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What did the project achieve?
Necrotising enterocolitis (NEC), a serious gut disease, and sepsis are two of the most serious illnesses affecting very premature babies, those born before 32 weeks of pregnancy. Sadly, many of these vulnerable infants will lose their lives in the first few weeks of life due to these dangerous complications – and those who survive are often left with lifelong disabilities.
“Our research has increased our understanding of the components of breastmilk, and why feeding with breast milk could reduce the risk of these life-threatening complications in preterm babies,” says Dr Darren Smith of the University of Northumbria at Newcastle. “In the longer term, we hope this knowledge will lead to new ways of supporting gut health and preventing serious illness in these very young children.”
This project focused on phages – naturally occurring viruses found in breastmilk that can infect, kill, or change how bacteria grow. The researchers believe that these tiny viruses play an important role in shaping the gut microbial community in premature babies, supporting the maturation of their immune system in early life.
Dr Smith’s team analysed breastmilk samples donated by mothers of very premature babies.
“We discovered that phages are abundant from the first week after birth and remain throughout the first 100 days of lactation,” says Dr Smith. “Interestingly, we also found that these phages can bind to naturally occurring fats in the breastmilk and are delivered from mother to child.”
In laboratory tests, the researchers found that phages taken from breastmilk could change the composition of bacteria in a model system, suggesting they may help shape early gut health.
Encouraged by these results, the team has now launched a larger study with £1.2m of funding from the UKRI Biotechnology and Biological Sciences Research Council (BBSRC). This next phase will explore in more detail the mechanism of how phages are carried in the fats of breastmilk and how this changes bacterial communities and compatibility with the immune system of preterm infants.
“We’re extremely excited to have received this significant award, which follows on from the Action-funded project,” says Dr Smith. “This research could really make a difference in understanding how a mother’s own milk could protect their premature babies by supporting the establishment of a healthy gut microbiome that provides some protection from life-threatening gastro-intestinal infections.”
This research was completed on
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
| Project Leader | Dr Darren L Smith, BSc PhD MRSB |
| Project Team | Dr Janet E Berrington, BM BS MD FRCPCHDr Nick D Embleton, MD FRCPCHDr Simon H Bridge, BSc MSc PhD MRSBDr Andrew Nelson PhD |
| Project Location | Applied Sciences, University of Northumbria at Newcastle |
| Project Location Other | Newcastle Neonatal Service, Newcastle upon Tyne Hospitals NHS Foundation Trust |
| Project duration | 2 years |
| Date awarded | 30 July 2018 |
| Project start date | 1 April 2019 |
| Project end date | 31 July 2021 |
| Grant amount | £175,826 |
| Grant code | GN2730 |
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