The impact of breastfeeding on the preterm infant's microbiome and metabolome: a pilot study

Keriann Schulkers Escalante; Shiyu S Bai-Tong; Sarah M Allard; Gertrude Ecklu-Mensah; Concepcion Sanchez; Se Jin Song; Jack Gilbert; Lars Bode; Pieter Dorrestein; Rob Knight; David J Gonzalez; Sydney A Leibel; Sandra L Leibel

doi:10.1038/s41390-024-03440-9

The impact of breastfeeding on the preterm infant's microbiome and metabolome: a pilot study

Pediatr Res. 2024 Aug 13. doi: 10.1038/s41390-024-03440-9. Online ahead of print.

Authors

Affiliations

¹ Department of Pediatrics, University of California San Diego, Rady Children's Hospital, La Jolla, CA, USA.
² Department of Pediatrics, University of California San Diego, La Jolla, CA, USA.
³ Department of Pharmacology and the Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, USA.
⁴ Center for Microbiome Innovation, University of California San Diego, La Jolla, CA, USA.
⁵ Department of Pediatrics and Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA, USA.
⁶ Department of Pediatrics, Larsson-Rosenquist Foundation Mother-Milk-Infant Center of Research Excellence (MOMI CORE), and the Human Milk Institute (HMI), University of California San Diego, La Jolla, CA, USA.
⁷ Collaborative Mass Spectrometry Innovation Center, University of California San Diego, La Jolla, CA, USA.
⁸ Department of Pediatrics, University of California San Diego, Rady Children's Hospital, La Jolla, CA, USA. [email protected].

PMID: 39138352
DOI: 10.1038/s41390-024-03440-9

Abstract

Background: Human milk is unquestionably beneficial for preterm infants. We investigated how the transition from tube to oral/breastfeeding impacts the preterm infants' oral and gut microbiome and metabolome.

Methods: We analyzed stool, saliva, and milk samples collected from a cohort of preterm infants enrolled in the MAP Study, a prospective observational trial. The microbiome and metabolome of the samples were analyzed from 4 longitudinal sample time points, 2 during tube feeds only and 2 after the initiation of oral/breastfeeding.

Results: We enrolled 11 mother-infant dyads (gestational age = 27.9 (23.4-32.2)) and analyzed a total of 39 stool, 44 saliva, and 43 milk samples over 4 timepoints. In saliva samples, there was a shift towards increased Streptococcus and decreased Staphylococcus after oral feeding/breastfeeding initiation (p < 0.05). Milk sample metabolites were strongly influenced by the route of feeding and milk type (p < 0.05) and represented the pathways of Vitamin E metabolism, Vitamin B12 metabolism, and Tryptophan metabolism.

Conclusion: Our analysis demonstrated that the milk and preterm infant's saliva microbiome and metabolome changed over the course of the first four to 5 months of life, coinciding with the initiation of oral/breastfeeds.

Impact: The microbiome and metabolome is altered in the infant's saliva but not their stool, and in mother's milk when feeds are transitioned from tube to oral/breastfeeding. We assessed the relationship between the gut and oral microbiome/metabolome with the milk microbiome/metabolome over a longitudinal period of time in preterm babies. Metabolites that changed in the infants saliva after the initiation of oral feeds have the potential to be used as biomarkers for disease risk.