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Breastfeeding, Skin-to-Skin, and Infant Microbiome

November 2018

Establishing early breastfeeding following delivery is important for so many reasons, but today I'd like to share with you information about the infant intestinal microbiome as influenced by the infant's earliest experiences.

"The human microbiome--that is the community of microorganisms that live on and in the human body--consists of upwards of 100 trillion cells, which outnumber human cells by a factor of ten and collectively contain 27 times more genes that the human genome. Different sites within and upon the human body harbor discrete populations of microbes. For example, the skin, mouth, nasal cavity, gut, reproductive tract, and possibly the placenta host unique microbial communities.” 2 "Various factors are involved in the development of this complex ecosystem. The infant's gestational age, mode of delivery, type of nutrition, and early use of antibiotics modify the composition of this microbiome and may have significant and long-lasting effects.” 1

bacteria microbiomes

There are several influences on the infant microbiome, including vaginal microbiota which varies widely between women; maternal health status such as gestational diabetes, periodontal disease, obesity, and hypertension; type of birth such as vaginal versus surgical; and various maternal health behaviors, from smoking to substance abuse to hygiene practices. All are known to impact the maternal vaginal, oral and/or gut microbiomes.

"Previous work has demonstrated that skin-to-skin care for the preterm infant is associated with greater intestinal function, superior feeding tolerance, and greater immune stamina including later decreased episodes of pneumonia and diarrhea... primarily breastfed infants [are shown to have] altered microbial oral repertoire patterns favoring a pattern in which organisms such as Pseudomonas and Neisseria exhibit a reduced prevalence... Our results support a patterned development of oral microbial development and further support the role of early maternal touch as an influence in the pace of microbial progression.” 3

The use of skin-to-skin care and exclusive breastfeeding leads to the improved development of the brain-gut-enteric microbiota axis, which is vital in brain development, behavior, and gene expression. "Our brain is intricately connected to our gut through the enteric nervous system, a very complex and extensive system that encompasses between 200 and 600 million neurons. The enteric nervous system provides a bidirectional communication between gastrointestinal cells and the central nervous system.” 1

"Micro-organisms hardly exist as single cells in nature, but rather live in complex communities coevolved and adapted to the habitats they colonize... Indeed, the pioneer bacteria colonizing the infant intestinal tract and the gradual diversification to a stable climax ecosystem play a crucial role in establishing host-microbe interactions essential for optimal symbiosis; and this colonization process may profoundly influence health throughout life.” 4

Research continues to show that breastfeeding has protective qualities due in part to the numerous allergens in human milk that are absent in artificial milk as well as many complicated interactions between the maternal microbiome and the infant's. One example is Human Milk Oligosaccharides (HMO) naturally present in human milk to selectively stimulate the growth/activity of intestinal bacteria, resulting in improved infant health.

To summarize, the care we provide and the food we feed our newborn infants is extremely important for immediate and life-long health.


Kathy Parkes, MSN-Ed, RN, IBCLC, FILCA CHC

Professional Development Educator



All are free to download from Google Scholar

1. 1. Douglas-Escobar, M., Elliott, E., and Neu, J. (2013). Effect of intestinal microbial ecology on the developing brain. JAMA Pediatr; 167(4): 374-379.

2.2. Dunlop, A.L., Mulle, J.G., Ferranti, E.P., Edwards, S., Dunn, A.B., and Corwin, E.J. (2015). The maternal microbiome and pregnancy outcomes that impact infant health: A review. Adv Neonatal Care; 15(6): 377-385.

3.3. Hendricks-Munoz, K.D., Xu, J., Parikh, H.I., Xu, P., Fettweis, J.M., Kim, Y., Louie, M., Buck, G.A., Thacker, L.R., and Sheth, N.U. (2015). Skin-to-skin care and the development of the preterm infant oral microbiome. Am J Perinatol; 32(13): 1205-1216,

4.4. Wopereis, H., Oozeer, R., Knipping, K., Belzer, C., and Knol, J. (2014). The first thousand days--intestinal microbiology of early life: Establishing a symbiosis. Pediatr Allergy Immunol; 25:428-438.


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