United Kingdom: An Original Investigation in Paediatrics

An original investigation in Paediatrics, published in JAMA Network Open, has concluded that there is no impact exerted by pasteurized human milk/products on gut bacteria. The researchers said the human milk products given to preterm infants to supplement a shortfall in the mother's own milk do not affect clinical outcomes via microbial mechanisms. The researchers have justified the possibility that diet benefits the health but does not change gut microbiota.

There needs to be more data regarding using an exclusive human milk diet than the one using bovine products in preterm infants. There are some studies which have demonstrated lower rates of key neonatal morbidities. The gut microbiome is the potential mediating pathway.

The researchers have answered the question regarding the "EFFECTS OF HUMAN MILK DIET ON GUT MICROBIOTA AND CLINICAL OUTCOMES IN PRETERM INFANTS." They determined the effect of the human milk diet on the richness of gut bacteria, diversity, and specific taxa proportion in preterm infants from enrollment to 34 weeks postmenstrual age.

Study Points

• The site of the trial was four neonatal intensive care units in the UK (2017-2020).
• Infants under 30 weeks gestation received their mother's milk and were recruited before 72 hours of age.
• The primary outcomes and measures include gut microbiome profile.
• The researchers enrolled 126 preterm infants and divided them into two groups: Control and intervention.
• Both the control and intervention group had 63 preterm infants each.
• In the control group, the median gestation was 27 weeks, with a median birthweight of 910 g.
• In the intervention group, the median gestation was 27.1 weeks and the median birthweight was 930 g.
• The researchers analyzed 472 stool samples from 116 infants.
• There were no differences in bacterial richness reported.
• The exclusive human milk diet group had a reduced relative abundance of Lactobacillus.

Concluding further, in preterm infants using human milk–derived formula and fortifier to enable an exclusive human milk diet, there were no effects on gut bacterial diversity's overall measure, but there were effects on specific bacterial taxa previously associated with human milk receipt. They said human milk–derived products' clinical impact is not modulated via microbiomic mechanisms.

Further Reading

Embleton ND, et al. Effect of an Exclusive Human Milk Diet on the Gut Microbiome in Preterm Infants: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(3):e231165. doi:10.1001/jamanetworkopen.2023.1165