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Maternal breastmilk, infant gut microbiome and the impact on preterm infant health

Lookup NU author(s): Dr Claire Granger, Professor Nicholas EmbletonORCiD, Dr Jeremy Palmer, Dr Chris LambORCiD, Dr Janet Berrington, Dr Christopher StewartORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


© 2020 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica. Aim: This narrative review summarises the benefits of maternal breastmilk to both the infant and the mother, specifically the benefits that relate to modification of the infant microbiome, and how this might vary in the preterm infant. Methods: We used PubMed to primarily identify papers, reviews, case series and editorials published in English until May 2020. Based on this, we report on the components of breastmilk, their associated hypothesised benefits and the implications for clinical practice. Results: Breastmilk is recommended as the exclusive diet for newborn infants because it has numerous nutritional and immunological benefits. Additionally, exposure to the maternal breastmilk microbiome may confer a lasting effect on gut health. In the preterm infant, breastmilk is associated with a significant reduction in necrotising enterocolitis, an inflammatory gastrointestinal disease and reduction in other key morbidities, together with improved neurodevelopmental outcomes. Conclusion: These impacts have long-term benefits for the child (and the mother) even after weaning. This benefit is likely due, in part, to modification of the infant gut microbiome by breastmilk microbes and bioactive components, and provide potential areas for research and novel therapies in preterm and other high-risk infants.

Publication metadata

Author(s): Granger CL, Embleton ND, Palmer JM, Lamb CA, Berrington JE, Stewart CJ

Publication type: Review

Publication status: Published

Journal: Acta Paediatrica

Year: 2021

Volume: 110

Issue: 2

Pages: 450-457

Print publication date: 01/02/2021

Online publication date: 15/08/2020

Acceptance date: 12/08/2020

ISSN (print): 0803-5253

ISSN (electronic): 1651-2227

Publisher: Blackwell Publishing Ltd


DOI: 10.1111/apa.15534