Prebiotic intake during pregnancy and breastfeeding benefits infant health – latest study

04-Jul-2024 - Last updated on 04-Jul-2024 at 02:06 GMT

A study found that prebiotics intake during pregnancy and breastfeeding benefits infant health. © Getty Images

Prebiotic supplementation during pregnancy and lactation has positive effects on the gut microbiome of mothers and their offspring, indicating that it is possible to intervene and modify the development of an infant’s health by regulating the gut microbiome of the mother, according to a new RCT.

Researchers in Australia conducted a randomised, placebo-controlled trial to investigate the effects of prebiotics on gut health in mothers and their offspring. They found that over the trial intervention period, which involved both antenatal and postnatal periods, maternal prebiotics had a significant impact on both the gut microbiome composition and short-chain fatty acids (SCFA) concentrations in mothers and their offspring.

“The abundance of Bifidobacterium, and the concentration of acetate significantly increased in the prebiotic group during pregnancy,” wrote the researchers in Clinical Nutrition.

Bifidobacterium aids digestion, inhibits the growth of harmful bacteria, supports the immune system, and contributes to overall gut health; and acetate is a type of SCFA produced by gut bacteria, it maintains gut health and has anti-inflammatory properties.

“For the first time in humans, this study also showed that maternal prebiotic supplementation impacts the composition of the infant microbiome, including a significant reduction in the abundance of Negativicutes, compared to the abundance in the placebo group. These results enhance our understanding of the impact of maternal diet on infant gut health, indicating that it is possible to intervene and modify the development of the infant microbiome in utero and during breastfeeding by dietary modulation of the maternal gut microbiome,” said the researchers.

Improving immune health in offspring

Improving maternal gut health in pregnancy and lactation is a potential strategy to improve immune and metabolic health in offspring and curtail the rising rates of inflammatory diseases linked to alterations in gut microbiota.

One of the most well known methods for positively modulating the microbiome is with prebiotic fibre supplements. Prebiotic fibre-based dietary supplements, in particular, fructo-oligosaccharide (FOS) and galacto-oligosaccharide (GOS), are commonly used.

FOS and GOS have also demonstrated beneficial effects when added to prebiotic infant formula. Each of these soluble fibres are well known for the ability to maintain a healthy gut ecosystem by favouring the growth of commensal bacteria, most notably Bifidobacterium spp, regulating levels of SCFA and reducing gut pH.

SCFA are involved in several important functions in the gut, which include reducing inflammation. The quantify and production of SCFA in the gut is almost exclusively determined by the resident gut microbiota, which is the major reason why prebiotic fibres can improve gut health.

Maternal microbiome also affects multiple aspects of foetal growth, including the development of the infant gut microbiome that may influence the child’s health in future. Microbial products, including genetic material and metabolites absorbed into the maternal blood, have the potential to cross the placental barrier and act as important external exposures that modulate foetal immune programming.

After birth, the establishment of the infant gut microbiome is further influenced by factors including breast milk composition, solid food diet, environmental exposures and antibiotic administration. Breastmilk also acts as both a pre- and pro-biotic, containing both human milk oligosaccharides (HMOs) and microbes that support the growth of mutualistic microorganisms in the infant gut. As the composition of breastmilk changes over time, and with maternal dietary habits, prebiotic fibre supplementation during lactation may also have the potential to influence infant gut health through this additional pathway.

Prior to this trial, there was no research investigating the effectiveness of maternal prebiotic supplementation in the development of the infant gut microbiome. The researchers therefore set up a double-blinded, randomised, placebo-controlled trial to investigate the effects of prebiotic supplement maternal prebiotic supplement on mothers and their offspring.

The study

The participants ingested supplements or placebos daily from less than 21 weeks gestation to six months post-partum. They were randomised to one of two groups; with one group receiving 14.2 g per day of prebiotic powder (GOS and FOS on a nine to one ratio), and the other receiving a placebo powder consisting of 8.7 g per day of maltodextrin.

Stool samples were collected at multiple timepoints from 74 mother–infant pairs as part of a larger, double-blinded, randomised controlled allergy intervention trial. The bacterial communities in the stool of both mothers and infants were analysed by examining a specific segment of bacterial DNA – the 16S rRNA gene (V4 region) sequences – and SCFA concentrations in the stool.

The results showed that there were significant differences in the maternal microbiota profiles among those who took probiotics.

“Significant differences in the maternal microbiota profiles between baseline (starting point) and either 28-weeks’ or 36-weeks’ gestation were found in the prebiotic supplemented women. Infant microbial beta-diversity also significantly differed between prebiotic and placebo groups at 12-months of age.

“Supplementation was associated with increased abundance of commensal Bifidobacteria in the maternal microbiota, and a reduction in the abundance of Negativicutes in both maternal and infant microbiota. There were also changes in SCFA concentrations with maternal prebiotics supplementation, including significant differences in acetic acid concentration between intervention and control groups from 20 to 28-weeks’ gestation,” said the researchers.

Bifidobacteria were significantly more abundant in the prebiotic group, both during and after pregnancy, demonstrating the ability of the prebiotic supplementation to elevate the abundance of this important genus in both the antenatal and post-natal periods.

“B. infantis, along with Streptococcus and Staphylococcus, were identified as core members of the infant gut microbiota (with >60% prevalence in infants), with no difference in abundance according to the randomised groups,” said the researchers.

Implications and further research

Maternal prebiotic supplementation of 14.2 g per day GOS/FOS was found to favourably modify both the maternal and the developing infant gut microbiome.

Therefore, modulation of maternal diet to promote a favourable community of maternal gut microbiota for early-life infant exposure is a good strategy for promoting development of a beneficial early-life gut microbiome, which can lead to long-term benefits.

“These results enhance our understanding of the impact of maternal diet on infant gut health, indicating that it is possible to intervene and modify the development of the infant microbiome in utero and during breastfeeding by dietary modulation of the maternal gut microbiome. The long-term follow-up of these infants will elucidate the impact of this intervention on the prevalence of childhood allergic diseases, and help clarify how early-life microbiome structure and function may influence childhood disease development,” concluded the researchers.

Source: Clinical Nutrition

DOI: https://doi.org/10.1016/j.clnu.2024.02.030

“Maternal prebiotic supplementation during pregnancy and lactation modifies the microbiome and short chain fatty acid profile of both mother and infant”

Authors: Jacqueline M. Jones, Stacey N. Reinke et al.

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