Infant Gastrointestinal Tract Research Articles

Sociocultural context of exclusive breastfeeding in Africa: A narrative review.

Although exclusive breastfeeding (EBF) has many benefits, it is not commonly practiced in several countries as a result of context-specific challenges. EBF practice is thus a global health discourse because over 200 million children suffer from malnutrition despite the abundance of human milk. The risk of starvation remains very high among African children with less than 40% of them exclusively breastfed. In Africa, the adoption or nonadherence to EBF is a sociocultural issue. Hence, this narrative review examined the sociocultural context of EBF in the region. PubMed, Google Scholar, and Scopus were searched using keywords related to EBF and Africa. Relevant data from selected studies were synthesized narratively and reported using a structured narrative format. EBF is strongly rooted in every culture and is a culturally determined behavior. Some believe that colostrum is dirty and harmful to newborns and, thus, needs to be purified. Despite the belief that human milk is the best food for babies, mothers often complement human milk with other foods right from birth because of perceived lactation inadequacy. Most African mothers believe in prelacteal feeding to help cleanse the infant's gastrointestinal tract for digestion, quench thirst, flush the bladder and help the mother to rest after childbirth before breastfeeding (BF) is initiated. The role of significant others was equally found important in the decision and duration of BF. The availability of family support (especially from grandmothers and husbands) reportedly encouraged EBF in Africa. The duration and exclusivity of BF in Africa are negatively associated with demographic variables like young age, low level of education, being unmarried, low income, out of employment, and parity (first-time mother). While there have been some efforts and policies to improve EBF, it is important to consider context-specific challenges and sociocultural factors. There is a need for more deliberate efforts to encourage mothers through the implementation of effective best practices concerning EBF in Africa.

The digestion fates of lipids with different unsaturated levels in people with different age groups

The digestion behavior of lipids plays a crucial role in their nutritional bioaccessibility, which subsequently impacts human health. This study aims to investigate potential variations in lipid digestion profiles among individuals of different ages, considering the distinct physiological functions of the gastrointestinal tract in infants, aging populations, and healthy young adults. The digestion fates of high oleic peanut oil (HOPO), sunflower oil (SO), and linseed oil (LINO) were investigated using in vitro digestion models representing infants, adults, and elders. Comparatively, lipid digestion proved to be more comprehensive in adults, leading to free fatty acid (FFA) levels of 64.53%, 62.32%, and 57.90% for HOPO, SO, and LINO, respectively. Besides, infants demonstrated propensity to selectively release FFAs with shorter chain lengths and higher saturation levels during the digestion. In addition, in the gastric phase, particle sizes among the elderly were consistently larger than those observed in infants and adults, despite adults generating approximately 15% FFAs within the stomach. In summary, this study enhances our fundamental comprehension of how lipids with varying degrees of unsaturation undergo digestion in diverse age groups.

Natural Oncolysis of Enterovirus 71 in Antitumor Therapy of Colorectal Cancer.

Colorectal cancer (CRC) is an intestinal malignant tumor with high morbidity and mortality worldwide. Inoperability or resistanance to radiation and chemotherapy occur in the conventional treatments against CRC. Oncolytic viruses (OVs) are one kind of virus that selectively infects and lyses cancer cells, which is considered to be a new anticancer therapy with biological and immune-based approaches. Enterovirus 71 (EV71), belonging to the enterovirus genus in the family Picornaviridae, is a single positive-stranded RNA virus. EV71 is transmitted in a fetal-oral route and infects gastrointestinal tract in infants. Here, EV71 is exploited to be a novel oncolytic virus in colorectal cancer. It is revealed that EV71 infection can selectively cause colorectal cancer cells cytotoxicity but not primary intestinal epithelial cells. Consistently, EV71 injection significantly inhibits tumor growth in nude mice xenografted colorectal cancer cells. In detail, EV71 infects colorectal cancer cells to repress the expression of Ki67 and B-cell leukemia 2 (Bcl-2) leading to the inhibition of cell proliferation, while activating the cleavage of poly-adenosine diphosphatase-ribose polymerase and Caspase-3 protein resulting in the promotion of cell apoptosis. The findings demonstrate the oncolytic feature of EV71 in CRC treatment and may provide a potential clue for clinical anticancer therapy.

