Probiotic supplementation and associated infant gut microbiome and health: a cautionary retrospective clinical comparison

C Quin,S K Gill,M Estaki,D L Gibson,D M Vollman,J A Barnett

doi:10.1038/s41598-018-26423-3

C Quin, S K Gill + Show 4 more

Open Access

https://doi.org/10.1038/s41598-018-26423-3

Copy DOI

Abstract

While probiotics are a multi-billion dollar industry, there is little evidence to show that supplementing infants provides any health benefits. We conducted an observational study where 35 of 86 participating mothers self-administered probiotics during breastfeeding, as well as directly to their infants. The primary objective was to determine if probiotic exposure influenced the infants’ fecal microbiome while the secondary objective assessed associated changes to the mothers’ breast milk immunity and infant health. Analysis of infant fecal microbiome throughout the first 6 months of life revealed that probiotics were associated with higher abundances of Bifidobacterium at week 1 only. Short-chain fatty acid production and predicted metagenomic functions of the microbial communities were not altered. While probiotics did not alter breast milk immune markers, fecal sIgA responses were higher among probiotic supplemented infants. Surprisingly, this was not associated with better health outcomes, as the probiotic cohort had higher incidences of mucosal-associated illnesses as toddlers. This retrospective clinical comparison suggests that probiotic exposure during infancy has limited effects on gut microbial composition yet is associated with increased infection later in life. These correlative findings caution against probiotic supplementation during infancy until rigorous controlled follow-up studies determining their safety and efficacy have occurred.

Highlights

In the past few decades microbial research has revealed the importance of the microbiome to human health
With respect to the secondary outcomes, we found that probiotic supplementation had no effect on the measured immune markers in the breast milk but did associate with significantly higher secretory immunoglobulin-A (sIgA) measured from infant stool
Probiotics have been proposed to influence a wide range of health outcomes presumably by altering the intestinal microbiota and immunity[28] but research is limited on the clinical effects of probiotic exposure during infancy

Summary

Introduction

In the past few decades microbial research has revealed the importance of the microbiome to human health. Only does this complicate the functional characterization of probiotics, and the process of manufacturing controls and standards to assure a high-quality product The consequences of this lack of regulatory oversight are increasingly evident: a premature infant died from gastrointestinal (GI) mucormycosis after being administered a probiotic, manufactured in the USA, which was contaminated with an opportunistic pathogenic mold[12]. The increased sIgA levels were not correlated with better health outcomes of toddlers, since parent-reported incidences of mucosal infectious diseases revealed higher disease instances in the probiotics group. This was true regardless of mode of delivery (MOD), presences of household pets, siblings, and preschool/daycare attendance as analysed using a multi-model approach. These correlative findings should be interpreted cautiously given the unstandardized nature of this study

Objectives

Methods

Results

Conclusion