Dr. Gabby Tender, PhD, associate officer, microbiome products at the Gates Foundation, spoke at Probiota Americas last week about how modulating maternal and infant microbiomes represents a promising strategy to reduce maternal, infant and neonatal mortality and morbidity. Dr. Tender works with the foundation’s Maternal Newborn Child Nutrition Health Team.
“Undernutrition, chronic infection and gut microbiome dysbiosis lead to an inflamed gut state,” she said. “You get small intestinal damage, you get chronic inflammation, and data are demonstrating that this leads to disruption and important destructive signals during pregnancy, which are associated with vulnerable pregnancy and infant trajectories.”
The Gates Foundation hypothesizes that if it can tackle a handful of key mechanisms of action, it can target adverse outcomes such as preterm birth, stillbirth, fetal growth restriction and preeclampsia.
An international dilemma
Dr. Tender noted that the microbiome matters when addressing childhood malnutrition—which affects approximately 42 million babies in South Asia and sub-Saharan Africa each year.
“If you can feed the microbes, the child would potentially do better,” she said. “At the same time, data were demonstrating that this malnutrition, and in this case stunting, actually occurred much earlier on in the life course than the previous review[...], and if there’s an intervention that could help within the first three months of life, potentially fewer children would have to be treated later. So, we started thinking a lot about infant probiotics.”
The Gates Foundation that administering probiotics to a high-risk infant may help displace potential pathogens in their bodies.
The science
In Western societies, health, including that of mothers and infants, is influenced by diet, processed food, antibiotics, sedentary lifestyles, the environment, pollutants and sterile and semi-sterile environments.
There is also the concern that 1 in 5 infants are born by C-section and that only 48% of infants globally consume human milk exclusively in the first six months of life.
“We also know that a healthy microbiome is critical for the establishment of the long-term health of an infant and that the predominant organism in a healthy microbiome is their bifidobacteria,” said Dr. Martin Kullen, PhD, vice president, human health science and innovation at Novonesis, during his presentation.
He discussed new synbiotic combinations of probiotics and prebiotics and how they offer possibilities for infant health and beyond. Dr. Kullen outlined research showing how Novonesis’ BB12, a well-known probiotic strain, and ISTILOS B. infantis, which may support gut barrier function and the development of the immune system in infants, can benefit Bifidobacteria growth. These products benefit gut health, immunity and infant comfort, he said.
“We’re seeing a decline in the prevalence of Bifidobacteria in humans today,” Dr. Kullen said. “We see this shift in a microbial population that’s associated with dysbiosis, decreased abundance of Bifidobacteria, increased abundance of undesirable bacteria. We also see as a consequence of this altered metabolic activity a reduction in short chain fatty acids and dysfunction in gut barrier integrity and immune dysregulation.”
Consequently, there is an increased risk of infection and an increased risk of inflammation, which can lead to gut-related discomforts. This includes symptoms such as crying and fussiness associated with colic, as well as irregular bowel movements for infants.
Probiota Americas also featured a talk by Dr. Lars Bode, PhD, professor and director at the Human Milk Institute.
He explained how infant milk formula is still based on bovine milk and there are hardly any glycans—simple sugars or complex carbohydrates—currently in infant formula. Glycans are essential for several biological processes, from cellular communication and immune responses to protein folding and tissue structure.
During the first few months of life, availability of exogenous or dietary glycans and endogenous (host cell) glycans is largely influenced by maternal and infant genetics.
Dr. Bode discussed how different permutations of maternal/infant secretor status—one of the strongest genetic determinants of exogenous and endogenous glycan composition—will enable the design of smart, targeted and personalized probiotics and synbiotics to improve maternal-infant health.
“It matters where you feed your probiotic, it matters to which infant you feed it to because some infants simply don’t have those structures in the intestine, the probiotic strain won’t have a chance to nibble on it,” he added.
