Difference in the Intestinal Microbiota between Breastfeed Infants and Infants Fed with Artificial Milk: A Systematic Review
Abstract
:1. Introduction
2. Materials and Methods
2.1. Protocol and Registration
2.2. Search Processing
2.3. Eligibility Criteria
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- Population: term and preterm infants breastfed or artificially fed.
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- Intervention: study of the microbiota of these infants.
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- Comparison: analysis of the difference in the microbiome of term and preterm newborns breastfed or artificially fed.
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- Outcome: main findings regarding differences in GM between breastfed and F-fed infants.
2.4. Data Processing
2.5. Quality Assessment
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- Bias due to confounding;
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- Bias arising from measurement of exposure;
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- Bias in the selection of participants into the study;
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- Bias due to post-exposure intervention;
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- Bias due to missing data;
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- Bias arising from measurement of the outcome;
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- Bias in the selection of the reported results.
3. Results
Quality Assessment and Risk of Bias of Included Articles
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- Bias due to confounding;
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- Bias arising from the measurement of exposure;
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- Bias in the selection of participants into the study;
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- Bias due to post-exposure intervention;
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- Bias due to missing data;
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- Bias arising from the measurement of the outcome;
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- Bias in the selection of the reported results.
4. Discussion
4.1. Gut Microbiota of Breastfed Infants
4.2. Gut Microbiota in F-Fed Infants
4.3. Inizio Modulo
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
BM | breast milk |
DNA | deoxyribo nucleic acid |
F | formula |
GM | gut microbiome |
HDM | human donated milk |
HM | human milk |
HMF | human milk fortifier |
M | microbiome |
LOS | late-onset sepsis |
MOM | own mother’s breastmilk |
NEC | necrotizing enterocolitis |
PI | preterm infants |
SIgA | stool secretory IgA |
TI | term infants |
TPN | total parenteral nutrition |
NICU | neonatal intensive care unit |
VLBW | very low birthweight |
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Article screening Strategy | Database: Scopus, Web of Science and PubMed |
Keywords: A “Gut Microbiota”; B “Gut Microbiome”; C “Neonatal Milk” | |
Boolean variable: “AND” and “OR” | |
Timespan: 2014–2024 | |
Language: English |
Authors | Study Design | Number of Patients | Average Age/Gender | Materials and Methods | Outcomes |
---|---|---|---|---|---|
C. Cai et al., 2019 [46] | Prospective cohort study | 20 | PI (born < 37 weeks) | Fecal samples were collected in early and late feeding stages. GM composition was evaluated through an oxidative stress marker. | GM of the infants fed the HM+ HMF diet showed an abundance of Veillonella (p < 0.05), which contrasted with that of the infants fed HM+ F. |
L. Béghin et al., 2021 [47] | Randomized controlled trial | 280 | TI born between 37 and 42 weeks | The study evaluated the effects of 4 infant F in term infants (TI). | FERM/scGOS/lcFOS F brought the microbiome (M) composition closer to that of breastfed infants. |
Ü. Parm et al., 2015 [48] | Multicenter study | 159 | PI born ≤ 32 weeks | The study evaluated the relationship between nutrition type and mucosa colonization and the development of late sepsis (LOS) and necrotizing enterocolitis (NEC) in PI. | Breast milk reduced the risk of LOS and mortality in PI. |
X. Cong et al., 2016 [49] | Prospective longitudinal study | 29 | PI 28 weeks 0 days–32 weeks 6 days gestational age, 0–7 days old, | The study evaluated day-to-day GM patterns in PI. In total, 378 stool samples were collected daily, and Deoxyribo Nucleic Acid (DNA) extracted from stool was used to sequence the V4 region of the 16S rRNA gene region. | Infants fed their mother’s own breastmilk (MBM) had a higher diversity of GM. |
X. Cong et al., 2017 [50] | Comparative study | 33 | PI 28 weeks 0 days–32 weeks 6 days gestational age, 0–7 days old, | The study evaluated the effect of feeding types on GM colonization of PI in NICU with the use of six types of feeding. | PI fed MOM (at least 70% of the total diet) had the highest abundance of Clostridiales, Lactobacillales, and Bacillales compared to other groups. |
K.E. Gregory et al., 2016 [13] | Comparative study | 30 | PI born ≤ 32 weeks. | The PI were divided into three groups, and they were fed three types of nutrition. The GM of the groups was evaluated. | The GM is influenced by postnatal time, birth weight, gestational age, and nutrition. PI feeding with breast milk had a protective effect against gut immaturity. |
