scholarly journals The Role of Human Milk Oligosaccharides and Probiotics on the Neonatal Microbiome and Risk of Necrotizing Enterocolitis: A Narrative Review

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 3052
Author(s):  
Lila S. Nolan ◽  
Jamie M. Rimer ◽  
Misty Good
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Mode Of Delivery ◽  
Intestinal Barrier ◽  
Vulnerable Population ◽  
Human Milk Oligosaccharides ◽  
Milk Oligosaccharides ◽  
Intestinal Homeostasis

Preterm infants are a vulnerable population at risk of intestinal dysbiosis. The newborn microbiome is dominated by Bifidobacterium species, though abnormal microbial colonization can occur by exogenous factors such as mode of delivery, formula feeding, and exposure to antibiotics. Therefore, preterm infants are predisposed to sepsis and necrotizing enterocolitis (NEC), a fatal gastrointestinal disorder, due to an impaired intestinal barrier, immature immunity, and a dysbiotic gut microbiome. Properties of human milk serve as protection in the prevention of NEC. Human milk oligosaccharides (HMOs) and the microbiome of breast milk are immunomodulatory components that provide intestinal homeostasis through regulation of the microbiome and protection of the intestinal barrier. Enteral probiotic supplements have been trialed to evaluate their impact on establishing intestinal homeostasis. Here, we review the protective role of HMOs, probiotics, and synbiotic combinations in protecting a vulnerable population from the pathogenic features associated with necrotizing enterocolitis.

scholarly journals Human Milk Oligosaccharides to Prevent Gut Dysfunction and Necrotizing Enterocolitis in Preterm Neonates

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1461 ◽  
Author(s):  
Stine Bering
Keyword(s):  
Preterm Birth ◽  
Human Milk ◽  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Bacterial Colonization ◽  
Health Benefits ◽  
Preterm Neonates ◽  
Human Milk Oligosaccharides ◽  
High Concentration ◽  
Milk Oligosaccharides

This review focuses on the evidence for health benefits of human milk oligosaccharides (HMOs) for preterm infants to stimulate gut adaptation and reduce the incidence of necrotizing enterocolitis (NEC) in early life. The health benefits of breastfeeding are partly explained by the abundant HMOs that serve as prebiotics and immunomodulators. Gut immaturity in preterm infants leads to difficulties in tolerating enteral feeding and bacterial colonization and a high sensitivity to NEC, particularly when breast milk is insufficient. Due to the immaturity of the preterm infants, their response to HMOs could be different from that in term infants. The concentration of HMOs in human milk is highly variable and there is no evidence to support a specifically adapted high concentration in preterm milk. Further, the gut microbiota is not only different but also highly variable after preterm birth. Studies in pigs as models for preterm infants indicate that HMO supplementation to formula does not mature the gut or prevent NEC during the first weeks after preterm birth and the effects may depend on a certain stage of gut maturity. Supplemented HMOs may become more important for gut protection in the preterm infants when the gut has reached a more mature phase.

scholarly journals Human milk oligosaccharides prevent Necrotizing Enterocolitis in neonatal rats

2010 ◽  
Vol 24 (S1) ◽  
Author(s):  
Lars Bode ◽  
Kerstin Goth ◽  
Yigit Guner ◽  
Caroline Nissan ◽  
Monica Zherebtsov ◽  
...  
Keyword(s):  
Human Milk ◽  
Necrotizing Enterocolitis ◽  
Neonatal Rats ◽  
Human Milk Oligosaccharides ◽  
Milk Oligosaccharides

scholarly journals The Role of Two Human Milk Oligosaccharides, 2′-Fucosyllactose and Lacto-N-Neotetraose, in Infant Nutrition

2019 ◽  
Vol 22 (4) ◽  
pp. 330 ◽  
Author(s):  
Badriul Hegar ◽  
Yulianti Wibowo ◽  
Ray Wagiu Basrowi ◽  
Reza Gunadi Ranuh ◽  
Subianto Marto Sudarmo ◽  
...  
Keyword(s):  
Human Milk ◽  
Infant Nutrition ◽  
Human Milk Oligosaccharides ◽  
Milk Oligosaccharides

scholarly journals The role of human milk oligosaccharides (HMOs) in the establishment and proliferation of Bifidobacterium infantis in the infant gut

2008 ◽  
Vol 22 (S1) ◽  
Author(s):  
Riccardo G LoCascio ◽  
Gabriel Paulino ◽  
Samara L Freeman ◽  
Carlito B Lebrilla ◽  
J. Bruce German ◽  
...  
Keyword(s):  
Human Milk ◽  
Human Milk Oligosaccharides ◽  
Bifidobacterium Infantis ◽  
Milk Oligosaccharides

scholarly journals B. infantis EVC001 Is Well-Tolerated and Improves Human Milk Oligosaccharide Utilization in Preterm Infants in the Neonatal Intensive Care Unit