Digestion of human milk processed by high pressure processing and Holder pasteurization using a dynamic in vitro model of the preterm infant

Holder pasteurization (HoP) (62.5 °C, 30 min) of donor human milk is widely used to inactivate potential pathogens but may lead to denaturation and aggregation of bioactive proteins, reducing their functionality. In contrast, high pressure processing (HPP) is a non-thermal technique that minimally affects assessed bioactive components; however, it is unclear how HPP affects protein digestion, and retention of functional bioactive proteins. Raw or processed (HoP; HPP[500 MPa,10 min]) pools of milk (N = 3, from 9 donors) were subjected in triplicate to in vitro digestion simulating the preterm infant gastrointestinal tract. Compared to raw or HPP, HoP increased intestinal proteolysis of lactoferrin and bioactive milk fat globule membrane proteins. Lysozyme activity was impacted by digestion following HoP (72 % to 7 %)—significantly more than HPP (75 % to 34 %) or raw (100 % to 39 %), which did not differ. Proteins in HPP-treated donor milk are digested no different than raw milk, while preserved bioactivity remains functional upon digestion.

Model infant formulas: Influence of types of whey proteins and lipid composition on the in vitro static digestion behavior

This work aimed at evaluating the influence of types of whey proteins (lactoferrin, whey protein isolate and/or whey protein hydrolysates) and lipid composition (high oleic sunflower oil, coconut oil and/or medium chain triacylglycerols) on the behavior of model infant formulas (IFs) under simulated conditions of the infant gastrointestinal tract using an in vitro static digestion model. The physicochemical conditions of the gastric medium resulted in the aggregation of oil the droplets and partial hydrolysis of the proteins, considering whey proteins were resistant to the gastric conditions. However, after intestinal digestion the proteins from all the IFs were extensively hydrolyzed. The lipid composition of the IFs did not influence the protein hydrolysis, but the protein composition of the IFs altered the release of free fatty acids. The presence of lactoferrin in the IFs resulted in a higher free fatty acids release compared to IFs of same lipid composition. In terms of lipid composition, IFs containing coconut oil and medium chain triacylglycerols showed extremely higher free fatty acids release than those containing only long chain triacylglycerols. These results are promising for the design of infant foods containing fast-absorbing functional ingredients.

Survival of Vaccine-Induced Human Milk SARS-CoV-2 IgG, IgA and SIgA Immunoglobulins across Simulated Human Infant Gastrointestinal Digestion.

Breastfeeding can be a vital way of acquiring passive immunity via the transfer of antibodies from the mother to the breastfeeding infant. Recent evidence points to the fact that human milk contains immunoglobulins (Ig) against the SARS-CoV-2 virus, either after natural infection or vaccination, but whether these antibodies can resist enzymatic degradation during digestion in the infant gastrointestinal (GI) tract or indeed protect the consumers remains inconclusive. Herein, we evaluated the levels of IgG, IgA, and secretory IgA (SIgA) antibodies against the spike protein of SARS-CoV-2 in 43 lactating mothers who received at least two doses of either an mRNA-based vaccine (Pfizer/BioNTech, Moderna; n = 34) or an adenovirus-based vaccine (AstraZeneca; n = 9). We also accessed the potential persistence of SARS-CoV-2 IgA, IgG, and secretory IgA (SIgA) antibodies from vaccinated women in the GI tract of the infants by means of a static in vitro digestion protocol. Our data depict that, although slightly reduced, the IgA antibodies produced after vaccination resist both the gastric and intestinal phases of infant digestion, whereas the IgGs are more prone to degradation in both phases of digestion. Additionally, SIgA antibodies were found to greatly resist the gastric phase of digestion albeit showing some reduction during the intestinal phase. The evaluation of the vaccine induced Ig profile of breastmilk, and the extent to which these antibodies can resist digestion in the infant GI tract provide important information about the potential protective role of this form of passive immunity that could help decision making during the COVID-19 pandemic and beyond.

