Project description:BACKGROUND:The infant skin microbiota may serve as a reservoir of bacteria that contribute to neonatal infections and stimulate local and systemic immune development. The objectives of our study were to characterize the skin microbiota of preterm and full-term infants during their birth hospitalization and describe its relationship to the microbiota of other body sites and the hospital environment. RESULTS:We conducted a cross-sectional study of 129 infants, including 40 preterm and 89 full-term infants. Samples were collected from five sites: the forehead and posterior auricular scalp (skin upper body); the periumbilical region, inguinal folds, and upper thighs (skin lower body); the oral cavity; the infant's immediate environment; and stool. Staphylococcus, Streptococcus, Enterococcus, and enteric Gram-negative bacteria including Escherichia and Enterobacter dominated the skin microbiota. The preterm infant microbiota at multiple sites had lower alpha diversity and greater enrichment with Staphylococcus and Escherichia than the microbiota of comparable sites in full-term infants. The community structure was highly variable among individuals but differed significantly by body site, postnatal age, and gestational age. Source tracking indicated that each body site both contributed to and received microbiota from other body sites and the hospital environment. CONCLUSION:The skin microbiota of preterm and full-term infants varied across individuals, by body site, and by the infant's developmental stage. The skin harbored many organisms that are common pathogens in hospitalized infants. Bacterial source tracking suggests that microbiota are commonly exchanged across body sites and the hospital environment as microbial communities mature in infancy.
Project description:BackgroundAs compared to full-term infants (39-41 weeks of gestation), early-term infants (37-38 wk) are at increased risk of adverse outcomes, including shorter exclusive breastfeeding (EB) duration and continued breastfeeding.ObjectivesTo compare early-term with full- and late-term infants regarding the prevalence of EB at 3 mo and any breastfeeding at 12 mo.MethodsData sets from two population-based birth cohorts conducted in the city of Pelotas, Brazil, were combined. Only term infants (37 0/7 through 41 6/7 weeks of gestation) were included in the analyses. Early-term infants (37 0/7 through 38 6/7 wk) were compared to the remaining term infants (39 0/7 through 41 6/7 wk). Information on breastfeeding was gathered through maternal interviews at the 3-mo and 12-mo follow-ups. The prevalence of EB at 3 mo and any breastfeeding at 12 mo with 95% CIs were calculated. Crude and adjusted prevalence ratios (PRs) were obtained through Poisson regression.ResultsA total of 6395 infants with information on gestational age and EB at 3 mo and 6401 infants with information on gestational age and any breastfeeding at 12 mo were analyzed. There was no difference between early-term infants and the remaining term infants regarding the prevalence of EB at 3 mo (29.2% and 27.9%, respectively) (P = 0.248). Prevalence of any breastfeeding at 12 mo was lower in early-term infants than among those born between 39 0/7 and 41 6/7 weeks of gestation (38.2% compared with 42.4%) (P = 0.001). In the adjusted analysis, the PR for any breastfeeding at 12 mo was 15% lower in the early-term group than in the remaining term infants (PR = 0.85; 95% CI: 0.76-0.95) (P = 0.004).ConclusionsThe prevalence of EB at 3 mo was similar among term infants. Nonetheless, in comparison with the remaining infants born at term, early-term infants were at increased risk of having been weaned before reaching 12 mo of age. Curr Dev Nutr 2023;xx:xx.
Project description:BackgroundHistorically, bifidobacteria were the dominant intestinal bacteria in breastfed infants. Still abundant in infants in developing nations, levels of intestinal bifidobacteria are low among infants in developed nations. Recent studies have described an intimate relationship between human milk and a specific subspecies of Bifidobacterium, B. longum subsp. infantis (B. infantis), yet supplementation of breastfed, healthy, term infants with this organism, has not been reported. The IMPRINT Study, a Phase I clinical trial, was initiated to determine the safety and tolerability of supplementing breastfed infants with B. infantis (EVC001).MethodsEighty mother-infant dyads were enrolled in either lactation support plus B. infantis supplementation (BiLS) or lactation support alone (LS). Starting with Day 7 postnatal, BiLS infants were fed 1.8-2.8 × 1010 CFU B. infantis EVC001 daily in breast milk for 21 days. Mothers collected fecal samples, filled out health questionnaires, and kept daily logs about their infants' feeding and gastrointestinal symptoms from birth until Day 61 postnatal. Safety and tolerability were determined from maternal reports.ResultsThere were no differences in the mean gestational age at birth, weight 1 and 2 months postnatal, and breast milk intake between groups. The mean Log10 change in fecal Bifidobacterium from Day 6 to Day 28 was higher (p = 0.0002) for BiLS (6.6 ± 2.8 SD) than for LS infants (3.5 ± 3.5 SD). Daily stool number was higher (p < 0.005) for LS and lower (p < 0.05) for BiLS infants during supplementation than at Baseline. During supplementation, watery stools decreased and soft stools increased by 36% over baseline in BiLS infants (p < 0.05) with no significant changes in stool consistency for the LS infants. None of the safety and tolerability endpoints, including flatulence, bloody stool, body temperature, ratings of gastrointestinal symptoms, use of antibiotics or gas-relieving medications, infant colic, jaundice, number of illnesses, sick doctor visits, or diagnoses of eczema were different for the groups at any point.ConclusionsThe B. infantis EVC001 supplement was safely consumed and well-tolerated. Stools were fewer and better formed in infants in the BiLS group compared with LS group. Adverse events were those expected in healthy infants and not different between groups.Trial registrationClinicalTrials.gov NCT02457338 . Registered May 27, 2015.
