Results of a double-blind, placebo-controlled, randomized trial indicated that probiotic supplementation for four weeks before and after birth may modulate levels of cytokines in the mammary gland as well as the synthesis of secretory IgA (sIgA –the first line of defense in protecting the mucous membranes) in the newborn gut.
The boost in sIgA levels may be linked to the temporal increase of transforming growth factor-beta1 (TGF-beta1) in the breast milk of supplemented mothers, said the researchers. “During early infancy, TGF-β1 probably has a crucial effect on the development of the immature gastrointestinal tract by influencing IgA production and oral tolerance induction,” wrote the researchers in Nutrients.
The study adds to an ever growing body of evidence supporting the potential long-term health benefits of a mother’s seeding her infant's microbiome. Previous studies have reported that administration of probiotics to pregnant mothers also has an effect on IgE levels in cord blood. The interaction between mother and child therefore even is more intimate than generally believed, and the new study helps elucidate potential mechanisms by which mother’s microbiome and mother’s breast milk influence development of the infant’s immune system and long-term health.
The new study, led by Maria Elisabetta Baldassarre from the Neonatology and Neonatal Intensive Care Unit at the University of Bari, also suggested that the probiotic supplementation could decrease incidence of infantile colic and regurgitation in infants, the researchers cautioned that it was too soon to recommend routine supplementation of high-dose probiotics during pregnancy and lactation.
From treatment to prevention
Commenting independently on the study’s findings, Dr Mary Ellen Sanders from consultancy Dairy & Food Culture Technologies, told us: “Well-controlled human studies with endpoints that really matter to people are important for the probiotic field. In this study, the tested probiotic showed reduced colic in breast-fed infants whose mothers took probiotics while pregnant and during lactation. Previous studies provided evidence that L. reuteri can treat colic and reduce crying time in infants. This new study suggests that this high-dose, multi-strain probiotic may prevent colic.”
Researchers from the Universities of Bari and Rome in Italy recruited 66 pregnant women and randomly assigned them to receive either the probiotic supplement of placebo from week 36 of gestation to four weeks after delivery. The probiotic was formulated with a total of 900 billion viable bacteria of Lactobacilli paracasei DSM 24733, L. plantarum DSM 24730, L. acidophilus DSM 24735, L. delbrueckii subsp. bulgaricus DSM 24734, Bifidobacterium longum DSM 24736, B. breve DSM 24732, B. infantis DSM 24737, and Streptococcus thermophilus DSM 24731. The product is sold in Europe as Vivomixx and in the US as Visbiome.
Results showed that the probiotic supplements had a significant impact on IL6 levels in colostrum and on IL10 and TGF-beta1 mean values in mature breast milk. In addition, sIgA levels in newborn feces were higher if the mothers took probiotics, compared to placebo.
“Our results […] indicate that oral probiotics supplementation to mothers in the perinatal period may also have consequences on inconsolable crying and regurgitation in the first month of life, however this data cannot be considered conclusive because the sample size calculation power was not adequate to evaluate differences between groups,” wrote the researchers.
“[W]e did not observe any significant differences in newborn gut microbiota composition between the placebo and the control groups, suggesting that maternal probiotic supplementation does not modify the amount of intestinal beneficial bacteria in the newborn. This also supports the hypothesis that colonization of the gut may not be essential for probiotic biological effects.”
Larger studies are warranted
The Scientific Advisory Board for the International Probiotics Association told NutraIngredients-USA: “The study by Baldassarre and co-workers made the interesting observation that prenatal maternal probiotic consumption influences the immune markers mothers milk; unfortunately, the variation between the subjects is not indicated. A few other studies have made similar observations.
“As the Baldassarre study and other studies are of limited size but the finding may provide a mechanistic understanding on how certain probiotics may influence atopic dermatitis risk, larger studies are warranted.”
2016, 8(11), 677; doi:10.3390/nu8110677
“Administration of a Multi-Strain Probiotic Product to Women in the Perinatal Period Differentially Affects the Breast Milk Cytokine Profile and May Have Beneficial Effects on Neonatal Gastrointestinal Functional Symptoms. A Randomized Clinical Trial”
Authors: M.E. Baldassarre