Abstract
Feeding preterm infants mother’s own milk (MOM) lowers rates of sepsis, decreases necrotizing enterocolitis, and shortens hospital stay. In the absence of freshly expressed MOM, frozen MOM (FMOM) is provided. When MOM is unavailable, preterm infants are often fed pasteurized donor human milk (DHM), rendering it devoid of beneficial bacteria. We have previously reported that when MOM is inoculated into DHM to restore the live microbiota [restored milk (RM)], a similar microbial diversity to MOM can be achieved. Yet, it is unknown if a similar diversity to MOM can be obtained when FMOM is inoculated into DHM. The goal of this study was to determine whether a similar microbial composition to MOM could be obtained when FMOM is used to personalize DHM. To this end, a fresh sample of MOM was obtained and divided into fresh and frozen fractions. MOM and FMOM were inoculated into DHM at different dilutions: MOM/FMOM 10% (RM/FRM10) and MOM/FMOM 30% (RM/FRM30) and incubated at 37°C. At different timepoints, culture-dependent and culture-independent techniques were performed. Similar microbiota expansion and alpha diversity were observed in MOM, RM10, and RM30 whether fresh or frozen milk was used as the inoculum. To evaluate if microbial expansion would result in an abnormal activation on the innate immune system, Caco-2 epithelial cells were exposed to RM/FRM to compare interleukin 8 levels with Caco-2 cells exposed to MOM or DHM. It was found that RM samples did not elicit a significant increase in IL-8 levels when compared to MOM or FMOM. These results suggest that FMOM can be used to inoculate DHM if fresh MOM is unavailable or limited in supply, allowing both fresh MOM and FMOM to be viable options in a microbial restoration strategy.
Highlights
The American Academy of Pediatrics recommends all preterm infants receive exclusive mother’s own milk (MOM) or donor human milk (DHM) when MOM is not available (Eidelman and Schanler, 2012)
Donor Human Milk Can Be Personalized With frozen MOM (FMOM)
It was found that 30% of fresh MOM inoculated in DHM (RM30) and incubated for 4 h resulted in microbial expansion (Cacho et al, 2017)
Summary
The American Academy of Pediatrics recommends all preterm infants receive exclusive mother’s own milk (MOM) or donor human milk (DHM) when MOM (fresh or frozen) is not available (Eidelman and Schanler, 2012). It is well known that pump-dependent mothers often produce insufficient amounts of MOM to provide exclusive MOM feedings (Eidelman and Schanler, 2012). DHM is obtained from pooled donors, pasteurized and frozen (HMBANA Guideline Committee, 2020). This process renders the milk devoid of live commensal bacteria. The variability observed in the composition of the milk microbiota may be attributed to different variables, such as diet, race, human milk oligosaccharides secretor status, mode of delivery, the mother’s skin, and the infant’s mouth (Novak and Innis, 2011; CabreraRubio et al, 2012, 2019; Biagi et al, 2017; Cacho et al, 2017; Vaidya et al, 2017; Xi et al, 2017)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
