June 21, 2016
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Antibiotics, C-section, formula feeding may disrupt microbiome development in infants

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Early life antibiotic exposure, delivery by cesarean section and formula feeding were associated with a disrupted development of the gut microbiome and reduced microbial diversity in infants, according to study results published in Science Translational Medicine.

“We found that the microbiota of infants assembles in a generally directional manner with waves of taxa succeeding the taxa that had been dominant earlier. However, we found evidence that [cesarean section] birth, formula feeding, and antibiotic exposures all disturb the normal maturation of the microbiota,” Martin J. Blaser, MD, from the departments of medicine and microbiology at New York University Langone Medical Center, told Healio Gastroenterology.

Martin J. Blaser

To model the development of the intestinal microbiota, and to determine the effects of birth mode, infant nutrition and antibiotic exposure, Blaser and colleagues obtained stool samples from 43 infants from birth to age 2 years and analyzed them using microbiome sequencing. They also collected vaginal, rectal and fecal specimens from the mothers before and after the child’s birth.

The researchers found that antibiotic exposure changed the trajectory of microbial diversity during the first months of life. Moreover, infants who were exposed to antibiotics showed delayed microbiota maturation, particularly between ages 6 months to 1 year, and also showed metagenomic differences.

Infants delivered by cesarean section had greater phylogenetic diversity, richness and evenness at baseline compared with those delivered vaginally, but this declined significantly in the first month of life and remained comparatively lower up to age 2 years.

“From [cesarean section], an abnormal microbial pattern is present past the first birthday, which is longer than we had anticipated,” Blaser said.

Finally, the researchers found that microbial diversity, composition and maturation were significantly reduced in children who were primarily formula-fed between ages 1 and 2 years.

“In this study, we did not examine health outcomes, so we have no data on whether these changes have consequence,” Blaser said. “However, the findings are consistent with epidemiologic studies indicating that these exposures are associated with increased risk of type 1 diabetes, celiac disease, allergies, and obesity.” – by Adam Leitenberger

Disclosures: Blaser reports he is a co-founder and equity holder in Commense Inc., and a consultant for Johnson & Johnson. Please see the full study for a list of all other researchers’ relevant financial disclosures.