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Background: Infant growth trajectories reflect current health status and may predict future obesity and metabolic diseases. Human milk is tailored to support optimal infant growth. However, nutrient intake rather than milk composition more accurately predicts growth outcomes. Although the role of protein leverage in infant growth is unclear, protein intake is important for early infancy growth. Materials and methods: This study of exclusively breastfeeding mothers with allergies (n = 161) from the Infant Fish Oil Supplementation Study assessed relationships between intake of human milk macronutrients and infant growth. Human milk fat, protein and lactose concentrations were measured at 3 months postpartum, and infant daily intakes were estimated using an average milk intake of 800 mL/day. Results: Higher human milk protein:energy ratio was associated with higher weight-for-age z-score at 2.5 years compared to 3 months and higher body mass index-for-age z-score change (6 months to 1 year compared to 3–6 months). Maternal atopy and birth season (summer) were negatively associated with human milk lactose concentration. Passive smoke exposure was associated with reduced energy and fat concentrations and increased lactose:energy ratio. Conclusions: Our results indicate that intake of human milk macronutrients may impact early childhood growth. [ABSTRACT FROM AUTHOR]

The ABREAST Conference, held in Perth, Australia, focused on advancing human lactation research and promoting knowledge and innovation in the field. The conference featured keynote speakers from various countries and covered a wide range of topics related to breastfeeding. A total of 161 registrations were received, and 30 manuscripts were accepted for presentation, with 23 manuscripts published. The conference was successful in fostering collaboration and the advancement of research in human lactation. [Extracted from the article]

Human milk contains a low-biomass, low-diversity microbiome, consisting largely of bacteria. This community is of great research interest in the context of infant health and maternal and mammary health. However, this sample type presents many unique methodological challenges. In particular, there are numerous technical considerations relating to sample collection and storage, DNA extraction and sequencing, viability, and contamination. Failure to properly address these challenges may lead to distortion of bacterial DNA profiles generated from human milk samples, ultimately leading to spurious conclusions. Here, these technical challenges are discussed, and various methodological approaches used to address them are analyzed. Data were collected from studies in which a breadth of methodological approaches were used, and recommendations for robust and reproducible analysis of the human milk microbiome are proposed. Such methods will ensure high-quality data are produced in this field, ultimately supporting better research outcomes for mothers and infants. [ABSTRACT FROM AUTHOR]

Diet is a key factor that shapes the gut microbiome. Maternal diet has been proposed as a potential modulator of the human milk microbiome. However, the effect of diet during lactation on the maternal microbiota remains unclear. This study, therefore, set out to determine the effect of a two-week reduced fat and sugar and increased fibre maternal dietary intervention on the maternal faecal and milk microbiota. Faecal swabs and human milk samples were collected from mothers (n = 11) immediately pre-intervention, immediately post-intervention, and 4- and 8-weeks post-intervention, and were analysed using full-length 16S rRNA gene sequencing. The maternal macronutrient intake was assessed across one week prior to the intervention using 24 h dietary recall and during the intervention using FoodWorks 10 Software. The maternal fat and sugar intake significantly decreased from pre-intervention (fat: 120.9 ± 39.4 g; sugar: 114.1 ± 40.9 g) to the first (fat: 52.9 ± 4.3 g, p < 0.001; sugar: 83.2 ± 5.1 g, p = 0.005) and second week of the intervention (fat: 52.3 ± 6.2 g, p < 0.001; sugar: 82.7 ± 6.5 g, p = 0.005). The dietary fibre intake significantly increased from pre-intervention (28.8 ± 8.3 g) to the first week of the intervention (34.6 ± 2.8 g, p = 0.012) but was not different in the second week of the intervention compared to pre-intervention. Significant changes in the bacterial composition of maternal faeces were detected after the dietary intervention, with decreases in the relative abundance of Bacteroides caccae and increases in the relative abundance of Faecalibacillus intestinalis. In human milk, a significant increase in Cutibacterium acnes and a decrease in Haemophilus parainfluenzae were detected. Significant differences in maternal faecal and human milk bacterial composition were maintained 4 to 8 weeks after the intervention. This pilot study demonstrates that short-term changes in maternal diet during lactation can alter the maternal faecal and human milk microbiota. [ABSTRACT FROM AUTHOR]

