Why breast-fed premature infants have a healthier gut than formula-fed ones: A probiotic bacteria strain in preemies seems to protect and strengthen the gut

Human breastmilk has long been considered “liquid gold” among clinicians treating premature infants in a newborn intensive care unit (NICU). Breastmilk-fed “preemies” are healthier, on average, than those fed formula. Why is that true, however, has remained a mystery.

New research from the University of Maryland School of Medicine’s (UMSOM) Institute for Genome Sciences (IGS), published online in the journal mBio in June found it is not just the content of breastmilk that makes the difference. It is also the way the babies digest it.

The research, led by Bing Ma, PhD, Assistant Professor of Microbiology and Immunology at UMSOM and a researcher at IGS, discovered a strain of the Bifidobacterium breve bacteria or B. breve in the gut of breastfed babies who received higher volumes of breastmilk than their counterparts. Those preemies had better nutrient absorption because they developed an intact intestinal wall, one week after birth. B. breve was much less prevalent in both formula-fed babies and breastfed babies with “leaky gut.” Babies with leaky gut do not develop a barrier to protect against bacteria and digested food from getting into the bloodstream. For the first time, the team also found that the way B. breve metabolizes breastmilk keeps breastfed babies healthier and allows them to gain weight by strengthening their underdeveloped intestinal barrier.

An immature or “leaky” gut can lead to necrotizing enterocolitis (NEC), which is the third leading cause of newborn death in United States and worldwide. In fact, NEC impacts up to 10 percent of premature babies with a devasting mortality rate as high as 50 percent.

“Our discovery could lead to promising and practical clinical interventions to strengthen the babies’ gut and, therefore, increase survival rates of the most vulnerable preemies,” said Dr. Ma.

Bifidobacterium in the gut or microbiome has long been known to have health benefits. It includes a diverse set of strains that have very different properties. Some strains are only found in adults; some are mostly in adolescence. One strain, Bifidobacterium infantis, has been seen predominantly in full-term infants.

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