Use of Highly Dispersed Silica in Biotechnology of Complex Probiotic Product Based on Bifidobacteria

Background. The probiotics immobilization technology is one of the most effective ways for controlled and continuous delivery of viable cells into the intestine. It is well known that multifaceted physiological roles of bifidobacteria are to normalize and stabilize the microbiocenosis, to form intestine colonization resistance, to synthesis amino acids, proteins and vitamins, to maintain non-specific resistance of the organism and so all. Such a wide range of positive effects on the macroorganism allows us to consider bifidobacteria as a basis for functional immobilized healthcare products development.
 Objective. Taxonomic position determination of the Bifidobacterium longum strain selected for immobilization, study of the viability of this bifidobacteria strain in a complex probionic product based on highly dispersed silica in simulated gastrointestinal tract's conditions and after freeze-drying.
 Methods. The production strain Bifidobacterium longum IMV B-7165 from the Institute of Food Resources of the National Academy of Agrarian Sciences of Ukraine collection of industrial strains has been used in the study. It was isolated from the healthy human infant's gastrointestinal tract.
 Commonly used bioinformatics, microbiological, biotechnological and statistical methods have been applied.
 Results. The best alignments for the sequence of bifidobacteria isolate "4202" 16S rRNA (it was previously deposited as Bifidobacterium longum IMV B-7165) and classic dendrograms based on these results were performed. According to the results of microscopic studies of samples of microorganisms with highly dispersed silica products ("Enterosgel", "Sillard P" and "Toxin.Net") it was found that the immobilization of the Streptococcus thermophilus and bifidobacteria cultures did not differ fundamentally. To study the immobilization effect on the bifidobacteria preservation and properties the following carriers were used: "Enterosgel", "Toxin.NET" and "Sillard P". The survival of immobilized bifidobacteria was further studied in simulated gastrointestinal conditions: immobilized cells are better protected from acid and bile, although with increasing acidity, survival decreases in both control and immobilized cells.
 Conclusions. The taxonomic position of a bifidobacterial isolate from the healthy human infants used in immobilization studies was clarificated (Bifidobacterium animalis subsp lactis). Under the simulated conditions of the upper gastrointestinal tract in the case of acid and bile impact, the best survival was demonstrated by immobilized cultures of bifidobacteria together with the Enterosgel sorbent (a content of 10% by weight of the culture). The survival of immobilized preparations after freeze-drying was slightly reduced in the case of immobilization on the "Enterosgel" and "Toxin.NET" samples of enterosorbents (a content from 15% to 25% by weight of the culture). The best results were observed in the case of immobilization of bifidobacteria with 5% content of the "Toxin.NET" enterosorbent (enterosgel + inulin).

Dynamics of antimicrobial protein secretion in mouse milk

Abstract Breast milk is the preferred food for the newborns and considered as complete ‘edible immune system’. In addition, breast milk is a source of innate and adaptive proteins which not only protects the naïve infant gastrointestinal tract from enteropathogens but also aid in the appropriate initial colonization of gut microbiota. In this study, we analyzed antimicrobial immune proteins in the milk from C57BL/6 dams at several time points, and observed distinctive patterns in the immune protein levels throughout the lactation period. The presence of innate immune proteins serum amyloid A (SAA), CD14, and notably lipocalin-2 (Lcn2) were observed in high quantities with Lcn2 and SAA present at microgram levels suggesting a potential niche for these proteins during neonatal immune development. Moreover, low dose LPS administration to dams significantly increased some of these proteins in the milk. In addition, adaptive immune proteins immunoglobulins (Ig) A and G with IgG were present in milk at higher quantities compared to IgA at day 5 post-delivery. Interestingly, class-switching occurs by day 15 indicating a selective adaptive immune preference towards IgA, which could be due to gut colonization of newborns with more complex gut microbiota with aging and IgA being a major gut homeostatic factor. Additionally, milk from IgA-deficient dams allowed for robust proliferation of E. coli compared to wild-type milk further signifying the potential involvement of IgA during the early colonization of microbes in the neonatal gut. Collectively, our findings provide insight in the various immune proteins with antimicrobial activity may play a major role in the initial microbial colonization in the gut, which has long-lasting consequences on the host. Supported by NIH R01-CA219144, NCI Diversity Supplement (CA219144-05S1)

