Abstract
Human milk represents a cornerstone for growth and development of infants, with extensive array of benefits. In addition to exceptionally nutritive and bioactive components, human milk encompasses a complex community of signature bacteria that helps establish infant gut microbiota, contributes to maturation of infant immune system, and competitively interferes with pathogens. Among bioactive constituents of milk, human milk oligosaccharides (HMOs) are particularly significant. These are non-digestible carbohydrates forming the third largest solid component in human milk. Valuable effects of HMOs include shaping intestinal microbiota, imparting antimicrobial effects, developing intestinal barrier, and modulating immune response. Moreover, recent investigations suggest correlations between HMOs and milk microbiota, with complex links possibly existing with environmental factors, genetics, geographical location, and other factors. In this review, and from a physiological and health implications perspective, milk benefits for newborns and mothers are highlighted. From a microbiological perspective, a focused insight into milk microbiota, including origins, diversity, benefits, and effect of maternal diet is presented. From a metabolic perspective, biochemical, physiological, and genetic significance of HMOs, and their probable relations to milk microbiota, are addressed. Ongoing research into mechanistic processes through which the rich biological assets of milk promote development, shaping of microbiota, and immunity is tackled.
Highlights
Introduction to Human Milk andImportance of BreastfeedingOver the past decades, human breast milk has been widely agreed upon as being the normal and optimal dietary start for infants, with unparalleled biological effects driven by the combined action of its nutritional and bioactive components [1]
In the breastfeeding week 2020 message, under the theme “support breastfeeding for a healthier planet”, the World Health Organization (WHO) called for protection, promotion, and support of women’s access to skilled breastfeeding, in line with the multifaceted benefits of this sustainable, biological food system [5]
A systematic review published by the WHO in 2013 suggests that breastfeeding substantially protects against morbidity/mortality from diarrhea, with a reduction of 50% in morbidity and 80–90%
Summary
Human breast milk has been widely agreed upon as being the normal and optimal dietary start for infants, with unparalleled biological effects driven by the combined action of its nutritional and bioactive components [1]. The American Academy of Pediatrics (AAP) continuously reinforces breastfeeding and mother’s milk as the normal standards for infant feeding and nutrition It recommends exclusive breastfeeding for six months, followed by continuation of breastfeeding as complementary foods are introduced, with possible extension of breastfeeding for one year of age or beyond, as desired [6]. The high concentration and structural diversity of HMOs that reach the infant colon, initiate a series of health effects [13] To this end, this review article presents up-to-date information about human milk benefits, human milk microbiota, and HMOs, and revises possible associations between microbial milk profiles and both maternal diet and HMOs
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