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Maternal Diet and Infant Feeding Practices Are Associated with Variation in the Human Milk Microbiota at 3 Months Postpartum in a Cohort of Women with High Rates of Gestational Glucose Intolerance.

  • LeMay-Nedjelski, Lauren1, 2
  • Asbury, Michelle R1, 2
  • Butcher, James3
  • Ley, Sylvia H4
  • Hanley, Anthony J1
  • Kiss, Alex5
  • Unger, Sharon6, 7, 8, 9
  • Copeland, Julia K10
  • Wang, Pauline W10
  • Stintzi, Alain3
  • O'Connor, Deborah L1, 2, 7, 8
  • 1 Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada. , (Canada)
  • 2 Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada. , (Canada)
  • 3 Ottawa Institute of Systems Biology and Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, Ontario, Canada. , (Canada)
  • 4 Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
  • 5 Department of Research Design and Biostatistics, Sunnybrook Research Institute, Toronto, Ontario, Canada. , (Canada)
  • 6 Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada. , (Canada)
  • 7 Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada. , (Canada)
  • 8 Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada. , (Canada)
  • 9 Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada. , (Canada)
  • 10 Centre for the Analysis of Genome Evolution and Function, University of Toronto, Toronto, Ontario, Canada. , (Canada)
Published Article
Journal of Nutrition
Oxford University Press
Publication Date
Feb 01, 2021
DOI: 10.1093/jn/nxaa248
PMID: 32886107


Human milk contains a diverse community of bacteria believed to play a role in breast health and inoculation of the infant's gastrointestinal tract. The role of maternal nutrition and infant feeding practices on the human milk microbiota remains poorly understood. Our aim was to explore the associations between maternal diet (delivery to 3 mo postpartum), infant feeding practices, and the microbial composition and predicted function in milk from women with varied metabolic status. This was an exploratory analysis of a previously completed prospective cohort study of women with varying degrees of gestational glucose intolerance (NCT01405547). Milk samples (n = 93 mothers) were collected at 3 mo postpartum. Maternal dietary information (validated food-frequency questionnaire) and infant feeding practices (human milk exclusivity, frequency of direct breastfeeding per day) were collected. V4-16S ribosomal RNA gene sequencing (Illumina MiSeq) was conducted to determine microbiota composition. Intake of polyunsaturated fat [β estimate (SE): 0.036 (0.018), P = 0.047] and fiber from grains [0.027 (0.013), P = 0.048] were positively associated with ɑ-diversity (Shannon index) of human milk. Overall microbial composition of human milk clustered based on human milk exclusivity (weighted UniFrac R2 = 0.034, P = 0.015; Bray-Curtis R2 = 0.041, P = 0.007), frequency of direct breastfeeding per day (Bray-Curtis R2 = 0.057, P = 0.026), and maternal fiber intake from grains (Bray-Curtis R2 = 0.055, P = 0.040). Total fiber, fiber from grains, dietary fat, and infant feeding practices were also associated with a number of differentially abundant taxa. The overall composition of predicted microbial functions was associated with total fiber consumption (Bray-Curtis R2 = 0.067, P = 0.036) and human milk exclusivity (Bray-Curtis R2 = 0.041, P = 0.013). Maternal consumption of fiber and fat, as well as mother's infant feeding practices, are important determinants of the human milk microbiota. Understanding whether these microbial changes impact an infant's overall health and development requires future study. Copyright © The Author(s) on behalf of the American Society for Nutrition 2020.

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