Maternal breastfeeding is associated with offspring microbiome diversity; a secondary analysis of the MicrobeMom randomized control trial

Cara A Yelverton; Sarah Louise Killeen; Conor Feehily; Rebecca L Moore; Shauna L Callaghan; Aisling A Geraghty; David F Byrne; Calum J Walsh; Elaine M Lawton; Eileen F Murphy; Douwe Van Sinderen; Paul D Cotter; Fionnuala M McAuliffe

doi:10.3389/fmicb.2023.1154114

Maternal breastfeeding is associated with offspring microbiome diversity; a secondary analysis of the MicrobeMom randomized control trial

Front Microbiol. 2023 Aug 31:14:1154114. doi: 10.3389/fmicb.2023.1154114. eCollection 2023.

Authors

Cara A Yelverton¹, Sarah Louise Killeen¹, Conor Feehily^{2

3}, Rebecca L Moore¹, Shauna L Callaghan¹, Aisling A Geraghty^{1

4}, David F Byrne¹, Calum J Walsh^{2

3}, Elaine M Lawton^{2

3}, Eileen F Murphy⁵, Douwe Van Sinderen^{3

6}, Paul D Cotter^{2

3}, Fionnuala M McAuliffe¹

Affiliations

¹ UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.
² APC Microbiome Ireland, National University of Ireland, Cork, Ireland.
³ Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland.
⁴ UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Dublin, Ireland.
⁵ PrecisionBiotics Group Ltd., Cork, Ireland.
⁶ School of Microbiology, University College Cork, Cork, Ireland.

Abstract

Background: Microbial dysbiosis in infancy can influence long-term health outcomes such as childhood obesity. The aim of this study is to explore relationships among maternal well-being during pregnancy, breastfeeding, and the infant gut microbiome.

Methods: This is a secondary analysis of healthy pregnant women from the MicrobeMom study, a double-blind randomized control trial of maternal probiotic supplementation (Bifidobacterium breve 702258) versus placebo antenatally and up to 3 months postpartum. Maternal well-being was assessed using the WHO-5 well-being index at 16 weeks' and 34 weeks' gestation. Breastfeeding practices were recorded at discharge from hospital and at 1 month postpartum. Infant stool samples were obtained at 1 month of age. Next generation shotgun sequencing determined infant microbial diversity. Independent sample t-tests and Mann-Whitney U tests informed adjusted regression analysis, which was adjusted for delivery mode, antibiotics during delivery, maternal age and body mass index (BMI), and probiotic vs. control study group.

Results: Women (n = 118) with at least one measure of well-being were on average 33 years (SD 3.93) of age and 25.09 kg/m² (SD 3.28) BMI. Exclusive breastfeeding was initiated by 65% (n = 74). Any breastfeeding was continued by 69% (n = 81) after 1 month. In early and late pregnancy, 87% (n = 97/111) and 94% (n = 107/114) had high well-being scores. Well-being was not associated with infant microbial diversity at 1 month. In adjusted analysis, exclusive breastfeeding at discharge from hospital was associated with infant microbial beta diversity (PC2; 0.254, 95% CI 0.006, 0.038). At 1 month postpartum, any breastfeeding was associated with infant microbial alpha diversity (Shannon index; -0.241, 95% CI -0.498, -0.060) and observed species; (-0.325, 95% CI -0.307, -0.060), and infant microbial beta diversity (PC2; 0.319, 95% CI 0.013, 0.045). Exclusive breastfeeding at 1 month postpartum was associated with infant alpha diversity (Shannon index -0.364, 95% CI -0.573, -0.194; Simpson index 0.339, 95% CI 0.027, 0.091), and infant's number of observed microbial species (-0.271, 95% CI -0.172, -0.037).

Conclusion: Breastfeeding practices at 1 month postpartum were associated with lower microbial diversity and observed species in infants at 1 month postpartum, which is potentially beneficial to allow greater abundance of Bifidobacterium.

Clinical trial registration: ISRCTN53023014.

Keywords: breastfeeding; infant health; microbiome; pregnancy; well-being.