Effect of Supplementation with Lactobacillus reuteri SGL 01 in Lactating Women on Breast Milk and Neonatal Gut Microbiota: An Exploratory, Randomized, Open-Label Clinical Trial
Highlights
- Maternal supplementation with Lactobacillus reuteri SGL 01 was associated with a beneficial modulation of the neonatal gut microbiota.
- Neonatal fecal samples showed increased concentrations of Bifidobacterium spp. and Lactobacillus spp. derived from the probiotic supplementation.
- Maternal supplementation with Lactobacillus reuteri SGL 01 in lactating women showed no significant effects on breast milk microbiota composition.
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Ethics
2.2. Sample Collection
2.3. Microbial Composition Analysis
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
| BMI | Body mass index |
| CFU | Colony-forming units (CFU) |
| GA | Gestational age |
| IQR | Interquartile range |
References
- Arrieta, M.C.; Stiemsma, L.T.; Amenyogbe, N.; Brown, E.M.; Finlay, B. The intestinal microbiome in early life: Health and disease. Front. Immunol. 2014, 5, 427. [Google Scholar] [CrossRef]
- Tamburini, S.; Shen, N.; Wu, H.C.; Clemente, J.C. The microbiome in early life: Implications for health outcomes. Nat. Med. 2016, 22, 713–722. [Google Scholar] [CrossRef]
- Martí, M.; Spreckels, J.E.; Ranasinghe, P.D.; Wejryd, E.; Marchini, G.; Sverremark-Ekström, E.; Jenmalm, M.C.; Abrahamsson, T. Effects of Lactobacillus reuteri supplementation on the gut microbiota in extremely preterm infants in a randomized placebo-controlled trial. Cell Rep. Med. 2021, 2, 100206. [Google Scholar] [CrossRef]
- Rodríguez, J.M.; Murphy, K.; Stanton, C.; Ross, R.P.; Kober, O.I.; Juge, N.; Avershina, E.; Rudi, K.; Narbad, A.; Jenmalm, M.C.; et al. The composition of the gut microbiota throughout life, with an emphasis on early life. Microb. Ecol. Health Dis. 2015, 26, 26050. [Google Scholar] [CrossRef]
- Fujimura, K.E.; Lynch, S.V. Microbiota in allergy and asthma and the emerging relationship with the gut microbiome. Cell Host Microbe 2015, 17, 592–602. [Google Scholar] [CrossRef]
- Bäckhed, F.; Roswall, J.; Peng, Y.; Feng, Q.; Jia, H.; Kovatcheva-Datchary, P.; Li, Y.; Xia, Y.; Xie, H.; Zhong, H.; et al. Dynamics and Stabilization of the Human Gut Microbiome during the First Year of Life. Cell Host Microbe 2015, 17, 690–703. [Google Scholar] [CrossRef] [PubMed]
- Szajewska, H.; Gyrczuk, E.; Horvath, A. Lactobacillus reuteri DSM 17938 for the management of infantile colic in breastfed infants: A randomized, double-blind, placebo-controlled trial. J. Pediatr. 2013, 162, 257–262. [Google Scholar] [CrossRef] [PubMed]
- Dos Reis Buzzo Zermiani, A.P.; de Paula Soares, A.; da Silva Guedes de Moura, B.L.; Miguel, E.R.A.; Lopes, L.D.G.; de Carvalho Scharf Santana, N.; da Silva Santos, T.; Demarchi, I.G.; Teixeira, J.J. Evidence of Lactobacillus reuteri to reduce colic in breastfed babies: Systematic review and meta-analysis. Complement. Ther. Med. 2021, 63, 102781. [Google Scholar] [CrossRef]
- Sung, V.; D’Amico, F.; Cabana, M.D.; Chau, K.; Koren, G.; Savino, F.; Szajewska, H.; Deshpande, G.; Dupont, C.; Indrio, F.; et al. Lactobacillus reuteri to Treat Infant Colic: A Meta-analysis. Pediatrics 2018, 141, e20171811. [Google Scholar] [CrossRef]
