Human milk oligosaccharides are associated with protection against diarrhea in breast-fed infants

Ardythe L. Morrow, Guillermo M. Ruiz-Palacios, Mekibib Altaye, Xi Jiang, M. Lourdes Guerrero, Jareen K. Meinzen-Derr, Tibor Farkas, Prasoon Chaturvedi, Larry K. Pickering a and David S. Newburg

J Pediatr 145:3;297-303 September 2004

Objective To determine the association between maternal milk levels of 2-linked fucosylated oligosaccharide and prevention of diarrhea as a result of Campylobacter, caliciviruses, and diarrhea of all causes in breast-fed infants.

Study design Data and banked samples were analyzed from 93 breast-feeding mother-infant pairs who were prospectively studied during 1988-1991 from birth to 2 years with infant feeding and diarrhea data collected weekly; diarrhea was diagnosed by a study physician. Milk samples obtained 1 to 5 weeks postpartum were analyzed for oligosaccharide content. Data were analyzed by Poisson regression.

Results Total 2-linked fucosyloligosaccharide in maternal milk ranged from 0.8 to 20.8 mmol/L (50%-92% of milk oligosaccharide). Moderate-to-severe diarrhea of all causes (n=77 cases) occurred less often (P=.001) in infants whose milk contained high levels of total 2-linked fucosyloligosaccharide as a percent of milk oligosaccharide. Campylobacter diarrhea (n=31 cases) occurred less often (P=.004) in infants whose mother’s milk contained high levels of 2´-FL, a specific 2-linked fucosyloligosaccharide, and calicivirus diarrhea (n=16 cases) occurred less often (P=.012) in infants whose mother’s milk contained high levels of lacto-N-difucohexaose (LDFH-I), another 2-linked fucosyloligosaccharide.

Conclusion This study provides novel evidence suggesting that human milk oligosaccharides are clinically relevant to protection against infant diarrhea.

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