Effect of donor human milk on host-gut microbiota and metabolic interactions in preterm infants

Clin Nutr. 2021 Mar;40(3):1296-1309. doi: 10.1016/j.clnu.2020.08.013. Epub 2020 Aug 19.

Abstract

Background & aims: Human milk is the gold standard for infant nutrition. Preterm infants whose mothers are unable to provide sufficient own mother's milk (OMM), receive pasteurized donor human milk (DHM). We studied metabolic signatures of OMM and DHM and their effect on the interplay of the developing microbiota and infant's metabolism.

Methods: Metabolic fingerprinting of OMM and DHM as well as infant's urine was performed using liquid chromatography-mass spectrometry and the infant's stool microbiota was analyzed by 16S rRNA sequencing.

Results: Significant differences in the galactose and starch and sucrose metabolism pathways when comparing OMM and DHM, and alterations of the steroid hormone synthesis and pyrimidine metabolism pathways in urine were observed depending on the type of feeding. Differences in the gut-microbiota composition were also identified.

Conclusion: The composition of DHM differs from OMM and feeding of DHM has a significant impact on the metabolic phenotype and microbiota of preterm infants. Our data help to understand the origin of the observed changes generating new hypothesis: i) steroid hormones present in HM have a significant influence in the activity of the steroid hormone biosynthesis pathway in preterm infants; ii) the pyrimidine metabolism is modulated in preterm infants by the activity of gut-microbiota. Short- and long-term implications of the observed changes for preterm infants need to be assessed in further studies.

Keywords: Donor human milk (DHM); Gut-microbiota; Nutrition; Own mother's milk (OMM); Preterm infant; Untargeted metabolomics.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacteria / classification
  • Bacteria / metabolism
  • Cohort Studies
  • Female
  • Galactose / metabolism
  • Gastrointestinal Microbiome / physiology*
  • Gonadal Steroid Hormones / biosynthesis
  • Humans
  • Infant Nutritional Physiological Phenomena
  • Infant, Newborn
  • Infant, Premature / metabolism*
  • Infant, Premature / urine
  • Male
  • Metabolomics
  • Milk Banks
  • Milk, Human*
  • Mothers*
  • Prospective Studies
  • Pyrimidines / metabolism
  • Starch / metabolism
  • Sucrose / metabolism
  • Tissue Donors*

Substances

  • Gonadal Steroid Hormones
  • Pyrimidines
  • Sucrose
  • Starch
  • pyrimidine
  • Galactose