Abstract
The mode of delivery has been suggested to modulate the bacterial composition of breast milk but the impact of intrapartum antibiotic use on the milk microbiota is currently not known. The aim of this study was to analyze the effects of the mode of the delivery and intrapartum antibiotic administration on the microbial composition of breast milk. Breast milk samples were collected from 84 healthy mothers 1 month after the delivery. In total, 61 mothers had delivered vaginally, 23 of which had received intrapartum antibiotics, 13 women had delivered with non-elective cesarean section, 7 of which had received antibiotics, and 10 mothers had delivered with elective cesarean section without intrapartum antibiotic treatment. Both mode of delivery and intrapartum antibiotic exposure were significantly associated with changes in the milk microbial composition as assessed by analysis of similarities (ANOSIM) test (p = 0.001). The mode of delivery had a more profound effect on the milk microbiota composition as compared to intrapartum antibiotic exposure. Although the clinical significance of breast milk microbiota is currently poorly understood, this study shows that cesarean section delivery has an independent effect on breast milk microbiota composition. The dysbiosis observed in infants born by cesarean section delivery may be aggravated by the aberrant breast milk microbiota.
Highlights
Human breast milk is considered the gold standard of infant nutrition
38 women who had delivered vaginally without intrapartum antibiotic exposure, 23 women who had delivered vaginally and received intrapartum antibiotics, 10 women who had delivered by elective cesarean section without intrapartum antibiotic exposure, 6 women who had delivered with non-elective cesarean section without intrapartum antibiotics and 7 women who had delivered with non-elective cesarean section and received intrapartum antibiotics were selected for this study
When the milk samples were separated based on antibiotic exposure, the species Bifidobacterium was uniquely found in the breast milk samples of mothers who did not receive antibiotics. Both mode of delivery and exposure to intrapartum antibiotics had an independent impact on the composition of the breast milk microbiota at 1 month postpartum in this study
Summary
Human breast milk is considered the gold standard of infant nutrition. Beyond its nutritional benefits, breastfeeding is known to reduce respiratory and gastrointestinal infections in early life, and decrease the risk of non-communicable diseases including type 2 diabetes mellitus, overweight and obesity in childhood as well as improve neuro-developmental outcomes in preterm infants [1]. The protective mechanisms of breastfeeding may partly be explained by its impact on the composition of gut microbiota. Breast milk contains several components, including oligosaccharides and glycoproteins, which modulate the neonatal gut microbiota composition by favoring the growth of specific bifidobacteria [2]. Breast milk harbors a unique microbiota which might serve as a continuous source of colonizing bacteria to the newborn infant [3,4,5]. Mode of Delivery and Breast Milk Microbiota
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