2022 ◽  
Vol 9 ◽  
Author(s):  
Sarah Bajorek ◽  
Rebbeca M. Duar ◽  
Maxwell Corrigan ◽  
Christa Matrone ◽  
Kathryn A. Winn ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Human Milk ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Fecal Microbiota ◽  
Metagenomic Sequencing ◽  
Human Milk Oligosaccharides ◽  
Milk Oligosaccharides

Not all infants carry specialized gut microbes, meaning they cannot digest human milk oligosaccharides and therefore do not receive complete benefits from human milk. B. infantis EVC001 is equipped to convert the full array of complex oligosaccharides into compounds usable by the infant, making it an ideal candidate to stabilize gut function and improve nutrition in preterm infants. A prospective, open-label study design was used to evaluate the tolerability of B. infantis EVC001 and its effects on the fecal microbiota in preterm infants in a Neonatal Intensive Care Unit. Thirty preterm infants <1,500 g and/or <33 weeks gestation at birth were divided into two matched groups, and control infants were enrolled and discharged prior to enrolling EVC001 infants to prevent cross-colonization of B. infantis: (1) fifteen control infants received no EVC001, and (2) fifteen infants received once-daily feedings of B. infantis EVC001 (8.0 x 109 CFU) in MCT oil. Clinical information regarding medications, growth, nutrition, gastrointestinal events, diagnoses, and procedures was collected throughout admission. Infant stool samples were collected at baseline, Study Days 14 and 28, and 34-, 36-, and 38-weeks of gestation. Taxonomic composition of the fecal microbiota, functional microbiota analysis, B. infantis, and human milk oligosaccharides (HMOs) in the stool were determined or quantified using 16S rRNA gene sequencing, metagenomic sequencing, qPCR, and mass spectrometry, respectively. No adverse events or tolerability issues related to EVC001 were reported. Control infants had no detectable levels of B. infantis. EVC001 infants achieved high levels of B. infantis (mean = 9.7 Log10 CFU/μg fecal DNA) by Study Day 14, correlating with less fecal HMOs (ρ = −0.83, P < 0.0001), indicating better HMO utilization in the gut. In this study, B. infantis EVC001 was shown to be safe, well-tolerated, and efficient in colonizing the preterm infant gut and able to increase the abundance of bifidobacteria capable of metabolizing HMOs, resulting in significantly improved utilization of human milk.Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT03939546, identifier: NCT03939546.

Assessment of the synbiotic properites of human milk oligosaccharides and Bifidobacterium longum subsp. infantis in vitro and in humanised mice

2017 ◽  
Vol 8 (2) ◽  
pp. 281-289 ◽  
Author(s):  
S. Musilova ◽  
N. Modrackova ◽  
P. Hermanova ◽  
T. Hudcovic ◽  
R. Svejstil ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Human Milk ◽  
Pathogenic Bacteria ◽  
Bifidobacterium Longum ◽  
Mode Of Delivery ◽  
Human Milk Oligosaccharides ◽  
Milk Oligosaccharides ◽  
High Concentrations

The mode of delivery plays a crucial role in infant gastrointestinal tract colonisation, which in the case of caesarean section is characterised by the presence of clostridia and low bifidobacterial counts. Gut colonisation can be modified by probiotics, prebiotics or synbiotics. Human milk oligosaccharides (HMOs) are infant prebiotics that show a bifidogenic effect. Moreover, genome sequencing of Bifidobacterium longum subsp. infantis within the infant microbiome revealed adaptations for milk utilisation. This study aimed to evaluate the synbiotic effect of B. longum subsp. infantis, HMOs and human milk (HM) both in vitro and in vivo (in a humanised mouse model) in the presence of faecal microbiota from infants born by caesarean section. The combination of B. longum and HMOs or HM reduced the clostridia and G-bacteria counts both in vitro and in vivo. The bifidobacterial population in vitro significantly increased and produce high concentrations of acetate and lactate. In vitro competition assays confirmed that the tested bifidobacterial strain is a potential probiotic for infants and, together with HMOs or HM, acts as a synbiotic. It is also able to inhibit potentially pathogenic bacteria. The synbiotic effects identified in vitro were not observed in vivo. However, there was a significant reduction in clostridia counts in both experimental animal groups (HMOs + B. longum and HM + B. longum), and a specific immune response via increased interleukin (IL)-10 and IL-6 production. Animal models do not perfectly mimic human conditions; however, they are essential for testing the safety of functional foods.

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