Another reason to favor exclusive breastfeeding: microbiome resilience

Alessio Fasano
2018 Jornal de Pediatria  
Knowledge of the human microbiome has rapidly accelerated thanks to the Human Microbiome Project and the increasing availability of culture independent highthroughput sequencing technology. With these new tools, we have come to appreciate the extensive complexity and dynamics of the human microbiome, particularly the one which colonizes our gastrointestinal tract. While some studies appear to suggest a rather chaotic, random establishment of the human gut microbiome early in life, the latest
more » ... life, the latest research seems to suggest a carefully planned design based on the co-evolutionary integration of our genome composition and function with the epigenetic influence of the symbiotic microbiome. Therefore, any departure from the evolutionary plan on how proper microbiome engraftment should occur, including maternal DOI of original article: and diet, mode of delivery, feeding regimen, exposure to antibiotics, and home environment, 1,2 just to name a few, may have potentially detrimental clinical consequences. Indeed, there is now evidence suggesting that the microbiome-mediated maturation of epithelial barriers and gut-associated lymphoid tissue (GALT) impacts the capacity of the host to develop responses that maintain normal homeostasis and prevent aberrant pro-inflammatory or allergic responses. This implies that disruptions in the development of a healthy microbiome ecosystem early in life can have lasting effects. 3 Establishment of a healthy microbiome may begin even before birth. Despite a longstanding belief that the fetus resides in a sterile environment, recent studies have revealed microbiota in both the placenta 4 and meconium. 5 Current mouse models suggest that presentation of maternal commensal bacterial components to the fetus in the last trimester of pregnancy is a likely mechanism for immune system maturation and oral tolerance. 6 There is growing evidence that exposure to healthy and diverse commensal species early in life confers protection against chronic inflammatory diseases (CIDs). Technology now allows for vast and sophisticated study of the human microbiome (microbes present in the human host and their functions), the
doi:10.1016/j.jped.2017.10.002 pmid:29111201 fatcat:fnq4ugwcj5e4hn56m3pqh64ck4