TY - JOUR
T1 - Source of human milk (mother or donor) is more important than fortifier type (human or bovine) in shaping the preterm infant microbiome
AU - Kumbhare, Shreyas V.
AU - Jones, William Diehl
AU - Fast, Sharla
AU - Bonner, Christine
AU - Jong, Geert ‘t
AU - Van Domselaar, Gary
AU - Graham, Morag
AU - Narvey, Michael
AU - Azad, Meghan B.
N1 - Funding Information:
We thank Dr. Shirin Moossavi, University of Calgary, and Dattatray Mongod, the University of Pune, for their inputs in microbiome analysis. We also thank the study participants, the clinical staff, NICU dietitians and diet technicians at the Health Sciences Centre, and the research support unit staff at Children’s Hospital Research Institute of Manitoba. This research was supported by Prolacta Biosciences and a Children's Hospital Research Institute of Manitoba (CHRIM) operating grant. Prolacta Biosciences provided a discount on the human-derived human milk fortifier tested in this study, guidance on study design, and funds to support clinical research operations. A CHRIM operating grant funded biological sample analyses. Neither entity was involved in data collection, data analysis, interpretation of results, writing of the manuscript, or decision to publish. Dr. Kumbhare was partially supported by a Molly Towell Perinatal Research Foundation postdoctoral fellowship. Dr. Azad is supported by a Tier 2 Canada Research Chair in the Developmental Origins of Chronic Disease and is a Fellow of the CIFAR Humans and the Microbiome program.
Funding Information:
We thank Dr. Shirin Moossavi, University of Calgary, and Dattatray Mongod, the University of Pune, for their inputs in microbiome analysis. We also thank the study participants, the clinical staff, NICU dietitians and diet technicians at the Health Sciences Centre, and the research support unit staff at Children's Hospital Research Institute of Manitoba. This research was supported by Prolacta Biosciences and a Children's Hospital Research Institute of Manitoba (CHRIM) operating grant. Prolacta Biosciences provided a discount on the human-derived human milk fortifier tested in this study, guidance on study design, and funds to support clinical research operations. A CHRIM operating grant funded biological sample analyses. Neither entity was involved in data collection, data analysis, interpretation of results, writing of the manuscript, or decision to publish. Dr. Kumbhare was partially supported by a Molly Towell Perinatal Research Foundation postdoctoral fellowship. Dr. Azad is supported by a Tier 2 Canada Research Chair in the Developmental Origins of Chronic Disease and is a Fellow of the CIFAR Humans and the Microbiome program. Conceptualization, M.B.A. and M.N.; methodology, S.V.K. W.D.J. G.J. M.G. M.N. and M.B.A.; investigation, S.V.K. W.D.J. C.B. S.F. and G.V.D.; formal analysis, S.V.K.; writing – original draft, S.V.K. and M.B.A.; writing – review & editing, S.V.K. W.D.J. S.F. C.B. G.J. G.V.D. M.G. M.N. and M.B.A.; funding acquisition, M.N. and M.B.A.; resources, M.G. M.N. and M.B.A.; supervision, M.B.A. M.B.A. has consulted for DSM Nutritional Products and serves on the Malaika Vx and Tiny Health scientific advisory boards. She has received honoraria for speaking at symposia sponsored by Medela, Prolacta Biosciences, and the Institute for Advancement of Breastfeeding and Lactation Education and has contributed without remuneration to online courses on breast milk and the infant microbiome produced by Microbiome Courses. S.V.K. is currently employed by Digbi Health (3T and AI Pvt. Ltd. India), a position taken up after concluding the research presented in this study. These entities had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the article; or decision to submit the article for publication.
Publisher Copyright:
© 2022
PY - 2022/9/20
Y1 - 2022/9/20
N2 - Milk fortifiers help meet the nutritional needs of preterm infants receiving their mother's own milk (MOM) or donor human milk. We conducted a randomized clinical trial (NCT03214822) in 30 very low birth weight premature neonates comparing bovine-derived human milk fortifier (BHMF) versus human-derived fortifier (H2MF). We found that fortifier type does not affect the overall microbiome, although H2MF infants were less often colonized by an unclassified member of Clostridiales Family XI. Secondary analyses show that MOM intake is strongly associated with weight gain and microbiota composition, including Bifidobacterium, Veillonella, and Propionibacterium enrichment. Finally, we show that while oxidative stress (urinary F2-isoprostanes) is not affected by fortifier type or MOM intake, fecal calprotectin is higher in H2MF infants and lower in those consuming more MOM. Overall, the source of human milk (mother versus donor) appears more important than the type of milk fortifier (human versus bovine) in shaping preterm infant gut microbiota.
AB - Milk fortifiers help meet the nutritional needs of preterm infants receiving their mother's own milk (MOM) or donor human milk. We conducted a randomized clinical trial (NCT03214822) in 30 very low birth weight premature neonates comparing bovine-derived human milk fortifier (BHMF) versus human-derived fortifier (H2MF). We found that fortifier type does not affect the overall microbiome, although H2MF infants were less often colonized by an unclassified member of Clostridiales Family XI. Secondary analyses show that MOM intake is strongly associated with weight gain and microbiota composition, including Bifidobacterium, Veillonella, and Propionibacterium enrichment. Finally, we show that while oxidative stress (urinary F2-isoprostanes) is not affected by fortifier type or MOM intake, fecal calprotectin is higher in H2MF infants and lower in those consuming more MOM. Overall, the source of human milk (mother versus donor) appears more important than the type of milk fortifier (human versus bovine) in shaping preterm infant gut microbiota.
KW - calprotectin
KW - gut inflammation
KW - gut microbiome
KW - human donor milk
KW - human milk fortifiers
KW - mother's own milk
KW - oxidative stress
KW - very low birth weight infants
UR - http://www.scopus.com/inward/record.url?scp=85138142454&partnerID=8YFLogxK
U2 - 10.1016/j.xcrm.2022.100712
DO - 10.1016/j.xcrm.2022.100712
M3 - Journal Article
C2 - 36029771
AN - SCOPUS:85138142454
VL - 3
JO - Cell Reports Medicine
JF - Cell Reports Medicine
IS - 9
M1 - 100712
ER -