Ensuring the well-being of an infant as he or she grows into a child and eventually an adult is one of the greatest vocations. For centuries, postulates have been tested to determine the best regimens to keep this process as smooth and as healthy as possible. Many methods have come and gone, relegated as nothing more than fads or marketing ploys. But one has stood the test of time and continues to be promoted from the pediatrician all the way to the World Health Organization: breastfeeding.
Maternal milk is an evolutionary conserved trait amongst mammals, including humans, and is a vital part of offspring rearing. For over a century, breastfeeding has been seen as a requirement to avoid neonatal death. By the 1920s, the practice was considered a factor in public health. As a result, medical professionals began to promote this route of nutrition.
Though the assertions never felt they needed a mechanism -- to them, breast milk was best -- the actual reasons behind these benefits were lacking for over a half century. One of the first explanations came from a 1982 study in which breastfeeding developed a particular type of gut microflora that was distinctly different from those fed by other means. Although at the time there was no means to understand how the microbes in the gut controlled health, more recent evidence has shown the involvement of the microbiome in infant health. Moreover, breast milk offers these bacteria a chance to improve health in both the short and long term.
Based on a collection of studies performed over the last few years, the establishment of the gut microbiome during infancy is now known. While some microbes are transferred from the mother to the baby at birth -- establishing a pioneering microbiome -- the development process takes months. Depending on the factors surrounding the child, the bacterial composition may be balanced or skewed towards dysbiosis. The most important requirement for a healthy future appears to be breast milk.
While this information provided a basis for breastfeeding as a benefit in the short term, in regards to long term health, there were still few answers. Though researchers believed the establishment of a proper microbiome could maintain the health benefits during aging, there was little to prove this. In essence, the evidence stopped at the moment a baby transitioned from breast milk to solid food. The question no one could answer was whether the benefits also ceased?
Last week, an American team of researchers provided some help in understanding the effects of transition and how breast milk plays a major role. They performed a small but intriguing study on the microbiome of children during the first year of life. Their goal was to show how attendance at daycare can change the nature of the microbiome. What they found instead was a revelation into that transition every child goes through from milk to solid food.
The study was relatively simple. The researchers followed nine babies from infancy to up to 13 months of age. Each child's delivery method (vaginal or C-section) was known as was their main nutritional source be it breast milk, formula or a combination of both. In all cases, the change to solid food was monitored as was their participation in daycares. During that time, stool samples were collected and analyzed to identify the microbiome constituents.
When the results came back, the expected outcome of a greater diversity in older children attending daycare was seen. But there were a few surprises that went beyond the original goal of the study. First, the children with the highest diversity of microbes -- usually considered to be an asset for life -- came from those who were fed formula, not breast milk.
The biggest surprise came when the team looked at the metabolic markers of the bacterial species upon transition to solid food. There was little change in those children who were breastfed, meaning there were no significant changes in the way the bacteria acted and less chance of the body being harmed. In contrast, when those who were not breastfed made the transition, hundreds of new processes were stimulated, including those representing pathogens.
The data suggested the chances for dysbiosis and the overgrowth of pathogens were higher with those not fed breast milk. If this happened, then a child would not only encounter short term problems, such as infection and diarrhea, but longer term consequences including many chronic ailments.
Though the study was not large enough to make a conclusion on the long term benefit of breastfeeding, the authors suggested this route of analysis may provide the key to understanding why breast milk appears to be the perfect food for a healthy life. The study also offers an opportunity to develop breast-milk-like formulae for those who simply cannot breastfeed. In this way, regardless of nutritional source, babies can be given the best options for a healthy transition into childhood and adulthood.
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