Acute Abdominal Distention in a Premature Low-birthweight Infant.

Acute Abdominal Distention in a Premature Low-birthweight Infant.

Digestion of Medium- and Long-Chain Triacylglycerol and sn-2 Palmitate in Infant Formula: A Study Based on Dynamic In Vitro Simulation of Infant Gastrointestinal Lipolysis.

In this study, lipolysis of triacylglycerols (TAGs) in infant formula (IF) composed of different oils and supplied with different structured TAGs, including medium- and long-chain triacylglycerol (MLCT) and sn-2 palmitate, was studied using a dynamic digestion model simulating the infant gastrointestinal tract. The molecular species of digestion products released during digestion, including diacylglycerols, monoacylglycerols (MAGs), and free fatty acids, as well as undigested TAGs, were identified and quantified using liquid chromatography-mass spectrometry. We observed clearly different lipolysis degrees (LDs), with diversity in digestion products of different IFs. IFs supplied with MLCT showed moderate medium-chain fatty acid release during gastric digestion and higher LD after intestinal digestion. The presence of sn-2 palmitate in IF was associated with higher content of MAG-16:0 in digestion products. The species and contents of digestion products in IF were highly influenced by structured TAGs.

Breast Milk: A Meal Worth Having.

A mother is gifted with breast milk, the natural source of nutrition for her infant. In addition to the wealth of macro and micro-nutrients, human milk also contains many microorganisms, few of which originate from the mother, while others are acquired from the mouth of the infant and the surroundings. Among these microbes, the most commonly residing bacteria are Staphylococci, Streptococci, Lactobacilli and Bifidobacteria. These microorganisms initiate and help the development of the milk microbiota as well as the microbiota of the gastrointestinal tract in infants, and contribute to developing immune regulatory factors such as cytokines, growth factors, lactoferrin among others. These factors play an important role in reducing the risk of developing chronic diseases like type 2 diabetes, asthma and others later in life. In this review, we will summarize the known benefits of breastfeeding and highlight the role of the breast milk microbiota and its cross-talk with the immune system in breastfed babies during the early years of life.

Pumping supplies alter the microbiome of pumped human milk: An in-home, randomized, crossover trial

The human milk microbiome may contribute to the benefits of breastfeeding by providing bacteria to the infant gastrointestinal tract. Many women pump their milk, but the effect of pumping on the milk microbiome is unknown. Our objective was to determine the effects of pumping supplies on the pumped human milk microbiome. This was an in-home, randomized, crossover trial of 2 collection methods. Women (n=52) pumped twice within 3.5h, once with their own breast pumps and milk collection supplies (OWN SUPP) and once with a hospital-grade pump and sterile collection supplies (STER SUPP). Pumping order was randomized. The milk microbiome was characterized by aerobic culturing and 16S ribosomal RNA gene sequencing. Milk collected with OWN SUPP yielded more total aerobic and gram-negative bacteria than milk collected with STER SUPP, reflecting a 6.6 (adjusted OR; 95% CI: 1.7, 25; P=0.006) higher odds of containing >104 total aerobic CFU/mL and 19 (adjusted OR; 95% CI: 4.1, 88; P<0.0001) higher odds of yielding culturable gram-negative bacteria. Milk collected with OWN SUPP yielded more Proteobacterias , including higher relative abundances of Acinetobacter and Stenotrophomonas, compared to milk collected with STER SUPP. Results were consistent across pumping-order groups. We demonstrated that pumping supplies altered the milk microbiome. On average, milk collected with OWN SUPP resulted in elevated levels of culturable total and gram-negative bacteria and proteobacterial DNA compared to milk collected with STER SUPP. More research is needed to assess implications for infant health.

