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Abstract
Recent evidence indicates that maternal dietary intake, including dietary supplements, during pregnancy and lactation may alter the infant gut or breastmilk microbiota, with implications for health outcomes in both the mother and infant. To review the effects of maternal nutritional supplementation during pregnancy and lactation on the infant gut or breastmilk microbiota a systematic literature search was conducted. A total of 967 studies published until February 2020 were found, 31 were eligible and 29 randomized control trials were included in the qualitative synthesis. There were 23 studies that investigated the effects of probiotic supplementation, with the remaining studies investigating vitamin D, prebiotics or lipid-based nutrient supplements (LNS). The effects of maternal nutritional supplementation on the infant gut microbiota or breastmilk microbiota were examined in 21 and 12 studies, respectively. Maternal probiotic supplementation during pregnancy and lactation generally resulted in the probiotic colonization of the infant gut microbiota, and although most studies also reported alterations in the infant gut bacterial loads, there was limited evidence of effects on bacterial diversity. The data available show that maternal probiotic supplementation during pregnancy or lactation results in probiotic colonization of the breastmilk microbiota. There were no observed effects between probiotic supplementation and breastmilk bacterial counts of healthy women, however, administration of Lactobacillus probiotic to nursing women affected by mastitis was associated with significant reductions in breastmilk Staphylococcal loads. Maternal LNS supplementation during pregnancy and lactation increased bacterial diversity in the infant gut, whilst vitamin D and prebiotic supplementation did not alter either infant gut bacterial diversity or counts. Heterogeneity in study design precludes any firm conclusions on the effects of maternal nutritional supplementation during pregnancy and lactation on the infant gut or breastmilk microbiota, warranting further research.
Highlights
The human microbiota is a rich and diverse community of 10 to 100 trillion microbes including bacteria, archaea, parasites, fungi and viruses
The results demonstrate that maternal probiotic supplementation may result in colonization of the breastmilk microbiota
The present systematic review suggests that maternal nutritional supplementation during pregnancy and lactation can impact on the infant gut microbiota or breastmilk microbiota, but with varying effects according to participant characteristics, type of supplement administered, and outcome measured
Summary
The human microbiota is a rich and diverse community of 10 to 100 trillion microbes including bacteria, archaea, parasites, fungi and viruses. Changes in maternal diet during pregnancy and lactation have been linked to alterations in the maternal gut and breastmilk microbiota and in the infant gut microbiota, with greater effects observed among breastfed infants compared to formula-fed infants [2] These findings indicate that maternal nutrition is a key factor that shapes the infant gut microbiota, supporting the potential for maternal nutritional interventions to improve health outcomes and reduce disease risk. Recent advances in biomolecular technologies and bioinformatics have enabled a better understanding of the development of the gut microbiota and the complex commensal and symbiotic human-to-microorganism relationships [1]. These developments have highlighted three stages where the vertical transfer of microbial species from mother to infant and the establishment of the infant gut microbiota may occur; in utero, at birth and through breastfeeding, each route is briefly summarized below
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