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Improved feeding tolerance and growth are linked to increased gut microbial community diversity in very-low-birth-weight infants fed mother's own milk compared with donor breast milk

The American journal of clinical nutrition, 2019-04, Vol.109 (4), p.1088-1097 [Peer Reviewed Journal]

2019 American Society for Nutrition. ;Copyright © American Society for Nutrition 2019. 2019 ;Copyright © American Society for Nutrition 2019. ;Copyright American Society for Clinical Nutrition, Inc. Apr 2019 ;ISSN: 0002-9165 ;EISSN: 1938-3207 ;DOI: 10.1093/ajcn/nqz006 ;PMID: 30982856

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Title:
Improved feeding tolerance and growth are linked to increased gut microbial community diversity in very-low-birth-weight infants fed mother's own milk compared with donor breast milk
Author: Ford, Steven L ; Lohmann, Pablo ; Preidis, Geoffrey A ; Gordon, Pamela S ; O'Donnell, Andrea ; Hagan, Joseph ; Venkatachalam, Alamelu ; Balderas, Miriam ; Luna, Ruth Ann ; Hair, Amy B
Subjects: Abundance ; Adult ; Bacteria - classification ; Bacteria - genetics ; Bacteria - isolation & purification ; Biodiversity ; Birth ; Birth weight ; Breast milk ; Children ; Communities ; Diet ; Digestive system ; Digestive tract ; donor milk ; Enterocolitis ; Feces - microbiology ; Feeding ; feeding intolerance ; Female ; Gastrointestinal Microbiome ; Gene sequencing ; growth ; Humans ; Infant ; Infant Health ; Infant Nutritional Physiological Phenomena ; Infant, Newborn ; Infant, Very Low Birth Weight - growth & development ; Infant, Very Low Birth Weight - metabolism ; Infants ; Intestinal microflora ; Intolerance ; Low birth weight ; Male ; Microbiomes ; Microbiota ; Microorganisms ; Milk ; Milk, Human - metabolism ; Morbidity ; Multivariate analysis ; Necrotizing enterocolitis ; neonate ; Original Research Communications ; premature infant ; Prospective Studies ; Ribonucleic acid ; RNA ; rRNA 16S ; very low birth weight ; Weight ; Young Adult
Is Part Of: The American journal of clinical nutrition, 2019-04, Vol.109 (4), p.1088-1097
Description: Mother's own milk (MOM) is protective against gut microbiota alterations associated with necrotizing enterocolitis (NEC) and feeding intolerance among preterm infants. It is unclear whether this benefit is preserved with donor milk (DM) feeding. We aimed to compare microbiota development, growth, and feeding tolerance in very-low-birth-weight (VLBW) infants fed an exclusively human milk diet of primarily MOM or DM. One hundred and twenty-five VLBW infants born at Texas Children's Hospital were enrolled and grouped into cohorts based on percentage of MOM and DM in enteral feeds. Feeds were fortified with DM-derived fortifier per unit protocol. Weekly stool samples were collected for 6 wk for microbiota analysis [16S ribosomal RNA (rRNA) sequencing]. A research nurse obtained weekly anthropometrics. Clinical outcomes were compared via Wilcoxon's rank-sum test and Fisher's exact test, as well as multivariate analysis. The DM cohort (n = 43) received on average 14% mothers’ milk compared with 91% for the MOM cohort (n = 74). Diversity of gut microbiota across all time points (n = 546) combined was increased in MOM infants (P < 0.001). By 4 and 6 wk of life, microbiota in MOM infants contained increased abundance of Bifidobacterium (P = 0.02) and Bacteroides (P = 0.04), whereas DM-fed infants had increased abundance of Staphylococcus (P = 0.02). MOM-fed infants experienced a 60% reduction in feeding intolerance (P = 0.03 by multivariate analysis) compared with DM-fed infants. MOM-fed infants had greater weight gain than DM-fed infants. Compared with DM-fed infants, MOM-fed infants have increased gut microbial community diversity at the phylum and genus levels by 4 and 6 wk of life, as well as better feeding tolerance. MOM-fed infants had superior growth. The incidence of NEC and other gastrointestinal morbidity is low among VLBW infants fed an exclusively human milk diet including DM-derived fortifier. This trial was registered at clinicaltrials.gov as NCT02573779.
Publisher: United States: Elsevier Inc
Language: English
Identifier: ISSN: 0002-9165
EISSN: 1938-3207
DOI: 10.1093/ajcn/nqz006
PMID: 30982856
Source: Oxford Journals Open Access Collection
Geneva Foundation Free Medical Journals at publisher websites
MEDLINE
Alma/SFX Local Collection

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Improved feeding tolerance and growth are linked to increased gut microbial community diversity in very-low-birth-weight infants fed mother's own milk compared with donor breast milk

2019 American Society for Nutrition. ;Copyright © American Society for Nutrition 2019. 2019 ;Copyright © American Society for Nutrition 2019. ;Copyright American Society for Clinical Nutrition, Inc. Apr 2019 ;ISSN: 0002-9165 ;EISSN: 1938-3207 ;DOI: 10.1093/ajcn/nqz006 ;PMID: 30982856

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