Novel Nanoliposome Codelivered DHA and Anthocyanidin: Characterization, In Vitro Infant Digestibility, and Improved Cell Uptake.

There are still many challenges in understanding the absorption and transport mechanism of liposomes in the gastrointestinal tract of infants, especially for liposome-coentrapped two or more substances. In this study, novel docosahexaenoic acid (DHA)-anthocyanidin-codelivery liposomes (DA-LPs) were fabricated and characterized, and their digestive and absorptive behaviors were evaluated using the in vitro infant digestive method combined with the Caco-2 cell model. The liposomal bilayer structure remained intact with the particles aggregated in simulated infant gastric fluid, while their phospholipid membrane underwent enzymatic lipolysis under simulated intestinal conditions. Compared to single substance-loaded liposomes (DHA- or anthocyanidin-loaded liposomes), the digested DA-LPs showed better cell viability, higher cellular uptake and membrane fluidity, and lower reactive oxygen species (ROS). It can be concluded that DA-LPs are promising carriers for simultaneously transporting hydrophobic and hydrophilic molecules and may be beneficial for improving nutrient absorption and alleviating intestinal stress oxidation.

The value of laboratory parameters in predicting the progression of necrotising enterocolitis.

Necrotizing enterocolitis (NEC) is a devastating disorder of the preterm infant's gastrointestinal tract. The majority of infants presenting with NEC are successfully treated medically. Others progress to significant bowel necrosis complicated by bowel perforation. Early detection of those requiring surgical intervention is preferrable and associated with improved outcomes (1, 2).

In vitro dynamic digestion of model infant formulae containing lactoferrin and medium chain triacylglycerols

Four different model infant formulae were compared under simulated conditions of the infant gastrointestinal tract using an in vitro dynamic digestion protocol. These formulae were based on whey protein isolate, whey protein isolate + lactoferrin, long chain triacylglycerols or long + medium chain triacylglycerols. In each of the four cases, the influence of protein and lipid composition on their subsequent structural disintegration, proteolysis and lipolysis during digestion was investigated. Structural characterization of the four types of infant formulae was done before and during simulated digestion using confocal microscopy and laser light scattering methods. Proteolysis was followed using molecular weight distribution methodology, primary amine quantification, amino acid bioaccessibility and peptide analyses. Lipolysis was determined by gas chromatography. During gastric digestion, the structure of infant formulae based on lactoferrin was barely affected by the physicochemical conditions in the gastric chamber and all the protein fractions were found to be resistant to gastric proteolysis, except for α-lactalbumin. The degree of lipolysis within the gastric and intestinal phase was influenced by the lipid composition, noting that those formulae containing medium chain triacylglycerols exhibited a higher extent of lipolysis. These results are relevant for the development of formulae enriched with functional ingredients that may provide bioactive peptides and faster energy delivery to the newborn baby.

Maternal Diet and Infant Feeding Practices Are Associated with Variation in the Human Milk Microbiota at 3 Months Postpartum in a Cohort of Women with High Rates of Gestational Glucose Intolerance