- Cabrera-Rubio, R.; Collado, M.C.; Laitinen, K.; Salminen, S.; Isolauri, E.; Mira, A. The human milk microbiome changes over lactation and is shaped by maternal weight and mode of delivery. Am. J. Clin. Nutr. 2012, 96, 544–551. [Google Scholar] [CrossRef] [PubMed]
- Fernández, L.; Rodríguez, J.M. Human Milk Microbiota: Origin and Potential Uses. Nestle Nutr. Inst. Workshop Ser. 2020, 94, 75–85. [Google Scholar] [CrossRef]
- Rodríguez, J.M. The origin of human milk bacteria: Is there a bacterial entero-mammary pathway during late pregnancy and lactation? Adv. Nutr. 2014, 5, 779–784. [Google Scholar] [CrossRef]
- Qi, C.; Zhou, J.; Tu, H.; Tu, R.; Chang, H.; Chen, J.; Li, D.; Sun, J.; Yu, R. Lactation-dependent vertical transmission of natural probiotics from the mother to the infant gut through breast milk. Food Funct. 2022, 13, 304–315. [Google Scholar] [CrossRef] [PubMed]
- Martín, R.; Langa, S.; Reviriego, C.; Jimínez, E.; Marín, M.L.; Xaus, J.; Fernández, L.; Rodríguez, J.M. Human milk is a source of lactic acid bacteria for the infant gut. J. Pediatr. 2003, 143, 754–758. [Google Scholar] [CrossRef]
- Wang, G.; Wang, X.; Ma, Y.; Cai, S.; Yang, L.; Fan, Y.; Zeng, X.; Qiao, S. Lactobacillus reuteri improves the development and maturation of fecal microbiota in piglets through mother-to-infant microbe and metabolite vertical transmission. Microbiome 2022, 10, 211. [Google Scholar] [CrossRef] [PubMed]
- Milani, C.; Duranti, S.; Bottacini, F.; Casey, E.; Turroni, F.; Mahony, J.; Belzer, C.; Delgado Palacio, S.; Arboleya Montes, S.; Mancabelli, L.; et al. The First Microbial Colonizers of the Human Gut: Composition, Activities, and Health Implications of the Infant Gut Microbiota. Microbiol. Mol. Biol. Rev. 2017, 81, e00036-e17. [Google Scholar] [CrossRef]
- Bergström, A.; Skov, T.H.; Bahl, M.I.; Roager, H.M.; Christensen, L.B.; Ejlerskov, K.T.; Mølgaard, C.; Michaelsen, K.F.; Licht, T.R. Establishment of intestinal microbiota during early life: A longitudinal, explorative study of a large cohort of Danish infants. Appl. Environ. Microbiol. 2014, 80, 2889–2900. [Google Scholar] [CrossRef]
- Dombrowska-Pali, A.; Wiktorczyk-Kapischke, N.; Chrustek, A.; Olszewska-Słonina, D.; Gospodarek-Komkowska, E.; Socha, M.W. Human Milk Microbiome—A Review of Scientific Reports. Nutrients 2024, 16, 1420. [Google Scholar] [CrossRef] [PubMed]
- Bozzi Cionci, N.; Baffoni, L.; Gaggìa, F.; Di Gioia, D. Therapeutic Microbiology: The Role of Bifidobacterium breve as Food Supplement for the Prevention/Treatment of Paediatric Diseases. Nutrients 2018, 10, 1723. [Google Scholar] [CrossRef]
- Lee, Z.M.; Bussema, C.; Schmidt, T.M. rrnDB: Documenting the number of rRNA and tRNA genes in bacteria and archaea. Nucleic Acids Res. 2009, 37, D489–D493. [Google Scholar] [CrossRef]
- Abrahamsson, T.R.; Sinkiewicz, G.; Jakobsson, T.; Fredrikson, M.; Björkstén, B. Probiotic lactobacilli in breast milk and infant stool in relation to oral intake during the first year of life. J. Pediatr. Gastroenterol. Nutr. 2009, 49, 349–354. [Google Scholar] [CrossRef] [PubMed]