Project description:ObjectiveTo investigate the effect of daily iron supplementation for 14 weeks on the serum iron concentration and other markers of iron status in exclusively breastfed infants in Gambia.MethodsA placebo-controlled, randomized, double-blind trial was performed in rural Gambia between 3 August 2021 and 9 March 2022. Overall, 101 healthy, exclusively breastfed infants aged 6 to 10 weeks were recruited at vaccination clinics and through community health workers. Infants were randomized to receive iron supplementation (7.5 mg/day as ferrous sulfate in sorbitol solution) or placebo for 98 days. Venous blood samples were collected at baseline and on day 99 to assess the serum iron concentration and other markers of iron and haematological status.FindingsAt day 99, the serum iron concentration was significantly higher in the iron supplementation group than the placebo group (crude difference in means: 2.5 µmol/L; 95% confidence interval: 0.6 to 4.3) and there were significant improvements in other iron and haematological markers. There were 10 serious adverse events (five in each group), 106 non-serious adverse events (54 with iron supplementation; 52 with placebo) and no deaths. There was no marked difference between the groups in maternally reported episodes of diarrhoea, fever, cough, skin infection, eye infection or nasal discharge.ConclusionIn exclusively breastfed Gambian infants, iron supplementation from 6 weeks of age was associated with a significant improvement in markers of iron status at around 6 months of age. There was no indication of adverse effects on growth or infections.
Project description:Study Objectives:Cortical activity patterns develop rapidly over the equivalent of the last trimester of gestation, in parallel with the establishment of sleep architecture. However, the emergence of mature cortical activity in wakefulness compared with sleep states in healthy preterm infants is poorly understood. Methods:To investigate whether the cortical activity has a different developmental profile in each sleep-wake state, we recorded 11-channels electroencephalography (EEG), electrooculography (EOG), and respiratory movement for 1 hr from 115 infants 34 to 43 weeks-corrected age, with 0.5-17 days of postnatal age. We characterized the trajectory of ?, ?, and ?-? oscillations in wakefulness, rapid eye movement (REM) sleep, and non-REM sleep by calculating the power spectrum of the EEG, averaged across artifact-free epochs. Results:?-Oscillations in wakefulness and REM sleep decrease with corrected age, particularly in the temporal region, but not in non-REM sleep. ?-Oscillations increase with corrected age in sleep, especially non-REM sleep, but not in wakefulness. On the other hand, ?-? oscillations decrease predominantly with postnatal age, independently of sleep-wake state, particularly in the occipital region. Conclusions:The developmental trajectory of ? and ? rhythms is state-dependent and results in changed cortical activity patterns between states with corrected age, which suggests that these frequency bands may have particular functional roles in each state. Interestingly, postnatal age is associated with a decrease in ?-? oscillations overlying primary visual cortex in every sleep-wake state, suggesting that postnatal experience (including the first visual input through open eyes during periods of wakefulness) is associated with resting-state visual cortical activity changes.
Project description:The implications of maternal gestational weight gain (GWG) and vitamin D status to neonatal bone health are unclear. We tested whether maternal 25-hydroxyvitamin D (25(OH)D) and GWG relate to neonatal bone mineral content (BMC) and bone mineral density (BMD). Healthy term appropriate for gestational age breastfed neonates (n = 142) and their mothers were recruited 24-36 h after delivery and followed at 1.0 ± 0.5 month. At birth, obstetric data were collected and newborn serum 25(OH)D was measured. At 1 month, neonatal whole-body (WB) BMC, WB BMC relative to body weight (WB BMC/kg), lumbar spine BMC and BMD, maternal and neonatal 25(OH)D concentrations, and anthropometry were measured. Infant BMC and BMD between maternal 25(OH)D (<50, ≥50 nmol/L) and GWG (insufficient, adequate, and excessive) categories were compared. Maternal 25(OH)D was not related to infant whole-body BMC, BMC/kg, lumbar spine BMC, and BMD. Infants in the excessive maternal GWG category had greater (p = 0.0003) whole-body BMC and BMC/kg and lumbar spine BMC and BMD than inadequate GWG, and greater (p = 0.0063) whole-body BMC/kg and lumbar spine BMC and BMD than adequate GWG. These results suggest that maternal GWG, but not vitamin D status, modestly relates to bone mass in neonates.