Human milk contains a diverse community of bacteria believed to play a role in breast health and inoculation of the infant's gastrointestinal tract. The role of maternal nutrition and infant feeding practices on the human milk microbiota remains poorly understood. Our aim was to explore the associations between maternal diet (delivery to 3 mo postpartum), infant feeding practices, and the microbial composition and predicted function in milk from women with varied metabolic status. This was an exploratory analysis of a previously completed prospective cohort study of women with varying degrees of gestational glucose intolerance (NCT01405547). Milk samples (n=93 mothers) were collected at 3 mo postpartum. Maternal dietary information (validated food-frequency questionnaire) and infant feeding practices (human milk exclusivity, frequency of direct breastfeeding per day) were collected. V4-16S ribosomal RNA gene sequencing (Illumina MiSeq) was conducted to determine microbiota composition. Intake of polyunsaturated fat [β estimate (SE): 0.036 (0.018), P=0.047] and fiber from grains [0.027 (0.013), P=0.048] were positively associated with ɑ-diversity (Shannon index) of human milk. Overall microbial composition of human milk clustered based on human milk exclusivity (weighted UniFrac R2=0.034, P=0.015; Bray-Curtis R2=0.041, P=0.007), frequency of direct breastfeeding per day (Bray-Curtis R2=0.057, P=0.026), and maternal fiber intake from grains (Bray-Curtis R2=0.055, P=0.040). Total fiber, fiber from grains, dietary fat, and infant feeding practices were also associated with a number of differentially abundant taxa. The overall composition of predicted microbial functions was associated with total fiber consumption (Bray-Curtis R2=0.067, P=0.036) and human milk exclusivity (Bray-Curtis R2=0.041, P=0.013). Maternal consumption of fiber and fat, as well as mother's infant feeding practices, are important determinants of the human milk microbiota. Understanding whether these microbial changes impact an infant's overall health and development requires future study.

Effect of storage, temperature, and extraction kit on the phylogenetic composition detected in the human milk microbiota.

Human milk is considered the optimum feeding regime for newborns and is a source of bacteria for the developing infant gastrointestinal tract. However, as with all low biomass samples, standardization across variabilities such as sample collection, storage, and extraction methods is needed to eliminate discrepancies in microbial composition across studies. The aim of this study was to investigate how different storage methods, temperatures, preservatives, and extraction kits influence the human milk microbiome, compared to fresh samples. Breast milk samples were processed via six different methods: fresh (Method 1), frozen at −80°C (Method 2), treated with RNAlater and stored at 4°C or −80°C (Methods 3 and 4), and treated with Milk Preservation Solution at room temperature (Methods 5 and 6). Methods 1‐5 were extracted using PowerFoodTM Microbial DNA Isolation kit (Mobio), and Method 6 was extracted using Milk DNA Preservation and Isolation kit (Norgen BioTek). At genus level, the most abundant genera were shared across Methods 1‐5. Samples frozen at −80°C had fewest significant changes while samples treated and extracted using Milk Preservation and Isolation kit had the most significant changes when compared to fresh samples. Diversity analysis indicated that variation in microbiota composition was related to the method and extraction kit used. This study highlighted that, when extraction from fresh milk samples is not an option, freezing at −80°C is the next best option to preserve the integrity of the milk microbiome. Furthermore, our results demonstrate that choice of extraction kit had a profound impact on the microbiota populations detected in milk.

The Bifidogenic Effect Revisited-Ecology and Health Perspectives of Bifidobacterial Colonization in Early Life.

Extensive microbial colonization of the infant gastrointestinal tract starts after parturition. There are several parallel mechanisms by which early life microbiome acquisition may proceed, including early exposure to maternal vaginal and fecal microbiota, transmission of skin associated microbes, and ingestion of microorganisms present in breast milk. The crucial role of vertical transmission from the maternal microbial reservoir during vaginal delivery is supported by the shared microbial strains observed among mothers and their babies and the distinctly different gut microbiome composition of caesarean-section born infants. The healthy infant colon is often dominated by members of the keystone genus Bifidobacterium that have evolved complex genetic pathways to metabolize different glycans present in human milk. In exchange for these host-derived nutrients, bifidobacteria’s saccharolytic activity results in an anaerobic and acidic gut environment that is protective against enteropathogenic infection. Interference with early-life microbiota acquisition and development could result in adverse health outcomes. Compromised microbiota development, often characterized by decreased abundance of Bifidobacterium species has been reported in infants delivered prematurely, delivered by caesarean section, early life antibiotic exposure and in the case of early life allergies. Various microbiome modulation strategies such as probiotic, prebiotics, synbiotics and postbiotics have been developed that are able to generate a bifidogenic shift and help to restore the microbiota development. This review explores the evolutionary ecology of early-life type Bifidobacterium strains and their symbiotic relationship with humans and discusses examples of compromised microbiota development in which stimulating the abundance and activity of Bifidobacterium has demonstrated beneficial associations with health.