- Alemu, B.K.; Azeze, G.G.; Wu, L.; Lau, S.L.; Wang, C.C.; Wang, Y. Effects of maternal probiotic supplementation on breast milk microbiome and infant gut microbiome and health: A systematic review and meta-analysis of randomized controlled trials. Am. J. Obstet. Gynecol. MFM 2023, 5, 101148. [Google Scholar] [CrossRef]
- Edwards, C.A.; Van Loo-Bouwman, C.A.; Van Diepen, J.A.; Schoemaker, M.H.; Ozanne, S.E.; Venema, K.; Stanton, C.; Marinello, V.; Rueda, R.; Flourakis, M.; et al. A systematic review of breast milk microbiota composition and the evidence for transfer to and colonisation of the infant gut. Benef. Microbes 2022, 13, 365–382. [Google Scholar] [CrossRef]
- Zaidi, A.Z.; Moore, S.E.; Okala, S.G. Impact of Maternal Nutritional Supplementation during Pregnancy and Lactation on the Infant Gut or Breastmilk Microbiota: A Systematic Review. Nutrients 2021, 13, 1137. [Google Scholar] [CrossRef] [PubMed]
- Moossavi, S.; Sepehri, S.; Robertson, B.; Bode, L.; Goruk, S.; Field, C.J.; Lix, L.M.; de Souza, R.J.; Becker, A.B.; Mandhane, P.J.; et al. Composition and Variation of the Human Milk Microbiota Are Influenced by Maternal and Early-Life Factors. Cell Host Microbe 2019, 25, 324–335.e324. [Google Scholar] [CrossRef]
- Gonia, S.; Heisel, T.; Miller, N.; Haapala, J.; Harnack, L.; Georgieff, M.K.; Fields, D.A.; Knights, D.; Jacobs, K.; Seburg, E.; et al. Maternal oral probiotic use is associated with decreased breastmilk inflammatory markers, infant fecal microbiome variation, and altered recognition memory responses in infants-a pilot observational study. Front. Nutr. 2024, 11, 1456111. [Google Scholar] [CrossRef] [PubMed]
- Baldassarre, M.E.; Di Mauro, A.; Mastromarino, P.; Fanelli, M.; Martinelli, D.; Urbano, F.; Capobianco, D.; Laforgia, N. Administration of a Multi-Strain Probiotic Product to Women in the Perinatal Period Differentially Affects the Breast Milk Cytokine Profile and May Have Beneficial Effects on Neonatal Gastrointestinal Functional Symptoms. A Randomized Clinical Trial. Nutrients 2016, 8, 677. [Google Scholar] [CrossRef]
- Xi, M.; Yan, Y.; Duan, S.; Li, T.; Szeto, I.M.; Zhao, A. Short-chain fatty acids in breast milk and their relationship with the infant gut microbiota. Front. Microbiol. 2024, 15, 1356462. [Google Scholar] [CrossRef]
- Jones, J.M.; Reinke, S.N.; Mousavi-Derazmahalleh, M.; Garssen, J.; Jenmalm, M.C.; Srinivasjois, R.; Silva, D.; Keelan, J.; Prescott, S.L.; Palmer, D.J.; et al. Maternal prebiotic supplementation during pregnancy and lactation modifies the microbiome and short chain fatty acid profile of both mother and infant. Clin. Nutr. 2024, 43, 969–980. [Google Scholar] [CrossRef]
- Wang, S.; Ryan, C.A.; Boyaval, P.; Dempsey, E.M.; Ross, R.P.; Stanton, C. Maternal Vertical Transmission Affecting Early-life Microbiota Development. Trends Microbiol. 2020, 28, 28–45. [Google Scholar] [CrossRef]
- Rousseau, C.; Levenez, F.; Fouqueray, C.; Doré, J.; Collignon, A.; Lepage, P. Clostridium difficile colonization in early infancy is accompanied by changes in intestinal microbiota composition. J. Clin. Microbiol. 2011, 49, 858–865. [Google Scholar] [CrossRef] [PubMed]
