The gut microbiome of extremely preterm infants randomized to the early progression of enteral feeding

Ariel A Salas; Kent A Willis; Waldemar A Carlo; Nengjun Yi; Li Zhang; William J Van Der Pol; Noelle E Younge; Elliot J Lefkowitz; Charitharth V Lal

The gut microbiome of extremely preterm infants randomized to the early progression of enteral feeding

Ariel A Salas, Kent A Willis, Waldemar A Carlo, Nengjun Yi, Li Zhang, William J Van Der Pol, Noelle E Younge, Elliot J Lefkowitz, Charitharth V Lal

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

BACKGROUND: Early progression of feeding could influence the development of the gut microbiome.

METHODS: We collected fecal samples from extremely preterm infants randomized to receive either early (feeding day 2) or delayed (feeding day 5) feeding progression. After study completion, we compared samples obtained at three different time points (week 1, week 2, and week 3) to determine longitudinal differences in specific taxa between the study groups using unadjusted and adjusted negative binomial and zero-inflated mixed models. Analyses were adjusted for a mode of delivery, breastmilk intake, and exposure to antibiotics.

RESULTS: We analyzed 137 fecal samples from 51 infants. In unadjusted and adjusted analyses, we did not observe an early transition to higher microbial diversity within samples (i.e., alpha diversity) or significant differences in microbial diversity between samples (i.e., beta diversity) in the early feeding group. Our longitudinal, single-taxon analysis found consistent differences in the genera Lactococcus, Veillonella, and Bilophila between groups.

CONCLUSIONS: Differences in single-taxon analyses independent of the mode of delivery, exposure to antibiotics, and breastmilk feeding suggest potential benefits of early progression of enteral feeding volumes. However, this dietary intervention does not appear to increase the diversity of the gut microbiome in the first 28 days after birth.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02915549.

IMPACT: Early progression of enteral feeding volumes with human milk reduces the duration of parenteral nutrition and the need for central venous access among extremely preterm infants. Early progression of enteral feeding leads to single-taxon differences in longitudinal analyses of the gut microbiome, but it does not appear to increase the diversity of the gut microbiome in the first 28 days after birth. Randomization in enteral feeding trials creates appealing opportunities to evaluate the effects of human milk diets on the gut microbiome.

Original language	English
Pages (from-to)	799-804
Number of pages	6
Journal	Pediatric Research
Volume	92
Issue number	3
State	Published - Sep 2022
Externally published	Yes

Keywords

Anti-Bacterial Agents
Enteral Nutrition
Gastrointestinal Microbiome
Humans
Infant
Infant, Extremely Premature
Infant, Newborn
Milk, Human

Cite this

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title = "The gut microbiome of extremely preterm infants randomized to the early progression of enteral feeding",

abstract = "BACKGROUND: Early progression of feeding could influence the development of the gut microbiome.METHODS: We collected fecal samples from extremely preterm infants randomized to receive either early (feeding day 2) or delayed (feeding day 5) feeding progression. After study completion, we compared samples obtained at three different time points (week 1, week 2, and week 3) to determine longitudinal differences in specific taxa between the study groups using unadjusted and adjusted negative binomial and zero-inflated mixed models. Analyses were adjusted for a mode of delivery, breastmilk intake, and exposure to antibiotics.RESULTS: We analyzed 137 fecal samples from 51 infants. In unadjusted and adjusted analyses, we did not observe an early transition to higher microbial diversity within samples (i.e., alpha diversity) or significant differences in microbial diversity between samples (i.e., beta diversity) in the early feeding group. Our longitudinal, single-taxon analysis found consistent differences in the genera Lactococcus, Veillonella, and Bilophila between groups.CONCLUSIONS: Differences in single-taxon analyses independent of the mode of delivery, exposure to antibiotics, and breastmilk feeding suggest potential benefits of early progression of enteral feeding volumes. However, this dietary intervention does not appear to increase the diversity of the gut microbiome in the first 28 days after birth.TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02915549.IMPACT: Early progression of enteral feeding volumes with human milk reduces the duration of parenteral nutrition and the need for central venous access among extremely preterm infants. Early progression of enteral feeding leads to single-taxon differences in longitudinal analyses of the gut microbiome, but it does not appear to increase the diversity of the gut microbiome in the first 28 days after birth. Randomization in enteral feeding trials creates appealing opportunities to evaluate the effects of human milk diets on the gut microbiome.",

keywords = "Anti-Bacterial Agents, Enteral Nutrition, Gastrointestinal Microbiome, Humans, Infant, Infant, Extremely Premature, Infant, Newborn, Milk, Human",

author = "Salas, {Ariel A} and Willis, {Kent A} and Carlo, {Waldemar A} and Nengjun Yi and Li Zhang and {Van Der Pol}, {William J} and Younge, {Noelle E} and Lefkowitz, {Elliot J} and Lal, {Charitharth V}",

note = "Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2022",

month = sep,

language = "English",

volume = "92",

pages = "799--804",

journal = "Pediatric Research",

issn = "0031-3998",

publisher = "Springer Nature",

number = "3",

}

TY - JOUR

T1 - The gut microbiome of extremely preterm infants randomized to the early progression of enteral feeding

