With Mark Underwood MD, and commentary by Caroline Apovian, MD
Breastfed infants who received a 3-week course of probiotics during the first month of life had sustained improvements in their gut microbiome,1 according to findings published in the journal, mSphere.
“We've looked at babies in northern California over the years, and initially were very surprised to see high numbers of bugs like E. coli, and low numbers of bugs like bifidobacteria, in the stools of babies who were born vaginally, never got antibiotics, and were breastfed. This would seem to be the ideal, low-risk population,” said Mark Underwood MD, chief of neonatology and professor of pediatrics at the University of California, Davis, “Instead, these babies guts were dominated by potential pathogens, and therefore we think, at risk for dysbiosis-associated diseases as they grow up.”2
To address this long-term risk of heightened chronic disease risk, the researchers examined whether it is possible to fundamentally change the composition of the microbiota in infants.
Infants in the test group received Bifidobacterium longum subsp. infantis (B. infantis) from day 7 to day 21. Compared to controls, they had significantly higher populations of Bifidobacteriaceae and four-fold lower fecal endotoxin levels in their stool, with benefits persisting 30 days post-treatment.1
Breastmilk was collected postnatally at day 21, and fecal samples from the infants were analyzed at baseline (day 6) and again after supplementation was completed on day 29. Both samples were analyzed for the presence of essential nutrients, which are not digested by the infant.1 The researchers believe that these essential nutrients may be useful as biomarkers in future research.1
The test group, which received probiotic B. infantis early in life, had lower pH in the stool, an 80% increase in the number of healthy bacteria, and an 80% decrease in the number of potential pathogens.1
“We chose this organism, not because it grows well, or because it's easy to produce, or because you can put it into a food product, but because of its genetic capacity to grow and to dominate the intestinal tract, and because of animal studies that show this to be an organism that decreases gut inflammation, and decreases gut permeability or leakiness. So it's really exciting for us to see these strong results come out of more than a decade of research,” said Dr. Underwood.
“In previous studies, they gave a probiotic, and they would find small amounts of that probiotic in the feces,” Dr. Underwood told EndocrineWeb. “In this case, we saw a really profound restructuring of that community, where it was dominated by the organism we were giving. And the part that was really striking that we've not seen in the other studies before, is that this dominance of a healthy or commensal organism persisted for a full month after we stopped giving the probiotic organism.”
“Antibiotics, Cesarean deliveries, formula feeding, hygiene, and other things have changed the microbiota in our guts, particularly those of children and babies,” said Dr. Underwood, “I think the evidence has become pretty compelling that there is an association between changes in the gut microbiota very early in life and the later risk for a variety of chronic diseases.”
Much of the research to date has underscored the importance of the gut microbiome and health. But obese and lean adults “seem to have differences in their gut microbiomes that correlate with disease and health,” said Caroline Apovian, MD, FACP, FACN, professor of medicine and pediatrics at Boston University School of Medicine and director of the Nutrition and Weight Management Center at Boston Medical Center, in Boston, Massachusetts.
“This study shows that it is possible to alter the microbiome of an infant with a specific probiotic associated with health and that this alteration is persistent at least one month after the feeding period,” Dr. Apovian told EndocrineWeb, “At this point the relevance for children and adults is tentative and more research needs to be done. However, it is a step in the direction of showing that infant feeding may have relevance for future gut microbiome health.”
Future research will help determine the long-term impact of early probiotics on chronic disease. Dr. Underwood noted that infant colic is one of many conditions associated with dysbiosis.1
“We certainly are interested in looking at formula-fed babies, too,” said Underwood, and further research will show whether healthier microbiomes translate into decreased risk for chronic disease in these children over time. That remains to be seen, but it's certainly an exciting idea,” he said.
This study was funded by Evolve Biosystems, Inc., Davis, California.