Project description:We tested healthy preterm (born near 28 +/- 2 weeks of gestational age) and full-term infants at various different ages. We compared the two populations on the development of a language acquisition landmark, namely, the ability to distinguish the native language from a rhythmically similar one. This ability is attained 4 months after birth in healthy full-term infants. We measured the induced gamma-band power associated with passive listening to (i) the infants' native language (Spanish), (ii) a rhythmically close language (Italian), and (iii) a rhythmically distant language (Japanese) as a marker of gains in language discrimination. Preterm and full-term infants were matched for neural maturation and duration of exposure to broadcast speech. We found that both full-term and preterm infants only display a response to native speech near 6 months after their term age. Neural maturation seems to constrain advances in speech discrimination at early stages of language acquisition.
Project description:BackgroundA high early protein intake is associated with rapid postnatal weight gain and altered body composition. We aimed to evaluate the safety of a low-protein formula in healthy full-term infants.MethodsA randomized controlled trial was conducted. A total of 118 infants were randomized to receive two different protein content formulas (formula A or formula B (protein content: 1.2 vs. 1.7 g/100 mL, respectively)) for the first 4 months of life. Anthropometry and body composition by air displacement plethysmography were assessed at enrolment and at two and 4 months. The reference group comprised 50 healthy, exclusively breastfed, full-term infants.ResultsWeight gain (g/day) throughout the study was similar between the formula groups (32.5 ± 6.1 vs. 32.8 ± 6.8) and in the reference group (30.4 ± 5.4). The formula groups showed similar body composition but a different fat-free mass content from breastfed infants at two and 4 months. However, the formula A group showed a fat-free mass increase more similar to that of the breastfed infants. The occurrence of gastrointestinal symptoms or adverse events was similar between the formula groups.ConclusionsFeeding a low-protein content formula appears to be safe and to promote adequate growth, although determination of the long-term effect on body composition requires further study.Trial registrationThe present study was retrospectively registered in ClinicalTrials.gov (trial number: NCT03035721 on January 18, 2017).
Project description:Abstract Objectives To investigate sex differences in bone mass including whole body (WB) bone mineral content (BMC), lumbar spine (LS) BMC and LS bone mineral density (BMD) during infancy. Methods This is a secondary analysis of data from a double-blinded randomized clinical trial (NCT00381914), in which healthy term breastfed infants were randomized to 1 of 4 doses of oral vitamin D supplementation (400−1600 IU/d) at 1 mo of age (+/− 2 wk). Serum 25-hydroxyvitamin D (25(OH)D) using liquid chromatography-tandem mass spectrometry, and BMC and BMD using dual-energy x-ray absorptiometry (Hologic) were measured at 1, 3, 6, 9, and 12 mo of age (+/- 2 wk). No effect of supplementation on BMC (WB and LS) and BMD (LS) was reported in the primary study. Infants (32 males (M), 31 females (F)) with baseline serum 25(OH)D ≥ 50 nmol/L, based on the Institute of Medicine's cutoff in support of bone health, were included in this secondary analysis. Differences between sexes over time in BMC and BMD were tested using mixed model repeated measures ANOVA accounting for the fixed effects of sex, time, and sex*time and the random effect of infant ID, with Tukey multiple comparison test. Results Infants were on average 39.5 ± 1.1 wk gestational age, with weight for age z-score of 0.40 ± 0.97 at birth. There were no differences between sexes in mineral accretion rates of the WB (M: 12.94 ± 8.83, F: 12.20 ± 7.71 g/mo; p = 0.36) and at the LS (M: 0.26 ± 0.28, F: 0.22 ± 0.31 g/mo; p = 0.33) between 1 to 12 mo of age, but M had higher overall WB BMC than F (166.16 ± 57.30 vs. 153.34 ± 50.06 g, p = 0.03). When adjusted for weight or length, no sex differences were observed over time in WB BMC per weight (M: 22.02 ± 2.29, F: 22.20 ± 2.27 g/kg; p = 0.58) and WB BMC per length (M: 2.47 ± 0.60, F: 2.34 ± 0.53 g/cm, p = 0.06). Similarly, when using the WB less head BMC measurement, no sex differences were observed (M: 84.80 ± 30.24, F: 78.41 ± 7.57 g; p = 0.07). In addition, LS BMC (M: 3.77 ± 1.34, F: 3.75 ± 0.22 g; p = 0.93) and LS BMD (M: 0.273 ± 0.051, F: 0.284 ± 0.054 g/m2; p = 0.10) did not vary by sex. Conclusions Sex differences in BMC in infancy, if any, are mostly driven by infant size. Based on BMC and accretion rates, sex-specific normative data do not appear required during infancy. Funding Sources Canadian Institutes of Health Research, Nutricia Research Foundation, and the Canadian Foundation for Innovation.