The gut microbiome refers to the community of microorganisms that live in the digestive tract. It plays a key role in various bodily functions such as digestion, immune system regulation, protects against allergies, autoimmune diseases, and even supports cognitive function. The early years of life are a critical period for its development, and there are three key factors that can influence earliest seeding of the infant's microbiome: maternal diet, mode of delivery, and breastfeeding.
Vaginal Delivery & The Gut Microbiome:
During vaginal delivery, the baby is exposed to the mother's vaginal and fecal bacteria (who knew that was beneficial?!). This inoculation helps to colonize baby's gut with beneficial microbes. Babies born via cesarean section may miss out on this important transfer of bacteria, as they are not exposed to the same microbes during delivery in a sterile hospital environment. While cesareans delivery can be life saving, and sometimes necessary for various medical reasons, when given the choice, it is helpful to consider the pros and cons of how you deliver. The good news for mamas who delivered via c-section is that breastfeeding also contributes to a rich gut microbiome!
Breastfeeding and Gut Microbiome:
According to Taylor, et al (2023) breast milk is not just a source of essential nutrients for infants, but also a rich and complex fluid that contains a wide variety of beneficial bacteria, immune cells, antibodies, and secreted proteins that further modulate the infant's gut microbiome.
"At 6 weeks postpartum, the composition and structure of gut microbiota of cesarean section-delivered infants differed from those of vaginally delivered infants, with decreased Bacteroides and Escherichia-Shigella and increased Klebsiella, Veillonella, and Enterococcus. At 6 months postpartum, these delivery mode-induced microbial shifts were restored by exclusive breastfeeding, resulting in similar gut microbial profiles between vaginally delivered and c-section delivered infants who were exclusively breastfed." (Liu, et al; 2023).
Once again, breastmilk saves the day! But what about formula fed babies? Research shows that compared to breastfed babies, babies who consume infant formula tend to have a less diverse gut microbiome, with lower levels of beneficial bacteria such as Bifidobacteria and Lactobacilli. Mothers who plan to breastfeed, should work with a lactation consultant before and after delivery to discuss feeding goals and have the support it takes to help breastfeeding get off to a strong start. However, if exclusive breastfeeding is not possible, baby still reaps many immune benefits of breastmilk even in small quantities.
What Impact Does Maternal Diet Have on the Milk Microbiome?
A lot! Both, prenatal and early postpartum nutrition can shape the macrobiotia of breastmilk. A diet high in simple sugars and saturated fats can be associated with less diverse microbiota, while complex carbohydrates, high fiber, dietary folate and other micronutrients (think fruits and vegetables) may increase the rich diversity in microbiome.
Benefits of a Healthy Gut Microbiome:
A diverse and balanced gut microbiome is associated with a range of health benefits for infants, including:
Stronger immune system: Beneficial bacteria in the gut help train the baby's immune system to recognize and fight off pathogens, reducing the risk of infections.
Improved digestion: A healthy gut microbiome can help regulate digestion, reduce digestive issues such as constipation or diarrhea, and promote nutrient absorption.
Protection against allergies and autoimmune diseases: Early exposure to a diverse range of bacteria through breastfeeding can help reduce the risk of developing allergies and autoimmune conditions later in life.
Tips for Supporting Your Baby's Gut Health:
Focus on your nutrition during pregnancy. Need help? Find a prenatal dietitian nutritionist who can support you. Discuss your goals for a birth plan with your medical team. Sometimes there are unforeseen circumstances or circumstances out of your control that warrant a cesarean delivery. If that is the case, know that breastfeeding will still be profoundly beneficial for supporting baby's gut microbiome in the long run. And while breastfeeding is natural, it takes work. If your goal is to breastfeed, plan to meet with a lactation consultant before delivery, again within 48 hours after delivery, and ongoing as needed. If feeding at breast is not possible, expressed breastmilk provides the same immune benefits! Even if a mama is not able to exclusively breastfeed, 2 ounces a day is enough to seed a rich gut microbiome over time. Not able to produce milk? Work with your lactation consultant on acquiring milk through a mother's milk bank. And for formula feeding families, you can still support your baby's gut health by choosing a high-quality formula that contains prebiotics.
Reference list:
Bode, L. (2012). Human milk oligosaccharides: every baby needs a sugar mama. Glycobiology, 22(9), 1147-1162.
Dominguez-Bello MG, Costello EK, Contreras M, Magris M, Hidalgo G, Fierer N, Knight R. Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. Proc Natl Acad Sci U S A. 2010 Jun 29;107(26):11971-5. doi: 10.1073/pnas.1002601107.
Koenig, J. E., Spor, A., Scalfone, N., Fricker, A. D., Stombaugh, J., Knight, R., ... & Ley, R. E. (2011). Succession of microbial consortia in the developing infant gut microbiome. Proceedings of the National Academy of Sciences, 108(Supplement 1), 4578-4585.
Liu Y, Ma J, Zhu B, Liu F, Qin S, Lv N, Feng Y, Wang S, Yang H. A health-promoting role of exclusive breastfeeding on infants through restoring delivery mode-induced gut microbiota perturbations. Front Microbiol. 2023 Jul 10;14:1163269. doi: 10.3389/fmicb.2023.1163269. PMID: 37492252; PMCID: PMC10363731.
Londoño-Sierra, D.C.; Mesa, V.; Guzmán, N.C.; Bolívar Parra, L.; Montoya-Campuzano, O.I.; Restrepo-Mesa, S.L. Maternal Diet May Modulate Breast Milk Microbiota—A Case Study in a Group of Colombian Women. Microorganisms 2023, 11, 1812. https://doi.org/10.3390/microorganisms11071812
Pannaraj, P. S., Li, F., Cerini, C., Bender, J. M., Yang, S., Rollie, A., ... & Aldrovandi, G. M. (2017). Association between breast milk bacterial communities and establishment and development of the infant gut microbiome. JAMA pediatrics, 171(7), 647-654.
Quigley, E. M. M. (2013). Gut bacteria in health and disease. Gastroenterology & hepatology, 9(9), 560.
Stewart, C. J., Ajami, N. J., O'Brien, J. L., Hutchinson, D. S., Smith, D. P., Wong, M. C., ... & Petrosino, J. F. (2018). Temporal development of the gut microbiome in early childhood from the TEDDY study. Nature, 562(7728), 583-588.
Taylor R, Keane D, Borrego P, Arcaro K. Effect of Maternal Diet on Maternal Milk and Breastfed Infant Gut Microbiomes: A Scoping Review. Nutrients. 2023 Mar 15;15(6):1420. doi: 10.3390/nu15061420. PMID: 36986148; PMCID: PMC10051234.
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