- Rutayisire, E.; Huang, K.; Liu, Y.; Tao, F. The mode of delivery affects the diversity and colonization pattern of the gut microbiota during the first year of infants’ life: A systematic review. BMC Gastroenterol. 2016, 16, 86. [Google Scholar] [CrossRef]
- Lundgren, S.N.; Madan, J.C.; Emond, J.A.; Morrison, H.G.; Christensen, B.C.; Karagas, M.R.; Hoen, A.G. Maternal diet during pregnancy is related with the infant stool microbiome in a delivery mode-dependent manner. Microbiome 2018, 6, 109. [Google Scholar] [CrossRef]
- Dotterud, C.K.; Avershina, E.; Sekelja, M.; Simpson, M.R.; Rudi, K.; Storrø, O.; Johnsen, R.; Øien, T. Does Maternal Perinatal Probiotic Supplementation Alter the Intestinal Microbiota of Mother and Child? J. Pediatr. Gastroenterol. Nutr. 2015, 61, 200–207. [Google Scholar] [CrossRef]
- Li, F.; Liu, J.; Maldonado-Gómez, M.X.; Frese, S.A.; Gänzle, M.G.; Walter, J. Highly accurate and sensitive absolute quantification of bacterial strains in human fecal samples. Microbiome 2024, 12, 168. [Google Scholar] [CrossRef]
- Catassi, G.; Aloi, M.; Giorgio, V.; Gasbarrini, A.; Cammarota, G.; Ianiro, G. The Role of Diet and Nutritional Interventions for the Infant Gut Microbiome. Nutrients 2024, 16, 400. [Google Scholar] [CrossRef] [PubMed]
- Corvaglia, L.; Tonti, G.; Martini, S.; Aceti, A.; Mazzola, G.; Aloisio, I.; Di Gioia, D.; Faldella, G. Influence of Intrapartum Antibiotic Prophylaxis for Group B Streptococcus on Gut Microbiota in the First Month of Life. J. Pediatr. Gastroenterol. Nutr. 2016, 62, 304–308. [Google Scholar] [CrossRef]
- Lai, C.; Huang, L.; Wang, Y.; Huang, C.; Luo, Y.; Qin, X.; Zeng, J. Effect of different delivery modes on intestinal microbiota and immune function of neonates. Sci. Rep. 2024, 14, 17452. [Google Scholar] [CrossRef]
- Shao, Y.; Forster, S.C.; Tsaliki, E.; Vervier, K.; Strang, A.; Simpson, N.; Kumar, N.; Stares, M.D.; Rodger, A.; Brocklehurst, P.; et al. Stunted microbiota and opportunistic pathogen colonization in caesarean-section birth. Nature 2019, 574, 117–121. [Google Scholar] [CrossRef] [PubMed]

| Target Microorganisms | Primer Sequences (5′-3′) | Amplicon Length (bp) | Annealing Temperature |
|---|---|---|---|
| Bifidobacterium spp. | |||
| BifTOT-F | TCGCGTCYGGTGTGAAAG | 243 | 55 °C |
| BifTOT-R | CCACATCCAGCRTCCAC | ||
| Lactobacillus spp. | |||
| Lac-F | GCAGCAGTAGGGAATCTTCCA | 349 | 60 °C |
| Lac-R | GCATTYCACCGCTACACATG | ||
| Bacteroides fragilis group | |||
| Bfra-F | CGGAGGATCCGAGCGTTA | 92 | 58 °C |
| Bfra-R | CCGCAAACTTTCACAACTGACTTA | ||
| Clostridium spp. | |||
| CI-F1 | TACCHRAGGAGGAAGCCAC | 232 | 52 °C |
| CI-F2 | GTTCTTCCTAATCTCTACGCAT | ||
| Target Primers | Initial Denaturation | Denaturation | Annealing | Cycles | Fw nM | Rev nM |
|---|---|---|---|---|---|---|
| Bifidobacterium spp. BifTOT F/BifTOT-R | 95 °C, 20 s | 95 °C, 30 s | 60 °C, 30 s | 40 | 200 | 300 |
| Lactobacillus spp. LAC-F/LAC-R | 95 °C, 20 s | 95 °C, 30 s | 60 °C, 30 s | 40 | 200 | 200 |
| Bacteroides fragilis group Bfra-F/Bfra-R | 95 °C, 20 s | 95 °C, 30 s | 60 °C, 30 s | 40 | 300 | 300 |
| Clostridium cluster I CI-F1/CI-F2 | 95 °C, 20 s | 95 °C, 30 s | 60 °C, 30 s | 40 | 200 | 200 |
| Supplemented Group (n = 15) | Control Group (n = 12) | p-Value | |
