Preterm infants fed on breastmilk healthier than formula-fed babies - research

University of Maryland scientists have discovered that preterm infants that were fed on breastmilk were much less likely to develop a deadly gut disease than those fed on milk formula.

This is because breastmilk naturally contains probiotic bacteria Bifidobacterium breve - or B. breve as it’s also known – which the researchers claim plays a key role in the prevention of so-called leaky gut syndrome.

The syndrome, which is common among preterm infants and can lead to life-threatening disease necrotizing enterocolitis (NEC), means the lining of the intestines is too weak to prevent ‘leakage’ of toxins and bacteria into the bloodstream.

The researchers concluded that supplementing B. breve to preemies, particularly those fed on milk formula but also breastfed babies, could improve prevention of the syndrome and its potentially devastating consequences.

Who's at risk

Formula is often a necessary dietary supplement for preterm infants as mothers may produce less milk than those who deliver at term, the scientists explained in their study.

They found that 63 of the neonates in the cohort selected for the study were exclusively breastfed, while others had their diet complemented with either formula (31) or donor breastmilk (12); nine were formula-fed. Among those fed exclusively on formula, intestinal permeability (IP) incidence was found to be significantly higher compared to either combination-fed infants or those who were exclusively breastfed.

The scientists estimated that around 150 to 180 mL/kg of cumulative intake of mother’s own milk (MOM) was associated with a reduced risk of developing ‘leaky gut’.

“Together, our results indicate that sufficient MOM used alone or combined with other forms of feeding significantly impacts IP in early preterm infants,”​ the researchers wrote in their analysis. “Even more importantly, these results imply that the benefits of breastmilk feeding are beyond nutrition alone, but extend to postnatal intestinal barrier maturation.”​

The solution

Previous studies had proposed feeding preterm infants breastmilk within the first 8 to 10 days since birth as a key prevention strategy, but researchers now argue that counting on the transmission of B. breve from the mother’s body alone may not be enough to protect infants.

Their newly-proposed course of action is to supplement Bifidobacterium and human milk oligosaccharides (HMOs) to all infants prophylactically through live biotherapeutics.

“Our study highlights the strong potential for the prophylactic administration of specific B. breve strains early in life along with specific human milk oligosaccharides (HMOs) to enhance the intestinal barrier in preterm neonates. (…)​

“[It] proposes mechanistic roles of breastmilk feeding and intestinal microbial colonization in postnatal intestinal barrier maturation; these observations are critical toward advancing therapeutics to prevent and treat hyperpermeable gut-associated conditions, including necrotizing enterocolitis.”​

Source: ASM Journals
‘Highly Specialized Carbohydrate Metabolism Capability in Bifidobacterium Strains Associated with Intestinal Barrier Maturation in Early Preterm Infants’
Published 13 June 2022
DOI: https://doi.org/10.1128/mbio.01299-22
Authors: Bing Ma, Sripriya Sundararajan, Gita Nadimpalli, Michael France, Elias McComb, Lindsay Rutt, Jose M. Lemme-Dumit, Elise Janofsky, Lisa S. Roskes, Pawel Gajer, Li Fu, Hongqiu Yang, Mike Humphrys, Luke J. Tallon, Lisa Sadzewicz, Marcela F. Pasetti, Jacques Ravel, Rose M. Viscardi