Association of gut microbiota and type of feeding: Molecular analysis of a cohort of preterm moroccan newborns

Abstract

BACKGROUND: We assessed the newborns' intestinal microbiota during the first three weeks of life using molecular biology techniques to understand colonization patterns according to feeding type. METHODS: We conducted a prospective, observational descriptive study at the National Reference Centre for Neonatology and Nutrition, in collaboration with the research laboratory of the Children's Hospital at the University Hospital Centre Ibn Sina in Rabat. Stool samples were collected from 29 preterm newborns upon admission to the neonatal unit and subsequently twice weekly over a three-week period. Microbial composition was analyzed using real-time polymerase chain reaction (RT-qPCR), targeting four phyla: Firmicutes, Bacteroidetes, Actinobacteria, and Proteobacteria. RESULTS: The gestational age of the included preterm infants ranged from 28 to 36 weeks of amenorrhea. Enteral nutrition was initiated between the second and sixth days after birth. None of the infants was nursed immediately after birth or during their hospitalization. However, in 79 % of cases, breast milk was collected at home for later use in feeding the newborns, and among these, 21 % received more than 50 % of the collected breast milk. Over the first two weeks of life, Lactobacillus spp. was only detected in infants nursed by both breast milk and formula milk. Enterococcus spp. was present in all breastfed infants. Clostridium difficile and Clostridium perfringens were found in 83 % of formula-fed newborns in the second week of life and in all newborns by the end of the third week. CONCLUSION: Promoting breastfeeding whenever possible is crucial for fostering a healthy gut microbiota. When breastfeeding is not feasible, incorporating infant formulas supplemented with probiotics and/or prebiotics can help establish a microbiota similar to that of breastfed infants. Additional preventive strategies, such as vaginal or fecal microbiota transplantation, may be considered, particularly for infants born via caesarean section.