|---|---|---|---|
| Maternal age (years), median (IQR) | 34 (31–37) | 36.5 (34–38.5) | 0.130 |
| Smoking during pregnancy, n (%) | 0 (0) | 1 (8) | 0.444 |
| Pre-pregnancy BMI, median (IQR) | 21 (20–23.5) | 20 (19–21) | 0.183 |
| BMI at birth, median (IQR) | 26 (23–26.7) | 25 (24.5–27) | 0.936 |
| GA at birth (weeks), median (IQR) | 40 (39–40.5) | 39.85 (39–40.5) | 1.000 |
| Neonatal birth weight (g), median (IQR) | 3325 (3145–3410) | 3400 (3193–3663) | 1.000 |
| Maternal Milk Samples | Bifidobacterium spp. (Log10 CFU/mL) | p-Value | Lactobacillus spp. (Log10 CFU/mL) | p-Value | ||
|---|---|---|---|---|---|---|
| T0 | T1 | T0 | T1 | |||
| Supplemented, median (IQR) | 3.45 (2.84–3.68) | 3.78 (3.07–4.19) | 0.125 | 5.58 (4.02–6.12) | 5.18 (3.47–6.38) | 0.629 |
| Controls, median (IQR) | 3.78 (3.06–4.66) | 3.38 (2.46–4.72) | 0.272 | 5.77 (4.15–6.06) | 5.49 (4.76–6.03) | 0.754 |
| Neonatal Fecal Samples | Bifidobacterium spp. (Log10 CFU/mL) | p-Value | Lactobacillus spp. (Log10 CFU/mL) | p-Value | ||
|---|---|---|---|---|---|---|
| T0 | T1 | T0 | T1 | |||
| Supplemented, median (IQR) | 5.69 (5.22–6.23) | 7.33 (6.71–8.20) | <0.001 | 5.09 (4.07–7.46) | 7.05 (5.74–7.41) | 0.029 |
| Controls, median (IQR) | 5.97 (5.19–6.48) | 6.98 (5.74–7.44) | 0.097 | 5.47 (5.04–6.89) | 7.00 (5.86–7.71) | 0.123 |
| Neonatal Fecal Samples | Clostridium spp. (Log10 CFU/mL) | p-Value | Bacteroides spp. (Log10 CFU/mL) | p-Value | ||
|---|---|---|---|---|---|---|
| T0 | T1 | T0 | T1 | |||
| Supplemented, median (IQR) | 2.48 (2.00–4.13) | 3.57 (2.22–4.63) | 0.003 | 8.25 (4.66–8.74) | 8.16 (4.66–9.10) | 0.615 |
| Controls, median (IQR) | 3.72 (2.38–5.07) | 2.66 (2.21–3.54) | 0.046 | 6.77 (4.55–8.54) | 6.06 (3.17–9.14) | 0.207 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.
Share and Cite
Pagliarini, E.; Poli, C.; Martini, S.; Cimatti, A.G.; Di Gioia, D.; Corvaglia, L.T. Effect of Supplementation with Lactobacillus reuteri SGL 01 in Lactating Women on Breast Milk and Neonatal Gut Microbiota: An Exploratory, Randomized, Open-Label Clinical Trial. Nutrients 2026, 18, 794. https://doi.org/10.3390/nu18050794
Pagliarini E, Poli C, Martini S, Cimatti AG, Di Gioia D, Corvaglia LT. Effect of Supplementation with Lactobacillus reuteri SGL 01 in Lactating Women on Breast Milk and Neonatal Gut Microbiota: An Exploratory, Randomized, Open-Label Clinical Trial. Nutrients. 2026; 18(5):794. https://doi.org/10.3390/nu18050794
Chicago/Turabian StylePagliarini, Elia, Caterina Poli, Silvia Martini, Anna Giulia Cimatti, Diana Di Gioia, and Luigi Tommaso Corvaglia. 2026. "Effect of Supplementation with Lactobacillus reuteri SGL 01 in Lactating Women on Breast Milk and Neonatal Gut Microbiota: An Exploratory, Randomized, Open-Label Clinical Trial" Nutrients 18, no. 5: 794. https://doi.org/10.3390/nu18050794
APA StylePagliarini, E., Poli, C., Martini, S., Cimatti, A. G., Di Gioia, D., & Corvaglia, L. T. (2026). Effect of Supplementation with Lactobacillus reuteri SGL 01 in Lactating Women on Breast Milk and Neonatal Gut Microbiota: An Exploratory, Randomized, Open-Label Clinical Trial. Nutrients, 18(5), 794. https://doi.org/10.3390/nu18050794

