Translating neonatal microbiome science into commercial innovation: metabolism of human milk oligosaccharides as a basis for probiotic efficacy in breast-fed infants

ABSTRACT

For over a century, physicians have witnessed a common enrichment of bifidobacteria in the feces of breast-fed infants that was readily associated with infant health status. Recent advances in bacterial genomics, metagenomics, and glycomics have helped explain the nature of this unique enrichment and enabled the tailored use of probiotic supplementation to restore missing bifidobacterial functions in at-risk infants. This review documents a 20-year span of discoveries that set the stage for the current use of human milk oligosaccharide-consuming bifidobacteria to beneficially colonize, modulate, and protect the intestines of at-risk, human milk-fed, neonates. This review also presents a model for probiotic applications wherein bifidobacterial functions, in the form of colonization and HMO-related catabolic activity in situ, represent measurable metabolic outcomes by which probiotic efficacy can be scored toward improving infant health.

KEYWORDS:

• Gut microbiota
• human milk oligosaccharides
• Bifidobacterium
• probiotics
• premature infants
• neonatal intensive care unit

Acknowledgments

The authors acknowledge the tremendous contributions from the many students, postdoctoral researchers, research staff, and faculty who have participated in the UC Davis Milk Bioactives Group, past and present. DAM thanks Dr. You-Tae Kim for help with Figure 2.

Author contributions

The authors jointly wrote and edited the manuscript. All authors contributed to the article and approved the submitted version.

Disclosure statement

DAM, JBG, and CBL are co-founders of Infinant Health, a company focused on probiotic-based manipulation of the infant gut microbiota; BCD Biosciences, a company advancing novel bioactive glycans; and Matrubials Inc., a company advancing milk-based antimicrobial peptides. None of these companies had any role in the conceptualization, design, analysis, or preparation of this manuscript.

Additional information

Funding

Research performed by the UC Davis Milk Bioactives group has been supported by Peter J Shields Endowed Chair in Dairy Food Science (DAM), the UC Davis RISE Program, the California Dairy Research Foundation, USDA grant 2008-35200-18776 and NIH grants HD059127, R21AT006180, R01AT007079, R01AT008759, R01HD061923, R01HD065122, and U01CA179582 and NIH Training grants F32HD093185, F32AT006642, and F32AT008533.