrustes randomization for associations were carried out.

Results: Firmicutes, Proteobacteria, Bacteroidetes and Actinobacteria were the most abundant taxa. Variation in microbiome composition was greater between individuals than within (p=0.001). Palmitic, oleic, stearic, and linoleic acids were the most abundant lipids. Variation in lipid composition was greater between individuals than within (p=0.040). Multivariate composition of the metabolome, but not microbiome, correlated with time (p=0.030). Total lipids, saturated lipids, and unsaturated lipids concentrations increased over time (p=0.012, p=0.008, p=0.023). Alpha diversity did not correlate with time (p=0.403). Microbiome composition was not associated with each samples' metabolome (p=0.450).

Conclusion: Neonate gut microbiomes were unique to each neonate; respective metabolome profiles demonstrated generalizable temporal developments. The overall variability suggests potential interplay between influences including maternal breastmilk composition, amount consumed and living environment.

Keywords: Breastfed; Formula milk; Formula-fed; Gastrointestinal microbiome; Human milk; Infant; Infant gut microbiome; Lipidomic; Metabolite; Metabolome.