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Breast Milk, Birth, and Infant Gut Microbes

April 2017

Using “Your Baby’s Microbiome”, by Toni Harman and Alex Wakeford, as our reference today, let’s take a basic look at how colostrum and mature breast milk as well as delivery method assist in establishing a healthy intestinal microbiota for infants.

surgical birth

Contained in both colostrum and mature breast milk is a type of carbohydrate that is indigestible by the infant, it is human milk oligosaccharide (HMO). The lactobacilli in the infant’s mouth mix with the HMOs to break down the lactose, used for production of energy. The remaining HMO ingredients feed the intestinal microbes. Mix in the microbes obtained during the birth produced by the mother’s vagina during the final portion of the pregnancy, and the bacteria begin to multiply quickly to colonize the infant’s gut. This process also prevents the replication of harmful bacteria and begins “training” the newly forming immune system.

What about those infants who are not breastfed? It is well documented that artificial infant milk is “missing critical components such as hormones, antibodies, anti-inflammatory substances, specific strains of microbes, and the HMOs that feed the infant’s gut microbes”, Harman and Wakeford, p. 62. Formula provides nutrition for the infant, but does not even closely resemble human milk, and could even be introducing bacteria to the infant that are not normally found in the newborn gut, impacting the immature immune system.

The delivery type can also make microbial changes. Vaginal delivery provides the specific microbes for the infant’s colonization of the gut and the training of the developing immune system. Surgical deliveries, though, innately bring with them several factors that can have a different effect altogether.

  • Synthetic oxytocin is often used to augment labor. But “if given too fast and too much in the beginning, the natural [oxytocin] system is not brought into it and labor may actually stop”, (p. 74), potentially increasing the rate of surgical deliveries.
  • Not being delivered through the maternal vaginal canal, the infant does not receive the full complement of lactobacilli-rich microbes. They will not, additionally, be exposed to fecal matter of the mother, missing out on the maternal intestinal microbes needed for healthy colonization.
  • In a surgical delivery, the first microbes to come into contact with the infant are those airborne in the surgical suite. These microbes seed the infant’s skin, mouth, eyes, ears, and nose immediately. Sources could be from all the other people in the delivery suite, towels, medical instruments, and more.
  • Infants birthed vaginally typically have guts higher in lactobacillus and Bifidobacterium, compared with those born surgically who have more streptococcus and staphylococcus.
  • Many mothers who give birth by Cesarean section are given antibiotics, creating a dysbiosis of infant gut microbiota having potentially life-long effects.

Breast milk varies from feeding to feeding, week to week, month to month, and according to the needs of the infant, no matter the age. Infants will make their “microbial needs” known to the mother through both the intra-mammary pathway and the respiratory pathway. These, then program the maternal creation of the antibacterial, antimicrobial, and anti-infective properties to increase content in her milk, thus providing an ongoing and interactive source of protection to her infant.

 

Kathy Parkes, MSN-Ed, BSPsy, RN, IBCLC, RLC, FILCA

Professional Development Educator

 

Reference:

Harman, T. and Wakeford, A. (2017). Your Baby’s Microbiome: The critical role of vaginal birth and breastfeeding for lifelong health. White River Junction, VT. Chelsea Green Publishing.

 

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