Neonatal jaundice is a common disease that affects up to 60% of new-borns. Herein, we performed a comparative analysis of the gut microbiome in neonatal jaundice and non-neonatal jaundice infants and identified gut microbial alterations in neonatal jaundice pre- and post-treatment. We prospectively collected 232 faecal samples from 51 infants at 5 time points (0, 1, 3, 6 and 12 months). Finally, 114 samples from 6 neonatal jaundice infants (NJI) and 19 non-NJI completed MiSeq sequencing and analysis. We characterized the gut microbiome and identified microbial differences and gene functions. Meconium microbial diversity from NJI was decreased compared with that from non-NJI. The genus Gemella was decreased in NJI versus non-NJI. Eleven predicted microbial functions, including fructose 1,6-bisphosphatase III and pyruvate carboxylase subunit B, decreased, while 3 functions, including acetyl-CoA acyltransferase, increased in NJI. After treatments, the microbial community presented significant alteration-based beta diversity. The phyla Firmicutes and Actinobacteria were increased, while Proteobacteria and Fusobacteria were decreased. Microbial alterations were also analysed between 6 recovered NJI and 19 non-NJI. The gut microbiota was unique in the meconium microbiome from NJI, implying that early gut microbiome intervention could be promising for the management of neonatal jaundice. Alterations of gut microbiota from NJI can be of great value to bolster evidence-based prevention against ‘bacterial dysbiosis’.

Background Cesarean birth is associated with a higher prevalence of delayed onset of lactogenesis II (DOLII) than vaginal birth. DOLII refers to the delayed initiation of copious milk production beyond 72 h after birth. This study aimed to determine the prevalence of, and factors associated with, DOLII among women who delivered via Cesarean section in China. Methods This prospective longitudinal cohort study recruited 468 women who delivered via Cesarean section at a tertiary hospital in China from 9 October 2021 to 17 May 2022. Face-to-face interviews were conducted during their delivery hospital stay to obtain information about demographic, medical, and breastfeeding factors. We assessed the onset of lactogenesis on postpartum day four, based on the maternal perception of changes in breast fullness. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for postpartum depression. Women with DOLII were interviewed via telephone or WeChat daily for one week postpartum to determine the timing of the onset of lactogenesis II. Univariate and multivariable logistic regression analyses were used to identify the determinants of DOLII. Results DOLII was experienced by 156 of 468 participants (33.3%). After adjusting for potential confounders, the odds of DOLII were 95% higher in primiparous women than multiparous women (adjusted odds ratio [aOR] 1.95; 95% confidence interval [CI] 1.29, 2.98), 75% higher in women with a serum albumin concentration < 35 g / L than women with normal serum albumin concentrations (aOR 1.78; 95% CI 1.09, 2.99), increased by 2.03-fold in women with an EPDS score ≥ 10 than women with an EPDS score < 10 (aOR 2.03; 95% CI 1.35, 3.07), and decreased in women with a higher number of breastfeeding sessions in the first 48 h postpartum (aOR 0.88; 95% CI 0.83, 0.93). Conclusions One-third of women with Cesarean section delivery experienced DOLII. DOLII was more likely in women who were primiparous, had a serum albumin concentration < 35 g / L, had a lower frequency of breastfeeding sessions, and had an EPDS score ≥ 10. Women with these risk factors who deliver via Cesarean section may need early breastfeeding support to ensure successful lactation.

Background: Neonatal jaundice is a common disease that affects up to 60% of newborns and the relationship between early gut microbiome and development of neonatal jaundice is not fully understood. This study aims to characterize gut microbiome of newborns and to explore its association with risk of neonatal jaundice.Methods: We collected 257 fecal samples from 58 infants at 5 time points of 0, 1, 3, 6 and 12 months prospectively, and finally 114 samples from 6 neonatal jaundice infants (NJI) with treatment and 19 matched non-NJI completed Miseq sequencing and analysis. We characterized gut microbiome, identified microbial differences and gene functions. Results: Meconium microbial diversity from NJI was decreased versus non-NJI. Genus Gemella was decreased in NJI versus non-NJI. Eleven predicted microbial functions including fructose-1,6-bisphosphatase III and Pyruvate carboxylase subunit B decreased, while 3 functions including acetyl CoA acyltransferase increased in NJI. After treatments, microbial community presented a significant alterations based beta-diversity. Phylum Firmicutes and Actinobacteria were increased, while Proteobacteria and Fusobacteria were decreased. Microbial alterations were also analyzed between 6 recovery NJI and 19 non-NJI. Conclusion: Gut microbiota was unique in meconium microbiome from NJI, implying early gut microbiome intervention could be promising for the management of neonatal jaundice. Alterations of gut microbiota from NJI can be of great value to bolster evidence-based prevention against ‘bacterial dysbiosis’.