Effect of digestion on stability of palivizumab IgG1 in the infant gastrointestinal tract.

Potentially, orally administered antibodies specific to enteric pathogens could be administered to infants to prevent diarrheal infections, particularly in developing countries where diarrhea is a major problem. However, to prevent infection, such antibodies would need to resist degradation within the gastrointestinal tract. Palivizumab, a recombinant antibody specific to respiratory syncytial virus (RSV), was used in this study as a model for examining the digestion of neutralizing antibodies to enteric pathogens in infants. The survival of this recombinant IgG1 across digestion in 11 infants was assayed via an anti-idiotype ELISA and RSV F protein-specific ELISA. Concentrations were controlled for any dilution or concentration that occurred in the digestive system using mass spectrometry-based quantification of co-administered, orally supplemented, indigestible polyethylene glycol (PEG-28). Binding activity of Palivizumab IgG1 decreased (26-99%) across each phase of in vivo digestion as measured by both anti-idiotype and RSV F protein-specific ELISAs. Antibodies generated for passive protection of the infant gastrointestinal tract from pathogens will need to be more resistant to digestion than the model antibody fed to infants in this study, or provided in higher doses to be most effective. Binding activity of palivizumab IgG1 decreased (26-99%) across each phase of in vivo infant digestion as measured by both anti-idiotype and RSV F protein-specific ELISAs. Palivizumab was likely degraded by proteases and changes in pH introduced in the gut. Antibodies generated for passive protection of the infant gastrointestinal tract from pathogens will need to be more resistant to digestion than the model antibody fed to infants in this study, or provided in higher doses to be most effective. The monoclonal antibody IgG1 tested was not stable across the infant gastrointestinal tract. The observation of palivizumab reduction was unlikely due to dilution in the gastrointestinal tract. The results of this work hint that provision of antibody could be effective in preventing enteric pathogen infection in infants. Orally delivered recombinant antibodies will need to either be dosed at high levels to compensate for digestive losses or be engineered to better resist digestion. Provision of enteric pathogen-specific recombinant antibodies to at-risk infants could provide a new and previously unexplored pathway to reducing the infection in infants. The strategy of enteric recombinant antibodies deserves more investigation throughout medicine as a novel means for treatment of enteric disease targets.

Lactobacillus commensals autochthonous to human milk have the hallmarks of potent probiotics.

Maternal milk is an important source of essential nutrients for the optimal growth of infants. Breastfeeding provides a continuous supply of beneficial bacteria to colonize the infant gastrointestinal tract (GIT) and offers health benefits for disease prevention and immunity. The purpose of this study was to isolate novel probiotic strains from the breast milk of native Pakistani mothers and to evaluate their probiotic potential. We isolated 21 strains of bacteria from the colostrum and mature milk of 20 healthy mothers, who had vaginal deliveries and were not taking antibiotics. After phenotypic and genotypic characterization, these isolates were tested for survival in the GIT using in vitro acid and bile tests. Nine strains showing good acid tolerance were assessed for their growth rate, bile resistance and ability to hydrolyze bile salts. Out of the four Lactobacillus isolates adjudged to be most promising as probiotics, three were Lactobacillus fermentum strains and one was a strain of Lactobacillus oris. This study demonstrates that human milk is a viable source of commensal bacteria beneficial to both adults and babies.