Can breastfeeding protect against antimicrobial resistance?

Abstract

Background The proportion of infections among young children that are antimicrobial-resistant is increasing across the globe. Newborns may be colonized with enteric antimicrobial-resistant pathogens early in life, which is a risk factor for infection-related morbidity and mortality. Breastfeeding is actively promoted worldwide for its beneficial impacts on newborn health and gut health. However, the role of breastfeeding and human milk components in mitigating young children’s carriage of antimicrobial-resistant pathogens and antibiotic resistance genes has not been comprehensively explored. Main body Here, we review how the act of breastfeeding, early breastfeeding, and/or human milk components, such as the milk microbiota, secretory IgA, human milk oligosaccharides, antimicrobial peptides, and microRNA -bearing extracellular vesicles, could play a role in preventing the establishment of antimicrobial-resistant pathogens in young children’s developing gut microbiomes. We describe findings from recent human studies that support this concept. Conclusion Given the projected rise in global morbidity and mortality that will stem from antimicrobial-resistant infections, identifying behavioral or nutritional interventions that could decrease children’s susceptibility to colonization with antimicrobial-resistant pathogens may be one strategy for protecting their health. We suggest that breastfeeding and human milk supplements deserve greater attention as potential preventive measures in the global effort to combat antimicrobial resistance, particularly in low- and middle-income settings.

Full breastfeeding protection against common enteric bacteria and viruses: results from the MAL-ED cohort study

“…Human milk also contains viruses that are bacteriophages ( 46 ). As recently reviewed by Nadimpalli et al ( 43 ), there is evidence that full breastfeeding is protective of acquisition and, in some cases, of first acquisition of specific enteropathogens. Our findings add to that literature by demonstrating consistent negative associations between the extent of full breastfeeding and detection of key bacterial pathogens that are principal causes of diarrhea in these infants and worldwide.…”

“…Exclusive breastfeeding may protect an infant from pathogens because of reduced oral exposure, and to the extent that water or other nonnutritive liquids are treated, the same may be true when there are intermittent days of full breastfeeding. Human milk has multiple constituents that are known to protect infants from infection and disease, including secretory IgA (sIgA) antibodies, its own microbiota, human-milk oligosaccharides, and other antimicrobial factors (e.g., lactoferrin, ɑ-lactalbumin, B-defensins), glycoproteins, and extracellular vesicles ( 43–45 ). Human milk also contains viruses that are bacteriophages ( 46 ).…”

The Impact of Intestinal Microorganisms and Their Metabolites on Type 1 Diabetes Mellitus

“…96 Studies have shown that breast milk contains many active ingredients, including bacteria, antimicrobial peptides, antibodies, immune cells, and breast milk oligosaccharides. 97 Among them, breast milk oligosaccharides can increase the abundance of beneficial Bifidobacterium and Lactobacillus in the intestine of an infant 98 and can be used as bait receptors to bind to pathogenic bacteria, thus preventing pathogens from adhering to intestinal epithelial cells; breast milk oligosaccharides can regulate the expression of mucins and polysaccharides, exert immunomodulatory effects through Toll receptors, 99 and reduce intestinal permeability. 100 Notably, Bifidobacterium longum subsp.…”

Ventilation-Induced Lung Injury (VILI) in Neonates: Evidence-Based Concepts and Lung-Protective Strategies

“…Good nutrition is necessary for somatic growth and development [99]. Likewise, optimal nutrition is also necessary for lung development and repair [100][101][102][103], as well as defense against infection [42,104,105] and oxidative stress [106][107][108], which are all risk factors for VILI. Preterm infants are at risk of poor nutritional states due to the increased work of breathing, immature gastrointestinal function, fluid restriction, and exposure to medications such as steroids and diuretics [42,109,110].…”