Premature birth: how does breastmilk help protect vulnerable babies from illness?

Each year around 10,000 babies are born extremely prematurely – before 32 weeks of pregnancy – in the UK.^1-3 Despite huge advances in neonatal care, estimates suggest up to 4,000 will develop a serious bowel disease and/or a life-threatening complication of infection (sepsis) after birth.^1-4 Many will lose their lives due to these dangerous complications and those who survive are often left with lifelong disabilities. Dr Darren Smith at the University of Northumbria at Newcastle is leading a team who are studying certain types of viruses within breast milk to understand their role in protecting babies from harm. Their work could lead to new ways to improve care and treatment for these tiny babies, saving and improving lives.

How are children’s lives affected now?

Necrotising enterocolitis (NEC), a serious bowel disease, and sepsis are the biggest threats to the lives of very premature babies after the first week of life.

“Too many lives are being lost because of these serious complications, and babies who do survive, often grow up with life-changing disabilities, including cerebral palsy,” says Dr Smith.

Despite their importance, sepsis and NEC are poorly understood, although they are both thought to be linked to imbalances in the community of microorganisms living inside the baby’s gut. Breast milk is known to reduce the risk of NEC and sepsis in premature babies, with evidence suggesting that this is due to immune-boosting factors rather than its nutrients.

“Developing a better understanding of what components of breast milk provide these protective effects and how they work could lead to new ways to prevent or treat these complex, life-threatening illnesses in vulnerable babies,” says Dr Smith.

How could this research help?

“Our aim is to investigate if viruses – known as phages – in breast milk play a part in protecting very preterm babies from serious illnesses,” says Dr Smith.

Phages are viruses that infect and kill bacteria – and the team believes that they may help to support babies’ inexperienced immune systems and to shape and maintain a healthy microbial gut community.

“We will first carry out a detailed census of the phages in breast milk samples collected from the mothers of very preterm babies,” says Dr Smith.

The team will then investigate the influence of breast milk phages on bacterial communities in the guts of newborn babies. They will also determine how phages are carried in breast milk, which could have implications for its handling and storage in special care baby units.

“Our work could shed new light on how we might help protect preterm babies from life-threatening illnesses, which we hope will one day lead to improvements in neonatal care and treatment,” says Dr Smith.

References

1.Office for National Statistics (England and Wales). Birth Characteristics, published 2016, Table 7: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarri...

2.IDS Scotland. Maternity and Births, published in 2016, Table 5: http://www.isdscotland.org/Health-Topics/Maternity-and-Births/Publicatio...

3.Northern Ireland Statistics and Research Agency, Registrar General Annual Report 2015. https://www.nisra.gov.uk/publications/registrar-general-annual-report-20...

4.Embleton, ND et al., Mechanisms affecting the gut of preterm infants in enteral feeding trials. Frontiers in Nutrition 2017; 4:14. doi:  10.3389/fnut.2017.00014