Administration of a Multi-Strain Probiotic Product to Women in the Perinatal Period Differentially Affects the Breast Milk Cytokine Profile and May Have Beneficial Effects on Neonatal Gastrointestinal Functional Symptoms. A Randomized Clinical Trial.

Maria Baldassarre,Paola Mastromarino,Domenico Martinelli,Daniela Capobianco,Margherita Fanelli,Flavia Urbano,Nicola Laforgia,Antonio Di Mauro

doi:10.3390/nu8110677

Maria Baldassarre, Paola Mastromarino + Show 6 more

Open Access

https://doi.org/10.3390/nu8110677

Copy DOI

Abstract

Background: Probiotic supplementation to women during pregnancy and lactation can modulate breast milk composition, with immune benefits being transferred to their infants. Aim: The aim of the study was to evaluate the effect of high-dose probiotic supplementation to women during late pregnancy and lactation on cytokine profile and secretory IgA (sIgA) in breast milk and thus to study if differences in breast milk composition can affect lactoferrin and sIgA levels in stool samples of newborns. The safety of maternal probiotic administration on neonatal growth pattern and gastrointestinal symptoms were also evaluated. Methods: In a double-blind, placebo-controlled, randomized trial, 66 women took either the probiotic (n = 33) or a placebo (n = 33) daily. Levels of interleukins (IL-6, IL-10 and IL-1β), transforming growth factor-β1 (TGF-β1), and sIgA in breast milk; and the level of sIgA and lactoferrin in newborn stool samples were analyzed at birth and then again at one month of life. Antropometrical evaluation and analysis of gastrointestinal events in newborns was also performed. Results: Probiotic maternal consumption had a significant impact on IL6 mean values in colostrum and on IL10 and TGF-β1 mean values in mature breast milk. Fecal sIgA mean values were higher in newborns whose mothers took the probiotic product than in the control group. Probiotic maternal supplementation seems to decrease incidence of infantile colic and regurgitation in infants. Conclusion: High-dose multi-strain probiotic administration to women during pregnancy influences breast milk cytokines pattern and sIgA production in newborns, and seems to improve gastrointestinal functional symptoms in infants.

Highlights

The primary outcomes of this study were to evaluate if maternal probiotics supplementation can modulate the cytokine profile and secretory IgA in breast milk and to study if differences in breast milk composition can affect lactoferrin and sIgA levels in newborn stool samples
We evaluated the mean values in colostrum and mature milk of two anti-inflammatory cytokines, transforming growth factor-β1 (TGF-β1) and IL-10, and two pro-inflammatory cytokines, IL-1β and IL-6
On the basis of the known role of TGF-β1 on the level of sIgA [16], that serves as a first line of defense in gut mucosal immunity [17], it is possible to hypothesize that the increase of TGF-β1 levels in breast milk, induced by this high dose probiotic preparation, may be responsible for the significantly higher sIgA levels found in stools of infants whose mothers took the probiotic product at T30 (Figure 3B)

Summary

Introduction

Several papers have shown that probiotic supplementation to women during pregnancy and lactation can modulate the microbial milk composition and the level of different breast milk immunity and immunity-modulating molecules, with health benefits ranging from gastrointestinal symptoms to allergies, transferred to the children [1].Nutrients 2016, 8, 677; doi:10.3390/nu8110677 www.mdpi.com/journal/nutrientsOur previously published studies demonstrated that the same high concentration multi-strain probiotic, when supplemented to mothers in the perinatal period, was associated with a modulation of the vaginal microbiota and vaginal cytokine secretion [2] and with an increase in levels of breast milk bifidobacteria and lactobacilli in women with vaginal deliveries, regardless of the milk concentrations of functional components such as oligosaccharides and lactoferrin [3].An improved microbial milk composition might have important consequences for the health of the newborn [4]. Several papers have shown that probiotic supplementation to women during pregnancy and lactation can modulate the microbial milk composition and the level of different breast milk immunity and immunity-modulating molecules, with health benefits ranging from gastrointestinal symptoms to allergies, transferred to the children [1]. The primary outcomes of this study were to evaluate if maternal probiotics supplementation can modulate the cytokine profile and secretory IgA (sIgA) in breast milk and to study if differences in breast milk composition can affect lactoferrin and sIgA levels in newborn stool samples. Aim: The aim of the study was to evaluate the effect of high-dose probiotic supplementation to women during late pregnancy and lactation on cytokine profile and secretory IgA (sIgA) in breast milk and to study if differences in breast milk composition can affect lactoferrin and sIgA levels in stool samples of newborns. Fecal sIgA mean values were higher in newborns whose mothers took the probiotic product than in the control group

Objectives

Results

Discussion

Conclusion