Mastitis is an inflammatory condition of the breast, with or without accompanying infection. The recent release of the revised Academy of Breastfeeding Medicine protocol on mastitis (Clinical Protocol #36) has caused controversy within the field. The updated protocol positions multiple typical human milk commensal bacteria as causative agents of mastitis. However, data to support these relationships are lacking. Here, we critically review human and animal evidence for the role of the milk microbiota in mastitis. Only three metataxonomic/metagenomic studies have characterized the human milk microbiome in cases of mastitis. These studies consistently report reduced alpha diversity and elevated levels of Staphylococcus aureus in mastitic milk samples; however, the remaining findings presented are conflicting and inconsistent. Collectively, the three studies included 45 sub-acute mastitis cases, 24 acute mastitis cases, and 52 healthy controls, and are thus limited by low participant numbers. In addition, the studies vary in their definition of sub-acute/acute mastitis, their methodologies, and antibiotic exposure in the mastitic groups. Further, these studies provide data on the state of the microbiome during mastitis, with no data currently available on the milk microbiome preceding the onset of mastitis. These kind of longitudinal data are critical to identify candidates for disease causation. Emerging evidence from animal models is suggestive of the involvement of the gut microbiota. Studies have reported that fecal microbiota transplantation from mastitic cows to germ-free mice results in mastitis symptoms. Future studies should therefore consider the maternal microbiome more broadly when assessing the etiology of mastitis. While S. aureus is frequently recognized as a mastitis-related pathogen, data from culture-based and culture-independent studies demonstrate that this species is present in healthy women and cannot be detected in a significant portion of cases. This suggests heterogenous causes for bacterial mastitis, necessitating broader screening. Overall, data in this field are sparse, and current clinical guidelines lack high-quality evidence to support them. There is therefore a pressing need for further research in this area to better characterize the causes of mastitis and thereby underpin future therapeutics. [ABSTRACT FROM AUTHOR]

This article explores the determinants of the human milk microbiome in allergic women. The study collected milk samples from women with allergic diseases and analyzed the composition of the milk microbiome using gene sequencing. The results showed that the season of infant birth had the strongest relationship with the milk microbiome, along with other factors such as delivery mode, feeding status, and maternal age. The study suggests that there is an interaction between season and maternal allergic diseases that influences the microbiome. [Extracted from the article]

This article discusses the potential use of biomarkers to detect low milk supply in breastfeeding mothers. The study examined various milk components in women with low milk supply and those with normal milk supply. The researchers found that concentrations of certain milk components, such as fat, total protein, whey, potassium, sodium, and zinc, were significantly different between the two groups. They developed predictive models using these milk component concentrations and found that the best model, which included all measured milk components, had an accuracy of 79% in predicting low milk supply. These findings suggest that milk composition differences could be used to test for low milk production. The study was conducted in accordance with ethical guidelines and informed consent was obtained from all participants. [Extracted from the article]

This article discusses the development of the human milk microbiota over the first two years postpartum. The study, conducted on a cohort of 86 mothers in Western Australia, found that the milk microbiota was low in diversity and dominated by Staphylococcus and Streptococcus species. The composition of the milk microbiota was influenced by various factors including infant age, maternal or infant antibiotic exposure, maternal probiotic use, parity, mode of delivery, and pre-pregnancy BMI. The findings highlight the dynamic nature of the milk microbiota over time in the first two years postpartum. [Extracted from the article]

This article explores the impact of gestational diabetes mellitus (GDM) on the human milk microbiome. The study involved 83 mothers, with 43 having GDM and 40 without GDM. The researchers found that the milk from mothers with GDM had a higher alpha diversity and a different composition compared to milk from mothers without GDM. However, there was no association between the milk microbiome and milk production. The study provides further insight into the differential microbiome outcomes related to GDM. [Extracted from the article]

Human milk (HM) contains an incredible array of microorganisms. These likely contribute to the seeding of the infant gastrointestinal microbiome, thereby influencing infant immune and metabolic development and later-life health. Given the importance of the HM microbiota in this context, there has been an increase in research efforts to characterize this in different populations and in relation to different maternal and infant characteristics. However, despite a decade of intensive research, there remain several unanswered questions in this field. In this review, the "5 W+H" approach (who, what, when, where, why, and how) is used to comprehensively describe the composition, function, and origin of the HM microbiome. Here, existing evidence will be drawn together and critically appraised to highlight avenues for further research, both basic and applied. Perhaps the most interesting of these is the potential to modulate the HM microbiome using pre/probiotics or dietary interventions. Another exciting possibility is the personalization of donor milk for women with insufficient supply. By gaining a deeper understanding of the HM microbiome, opportunities to intervene to optimize infant and lifelong health may be identified. [ABSTRACT FROM AUTHOR]

The human microbiome plays a number of critical roles in host physiology. Evidence from longitudinal cohort studies and animal models strongly supports the theory that maldevelopment of the microbiome in early life can programme later-life disease. The early-life microbiome develops in a clear stepwise manner over the first 3 years of life. During this highly dynamic time, insults such as antibiotic use and formula feeding can adversely affect the composition and temporal development of the microbiome. Such experiences predispose infants for the development of chronic health conditions later in life. This review highlights key factors that disrupt the early-life microbiome and highlights major non-communicable diseases which are underpinned by early-life dysbiosis. [ABSTRACT FROM AUTHOR]