Department of Paediatrics, Fribourg Hospital HFR and Faculty of Science and Medicine, University of Fribourg, Switzerland; Department of Paediatrics, The University of Melbourne, Parkville, Australia; Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Australia; Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia.
Department of Paediatrics, The University of Melbourne, Parkville, Australia; Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Australia; Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia.
J Infect. 2020 Jul;81(1):17-47. doi: 10.1016/j.jinf.2020.01.023. Epub 2020 Feb 6.
Breastfeeding is associated with considerable health benefits for infants. Aside from essential nutrients, immune cells and bioactive components, breast milk also contains a diverse range of microbes, which are important for maintaining mammary and infant health. In this review, we summarise studies that have investigated the composition of the breast milk microbiota and factors that might influence it. We identified 44 studies investigating 3105 breast milk samples from 2655 women. Several studies reported that the bacterial diversity is higher in breast milk than infant or maternal faeces. The maximum number of each bacterial taxonomic level detected per study was 58 phyla, 133 classes, 263 orders, 596 families, 590 genera, 1300 species and 3563 operational taxonomic units. Furthermore, fungal, archaeal, eukaryotic and viral DNA was also detected. The most frequently found genera were Staphylococcus, Streptococcus Lactobacillus, Pseudomonas, Bifidobacterium, Corynebacterium, Enterococcus, Acinetobacter, Rothia, Cutibacterium, Veillonella and Bacteroides. There was some evidence that gestational age, delivery mode, biological sex, parity, intrapartum antibiotics, lactation stage, diet, BMI, composition of breast milk, HIV infection, geographic location and collection/feeding method influence the composition of the breast milk microbiota. However, many studies were small and findings sometimes contradictory. Manipulating the microbiota by adding probiotics to breast milk or artificial milk offers an exciting avenue for future interventions to improve infant health.
母乳喂养对婴儿的健康有很大的好处。除了必需的营养物质、免疫细胞和生物活性成分外，母乳还含有多种微生物，这些微生物对维持乳腺和婴儿的健康非常重要。在这篇综述中，我们总结了研究母乳微生物群组成及其影响因素的研究。我们共确定了 44 项研究，涉及 2655 名女性的 3105 份母乳样本。有几项研究报告称，母乳中的细菌多样性高于婴儿或母体粪便。每一项研究检测到的细菌分类群的最大数量为 58 门、133 纲、263 目、596 科、590 属、1300 种和 3563 个操作分类单位。此外，还检测到真菌、古菌、真核生物和病毒 DNA。最常发现的属是葡萄球菌属、链球菌属、乳杆菌属、假单胞菌属、双歧杆菌属、棒状杆菌属、肠球菌属、不动杆菌属、罗特氏菌属、表皮葡萄球菌属、韦荣球菌属和拟杆菌属。有证据表明，胎龄、分娩方式、生物性别、产次、产时抗生素、哺乳阶段、饮食、BMI、母乳成分、HIV 感染、地理位置以及采集/喂养方式会影响母乳微生物群的组成。然而，许多研究规模较小，结果有时相互矛盾。通过向母乳或人工奶中添加益生菌来操纵微生物群，为未来改善婴儿健康的干预措施提供了一个令人兴奋的途径。
