Association of Cesarean Delivery and Formula Supplementation With the Intestinal Microbiome of 6-Week-Old Infants

Madan, Juliette C.; Hoen, Anne G.; Lundgren, Sara; Farzan, Shohreh F.; Cottingham, Kathryn L.; Morrison, Hilary G.; Sogin, Mitchell L.; Li, Hongzhe; Moore, Jason H.; Karagas, Margaret R.

doi:10.1001/jamapediatrics.2015.3732

Cited by 246 publications

(267 citation statements)

References 37 publications

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“…Compared to exclusive breastfeeding, partial formula feeding led to an increase in Enterobacteriaceae and streptococci at the expense of bifidobacteria, as early as day 3. Consistent with earlier studies (Azad et al, 2013;Bäckhed et al, 2015;Madan et al, 2016), Caesarean-section was associated with strong reduction of Bacteroides. In this sample set, none of the infants delivered by Caesarean section were exclusively breastfed, which likely reflects clinical reality in this population; also elsewhere Caesarean section is associated with lower rates of breastfeeding, e.g.…”

Section: Discussionsupporting

confidence: 91%

“…The impact of delivery mode and feeding mode on infant faecal microbiota were unambiguous, and consistent with earlier studies (Adlerberth and Wold, 2009;Bäckhed et al, 2015;Bokulich et al, 2016;Madan et al, 2016). The differences between vaginally delivered and Caesareansection delivered infants are apparent in early days and weeks and diminish with time (Dogra et al, 2015;Stokholm et al, 2016), which may explain the relatively minor effects reported in some studies (Chu et al, 2017).…”

Section: Discussionsupporting

confidence: 85%

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Does the maternal vaginal microbiota play a role in seeding the microbiota of neonatal gut and nose?

Sakwińska

Foata

Berger

et al. 2017

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The acquisition and early maturation of infant microbiota is not well understood despite its likely influence on later health. We investigated the contribution of the maternal microbiota to the microbiota of infant gut and nose in the context of mode of delivery and feeding. Using 16S rRNA sequencing and specific qPCR, we profiled microbiota of 42 mother-infant pairs from the GUSTO birth cohort, at body sites including maternal vagina, rectum and skin; and infant stool and nose. In our study, overlap between maternal vaginal microbiota and infant faecal microbiota was minimal, while the similarity between maternal rectal microbiota and infant microbiota was more pronounced. However, an infant's nasal and gut microbiota were no more similar to that of its own mother, than to that of unrelated mothers. These findings were independent of delivery mode. We conclude that the transfer of maternal vaginal microbes play a minor role in seeding infant stool microbiota. Transfer of maternal rectal microbiota could play a larger role in seeding infant stool microbiota, but approaches other than the generally used analyses of community similarity measures are likely to be needed to quantify bacterial transmission. We confirmed the clear difference between microbiota of infants born by Caesarean section compared to vaginally delivered infants and the impact of feeding mode on infant gut microbiota. Only vaginally delivered, fully breastfed infants had gut microbiota dominated by Bifidobacteria. Our data suggest that reduced transfer of maternal vaginal microbial is not the main mechanism underlying the differential infant microbiota composition associated with Caesarean delivery. The sources of a large proportion of infant microbiota could not be identified in maternal microbiota, and the sources of seeding of infant gut and nasal microbiota remain to be elucidated.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 85%

Does the maternal vaginal microbiota play a role in seeding the microbiota of neonatal gut and nose?

Sakwińska

Foata

Berger

et al. 2017

View full text Add to dashboard Cite

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“…At 6 wks of age, MF infants exhibited the largest within group compositional differences and harbored a microbiota significantly different than BF but not FF infants. 29 As further shown in Table 1, MF infants tend to group with FF infants and differ from BF infants. 16,18,47 Conversely, Fallani and associates 52 detected, in a much larger sample of infants, significantly higher proportions of bifidobacteria in MF compared to FF infants of the same age.…”

Section: (Finland)mentioning

confidence: 75%

“…29,52 The dietary patterns of MF infants are highly variable within and across studies, and are often not well described, which presents an obstacle when trying to draw conclusions relative to the effect of the proportion of HM and formula consumed on microbial composition. At 6 wks of age, MF infants exhibited the largest within group compositional differences and harbored a microbiota significantly different than BF but not FF infants.…”

Section: (Finland)mentioning

confidence: 99%

The role of early life nutrition in the establishment of gastrointestinal microbial composition and function

2017

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The development of the human infant intestinal microbiota is a sequential process that begins in utero and continues during the first 2 to 3 years of life. Microbial composition and diversity are shaped by host genetics and multiple environmental factors, of which diet is a principal contributor. An understanding of this process is of clinical importance as the microbiota acquired in early life influence gastrointestinal, immune and neural development, and reduced microbial diversity or dysbiosis during infancy is associated with disorders in infancy and later childhood. The goal of this article was to review the published literature that used culture-independent methods to describe the development of the gastrointestinal microbiota in breast-and formula-fed human infants as well as the impact of prebiotic and probiotic addition to infant formula, and the addition of solid foods.

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“…The gut microbiota plays a critical role in infant immune and metabolic development, and the mode of delivery is a major determinant of early life exposure and colonization [Madan et al, 2016]. The human gastrointestinal tract is essentially uncolonized in utero, so exposure to microbes during delivery and in the environment immediately following birth is key to the establishment of the microbiota.…”

Section: Introductionmentioning

confidence: 99%

Dysbiosis in Children Born by Caesarean Section

Garcia¹,

Yee²,

Gilbert³

et al. 2018

Ann Nutr Metab

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The rate of Caesarean-section delivery in the United States has increased by 60% from 1996 through to 2013 and now accounts for > 30% of births [CDC, 2017]. The purpose of this review is to present the current understanding of both the microbial risk factors that increase the likelihood of a Caesarean-section delivery and the microbial dysbiosis that is thought to result from the Caesarean section. We provide examples of research into the impact of early-life microbial dysbiosis on infant development and long-term health outcomes, as well as consider the efficacy and the long-term implications of microbiome-based therapies to mitigate this dysbiosis. The steep rise in the Caesarean-section delivery rate makes it imperative to understand the potential of microbiota modulation for the treatment of dysbiosis.

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Association of Cesarean Delivery and Formula Supplementation With the Intestinal Microbiome of 6-Week-Old Infants

Cited by 246 publications

References 37 publications

Does the maternal vaginal microbiota play a role in seeding the microbiota of neonatal gut and nose?

Does the maternal vaginal microbiota play a role in seeding the microbiota of neonatal gut and nose?

The role of early life nutrition in the establishment of gastrointestinal microbial composition and function

Dysbiosis in Children Born by Caesarean Section

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