Personalization of the Microbiota of Donor Human Milk with Mother's Own Milk.

Nicole T Cacho,Kaylie A Padgett,Leslie A Parker,Graciela L Lorca,Laura E Carr,Guillermo E Marcial,Josef Neu,Nan Li,Dominick J Lemas,Natalie A Harrison

doi:10.3389/fmicb.2017.01470

Abstract

The American Academy of Pediatrics recommends that extremely preterm infants receive mother’s own milk (MOM) when available or pasteurized donor breast milk (DBM) when MOM is unavailable. The goal of this study was to determine whether DBM could be inoculated with MOM from mothers of preterm infants to restore the live microbiota (RM). Culture dependent and culture independent methods were used to analyze the fluctuations in the overall population and microbiome, respectively, of DBM, MOM, and RM samples over time. Using MOM at time = 0 (T0) as the target for the restoration process, this level was reached in the 10% (RM-10) and 30% (RM-30) mixtures after 4 h of incubation at 37°C, whereas, the larger dilutions of 1% (RM-1) and 5% (RM-5) after 8 h. The diversity indexes were similar between MOM and DBM samples, however, different genera were prevalent in each group. Interestingly, 40% of the bacterial families were able to expand in DBM after 4 h of incubation indicating that a large percentage of the bacterial load present in MOM can grow when transferred to DBM, however, no core microbiome was identified. In summary, the microbiome analyses indicated that each mother has a unique microbiota and that live microbial reestablishment of DBM may provide these microbes to individual mothers’ infants. The agreement between the results obtained from the viable bacterial counts and the microbiome analyses indicate that DBM incubated with 10–30% v/v of the MOM for 4 h is a reasonable restoration strategy.

Highlights

The benefits of human milk for preterm infants include immune and nutritional protection against infection, decreased necrotizing enterocolitis (NEC), and other morbidities (Wight, 2001)
At baseline t = 0, the amount of four bacterial populations were quantified in mother’s own milk (MOM) and used as the target goal for each individual mother
In this work we show that by using a small amount of MOM to inoculate pasteurized donor breast milk (DBM), it is possible to reestablish the potentially beneficial naturally occurring microbes

Summary

Introduction

The benefits of human milk for preterm infants include immune and nutritional protection against infection, decreased necrotizing enterocolitis (NEC), and other morbidities (Wight, 2001). The current practice at the Abbreviations: DBM, donor breast milk; MOM, mother’s own milk; NICU, Neonatal Intensive Care Unit; RM, restored microbiota pasteurized donor milk. Up to 200 different bacterial species have been found in human milk. Hunt et al (2011) studied milk samples from 16 healthy women collected at three different time points. Each individual demonstrated a unique milk microbiome that was stable over time (Hunt et al, 2011). These data highlight a personalized collection of milk microbes from each mother that is optimized for the health of her own infant

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