Antibiotics Influence the Breast Milk Microbiota of Mothers With Preterm Babies

Mothers of preterm babies have highly individual microbiomes in their breast milk, the diversity and abundance of which is greatly affected by even short antibiotics courses.

The study suggests judicious use of antibiotics, though it may often be necessary for mothers of preterm babies. The class of antibiotics, timing, and exposure to it seem to affect the breast milk microbiome, with the potential to influence the growth and immunity to disease in newborns.

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‘The microbiota in mothers' breast milk with preterm babies are influenced by the mother's BMI, mode of delivery, and antibiotic use. Antibiotics are often an essential treatment for mothers of preterm infants, but they should be used judiciously.’
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"It came as quite a shock to us that even one day of antibiotics was associated with profound changes in the microbiota of breast milk", says Deborah O’Connor, who is a professor and chair of nutritional sciences at U of T and a senior associate scientist at SickKids. "I think the take-home is that while antibiotics are often an essential treatment for mothers of preterm infants, clinicians and patients should be judicious in their use."

The research by the University of Toronto and The Hospital for Sick Children, is published in Cell Host and Microbe.

Mothers of preterm babies are prescribed antibiotics for mastitis, blood infection, and premature rupture of membranes. In the study that looked at 490 breast milk samples from 86 mothers whose infants were born preterm, around 60% of women took antibiotics.

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The samples were examined during the first eight weeks after delivery. The mother’s BMI and mode of delivery influenced breast milk microbiota. The effect of antibiotics lasted for weeks, and the changes induced by these drugs affected the microbes that play a role in gut health, in developing certain diseases, and metabolic processes that influence babies’ growth.

Despite the vast use and need for antibiotics, there is a high potential for its over-use.

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"Overall we saw a decrease in metabolic pathways, and increase in more pathogenic pathways in bacteria over time," says Michelle Asbury, a doctoral student in O’Connor’s lab and lead author on the paper. "Of particular concern was an association between antibiotics and a Proteobacteria phylum member called Pseudomonas. When elevated, Proteobacteria in a preterm infant’s gut can precede necrotizing enterocolitis."

As breastfeeding benefits outweigh the risk of antibiotics on breast milk microbiome, mothers should resort to breastfeeding when possible.

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"But I think we can look to narrow the spectrum of antibiotics we use and to shorten the duration when possible," says Sharon Unger is a co-author of the study.

Unger says it holds great promise for preterm infants. "Clearly the microbiome is important for their metabolism, growth and immunity. But emerging evidence on the gut-brain axis and its potential to further improve neurodevelopment for these babies over the long term warps my mind."

Source-Medindia