AU - Salas, Ariel A

AU - Willis, Kent A

AU - Carlo, Waldemar A

AU - Yi, Nengjun

AU - Zhang, Li

AU - Van Der Pol, William J

AU - Younge, Noelle E

AU - Lefkowitz, Elliot J

AU - Lal, Charitharth V

PY - 2022/9

Y1 - 2022/9

N2 - BACKGROUND: Early progression of feeding could influence the development of the gut microbiome.METHODS: We collected fecal samples from extremely preterm infants randomized to receive either early (feeding day 2) or delayed (feeding day 5) feeding progression. After study completion, we compared samples obtained at three different time points (week 1, week 2, and week 3) to determine longitudinal differences in specific taxa between the study groups using unadjusted and adjusted negative binomial and zero-inflated mixed models. Analyses were adjusted for a mode of delivery, breastmilk intake, and exposure to antibiotics.RESULTS: We analyzed 137 fecal samples from 51 infants. In unadjusted and adjusted analyses, we did not observe an early transition to higher microbial diversity within samples (i.e., alpha diversity) or significant differences in microbial diversity between samples (i.e., beta diversity) in the early feeding group. Our longitudinal, single-taxon analysis found consistent differences in the genera Lactococcus, Veillonella, and Bilophila between groups.CONCLUSIONS: Differences in single-taxon analyses independent of the mode of delivery, exposure to antibiotics, and breastmilk feeding suggest potential benefits of early progression of enteral feeding volumes. However, this dietary intervention does not appear to increase the diversity of the gut microbiome in the first 28 days after birth.TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02915549.IMPACT: Early progression of enteral feeding volumes with human milk reduces the duration of parenteral nutrition and the need for central venous access among extremely preterm infants. Early progression of enteral feeding leads to single-taxon differences in longitudinal analyses of the gut microbiome, but it does not appear to increase the diversity of the gut microbiome in the first 28 days after birth. Randomization in enteral feeding trials creates appealing opportunities to evaluate the effects of human milk diets on the gut microbiome.

AB - BACKGROUND: Early progression of feeding could influence the development of the gut microbiome.METHODS: We collected fecal samples from extremely preterm infants randomized to receive either early (feeding day 2) or delayed (feeding day 5) feeding progression. After study completion, we compared samples obtained at three different time points (week 1, week 2, and week 3) to determine longitudinal differences in specific taxa between the study groups using unadjusted and adjusted negative binomial and zero-inflated mixed models. Analyses were adjusted for a mode of delivery, breastmilk intake, and exposure to antibiotics.RESULTS: We analyzed 137 fecal samples from 51 infants. In unadjusted and adjusted analyses, we did not observe an early transition to higher microbial diversity within samples (i.e., alpha diversity) or significant differences in microbial diversity between samples (i.e., beta diversity) in the early feeding group. Our longitudinal, single-taxon analysis found consistent differences in the genera Lactococcus, Veillonella, and Bilophila between groups.CONCLUSIONS: Differences in single-taxon analyses independent of the mode of delivery, exposure to antibiotics, and breastmilk feeding suggest potential benefits of early progression of enteral feeding volumes. However, this dietary intervention does not appear to increase the diversity of the gut microbiome in the first 28 days after birth.TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02915549.IMPACT: Early progression of enteral feeding volumes with human milk reduces the duration of parenteral nutrition and the need for central venous access among extremely preterm infants. Early progression of enteral feeding leads to single-taxon differences in longitudinal analyses of the gut microbiome, but it does not appear to increase the diversity of the gut microbiome in the first 28 days after birth. Randomization in enteral feeding trials creates appealing opportunities to evaluate the effects of human milk diets on the gut microbiome.

KW - Anti-Bacterial Agents

KW - Enteral Nutrition

KW - Gastrointestinal Microbiome

KW - Humans

KW - Infant

KW - Infant, Extremely Premature

KW - Infant, Newborn

KW - Milk, Human

UR - http://www.scopus.com/inward/record.url?scp=85119347487&partnerID=8YFLogxK

M3 - Article

C2 - 34775476

SN - 0031-3998

VL - 92

SP - 799

EP - 804

JO - Pediatric Research

JF - Pediatric Research

IS - 3

ER -

The gut microbiome of extremely preterm infants randomized to the early progression of enteral feeding

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