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Nutrients 2018, 10(10), 1556; https://doi.org/10.3390/nu10101556

Low Diversity of Human Milk Oligosaccharides is Associated with Necrotising Enterocolitis in Extremely Low Birth Weight Infants

1
Department of Clinical and Experimental Medicine, Linköping University, 58183 Linköping, Sweden
2
Department of Neonatology, Karolinska University Hospital, 17176 Stockholm, Sweden
3
Department of Women´s and Children´s Health, Karolinska Insitute, 17177 Stockholm, Sweden
4
Department of Clinical Chemistry, Linköping University, 58185 Linköping, Sweden
5
Department of Pediatrics, Linköping University, 58183 Linköping, Sweden
*
Author to whom correspondence should be addressed.
Received: 25 September 2018 / Revised: 12 October 2018 / Accepted: 12 October 2018 / Published: 20 October 2018
(This article belongs to the Special Issue Probiotics and Prebiotics in Pediatrics)
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Abstract

Difference in human milk oligosaccharides (HMO) composition in breast milk may be one explanation why some preterm infants develop necrotizing enterocolitis (NEC) despite being fed exclusively with breast milk. The aim of this study was to measure the concentration of 15 dominant HMOs in breast milk during the neonatal period and investigate how their levels correlated to NEC, sepsis, and growth in extremely low birth weight (ELBW; <1000 g) infants who were exclusively fed with breast milk. Milk was collected from 91 mothers to 106 infants at 14 and 28 days and at postmenstrual week 36. The HMOs were analysed with high-performance anion-exchange chromatography with pulsed amperometric detection. The HMOs diversity and the levels of Lacto-N-difucohexaose I were lower in samples from mothers to NEC cases, as compared to non-NEC cases at all sampling time points. Lacto-N-difucohexaose I is only produced by secretor and Lewis positive mothers. There were also significant but inconsistent associations between 3′-sialyllactose and 6′-sialyllactose and culture-proven sepsis and significant, but weak correlations between several HMOs and growth rate. Our results suggest that the variation in HMO composition in breast milk may be an important factor explaining why exclusively breast milk fed ELBW infants develop NEC. View Full-Text
Keywords: neonatal; preterm; breast milk; oligosaccharides; diversity; necrotizing enterocolitis; sepsis; growth neonatal; preterm; breast milk; oligosaccharides; diversity; necrotizing enterocolitis; sepsis; growth
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Wejryd, E.; Martí, M.; Marchini, G.; Werme, A.; Jonsson, B.; Landberg, E.; Abrahamsson, T.R. Low Diversity of Human Milk Oligosaccharides is Associated with Necrotising Enterocolitis in Extremely Low Birth Weight Infants. Nutrients 2018, 10, 1556.

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