Karina Corona-Cervantes et al., 2020 [51] | Descriptive cross-sectional study | 67 mother-neonate pairs | age between 37 and 41 weeks | To assess the effect of human milk microbiota on the bacterial composition of the neonate’s gut in the early days, high-throughput sequencing of DNA was used. | Breast milk provides 67.7% of the bacteria in newborns within six days of birth, with significant diversity and abundance of Proteobacteria and Firmicutes. The mode of delivery influences neonatal intestinal microbiota, but not that of breast milk. |
Elvira Estorninos et al., 2022 [52] | Randomized controlled trial | 230 infants | 21–26 days postpartum, | Both an intact cow-milk-based F and one with 7.2 g MOS/L (bovine-milk-derived oligosaccharides/L) were effective until 6 months, with gut health and immune response assessed through fecal samples. | Bovine-milk-derived oligosaccharides shift the GM and metabolic signature closer to those of human-milk-fed infants. |
Yapeng Li et al. [17] | Comparative observational study | 23 healthy newborns | first month of age | Samples of newborn stool and breast milk were collected. Samples collected on the day of birth (0 days) and 30 days after birth. Second-generation 16S rRNA sequencing and SCFA detection. | Construction and colonization of the intestinal microbiota in newborns. Relationship between breast milk microbiota and intestinal microbiota of newborns. Determination of short-chain fatty acids. |
Embleton N. et al., 2023 [53] | Randomized clinical trial | 126 PI | 72 h of age | Infants were recruited from UK neonatal intensive care units and randomized to either a standard (control) or exclusive human milk diet. The control group received MOM and preterm F milk, while the intervention group received a ready-to-feed pasteurized human milk product. Data on weight gain and morbidities were collected until hospital discharge. | No impact on gut bacterial diversity in PI was found using human milk-derived F or fortifier, suggesting clinical impact is not influenced by microbiomic mechanisms. |
Manman Liu et al. [34] | Retrospective study | 31 infants | 32 weeks | Information on duration of full enteral feeding, weight gain and postnatal infections in premature infants. Comparison of two clinical feeding methods, namely breastfeeding and F. Use of Pearson’s correlation coefficient to determine the correlation between intestinal flora and clinical outcomes. | No significant differences were found between the two feeding methods in terms of clinical indicators (duration of complete enteral feeding, weight gain and postnatal infections). Both feeding methods had no significant effect on clinical indicators in premature infants. |
Kumbhare et al. [54] | Randomized clinical trial | 30 PI | 14 days | Comparison between two types of human milk fortifiers: Bovine-derived fortifier. Fortifier derived from human milk. Sequencing of the GM to determine microbial composition. Measurement of urinary F2-isoprostanes as a marker of oxidative stress. Measurement of fecal calprotectin as a marker of intestinal inflammation. | The source of human milk (mother vs. donor) appears to have a greater impact on the composition of the GM in PI than the type of milk fortifier (human vs. bovine). |
Yang R. et al. [55] | Longitudinal observational study | 60 PI | 37 weeks | Basic general characteristics of premature newborns, recording of daily breast milk intake, use of probiotics and antibiotics. Collection of fecal samples at the 1st, 2nd, 3rd and 4th weeks after birth. Bioinformatic methods to analyze longitudinal intra-group variations in the structure and diversity of the intestinal microbiota, and cross-sectional differences between groups with breast milk intake >70% and ≤70%. | The development and evolution of the intestinal microbiota in premature infants during the hospital stay are continuous and non-random processes. |
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Inchingolo, F.; Inchingolo, A.M.; Latini, G.; Ferrante, L.; de Ruvo, E.; Campanelli, M.; Longo, M.; Palermo, A.; Inchingolo, A.D.; Dipalma, G. Difference in the Intestinal Microbiota between Breastfeed Infants and Infants Fed with Artificial Milk: A Systematic Review. Pathogens 2024, 13, 533. https://doi.org/10.3390/pathogens13070533
Inchingolo F, Inchingolo AM, Latini G, Ferrante L, de Ruvo E, Campanelli M, Longo M, Palermo A, Inchingolo AD, Dipalma G. Difference in the Intestinal Microbiota between Breastfeed Infants and Infants Fed with Artificial Milk: A Systematic Review. Pathogens. 2024; 13(7):533. https://doi.org/10.3390/pathogens13070533
Chicago/Turabian StyleInchingolo, Francesco, Angelo Michele Inchingolo, Giulia Latini, Laura Ferrante, Elisabetta de Ruvo, Merigrazia Campanelli, Marialuisa Longo, Andrea Palermo, Alessio Danilo Inchingolo, and Gianna Dipalma. 2024. "Difference in the Intestinal Microbiota between Breastfeed Infants and Infants Fed with Artificial Milk: A Systematic Review" Pathogens 13, no. 7: 533. https://doi.org/10.3390/pathogens13070533