Human milk sugars for the prevention of brain injury in extreme preterm infants
Can we use human milk sugars to protect preterm infants from developing brain injury?
In a public private partnership between the UMC Utrecht and Danone Nutricia Research, this project aims to identify human milk sugars (HMS) that protect preterm infants from developing brain injury. Additionally, we tested in an experimental model whether supplementation with HMS can be used as a therapeutic approach for preterm brain injury.
Approximately 10% of all babies are born preterm. Of the surviving extremely preterm born infants, 50% will develop brain injury, leading to life-long neurodevelopmental impairments, and effective therapies are currently lacking. Neonatal infections in preterm infants are an important risk factor for the development of brain injury and breast milk is known to protect against infections. Human milk sugars (HMS) are the third most abundant components of human milk, but the quantity of specific HMS-structures in milk varies widely between mothers. It has been demonstrated that absence of specific HMS increase the risk of infections in preterm infants.
Whether specific HMS also provide protection against development of preterm brain injury is not known and was investigated in this project. The neuroprotective effects of specific HMS would allow future characterization of HMS profiles in breast milk to identify those preterm infants at (higher) risk for impaired neurodevelopment. In addition, breast milk supplemented with specific HMS in early-life may be used as a preventative therapy to reduce the risk of brain injury in extreme preterm infants.
Breast milk samples were collected of 80 extremely preterm infants. The profiles of HMS will be correlated to brain injury on MRI at term-equivalent age. Additionally, an experiment model demonstrated that early-life HMS supplementation protected against the development of preterm brain injury, potentially through regulating the gut microbiota and brain immune cells. These findings suggest that early-life supplementation with HMS may indeed be a promising strategy to improve neurodevelopmental outcome following preterm birth.
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