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Modulation of rotavirus enteritis during breast-feeding. Implications on alterations in the intestinal bacterial
Insights
Breastfeeding may reduce rotavirus gastroenteritis severity in infants by promoting beneficial gut bacteria. While infection rates were similar, breast-fed infants experienced milder illness, suggesting a protective effect of altered fecal flora.
Area of Science:
- Pediatrics
- Microbiology
- Gastroenterology
Background:
- Rotavirus (RV) infection is a significant cause of infant gastroenteritis.
- Feeding methods, particularly breastfeeding, may influence infant health outcomes.
- The role of gut microbiota in modulating viral infections is an area of active research.
Purpose of the Study:
- To investigate the impact of long-term infant feeding methods (breast milk vs. formula) on rotavirus infection rates and clinical presentation.
- To analyze the association between feeding method, fecal microbiota composition, and rotavirus gastroenteritis severity.
Main Methods:
- Prospective cohort study of 197 infants over one rotavirus season.
- Feeding classification based on long-term breast milk or formula intake (≥18 weeks).
- Rotavirus detection in feces using electron microscopy and enzyme-linked immunosorbent assay (ELISA); fecal flora analysis via bacterial cultures, biochemical reactions, and gas-liquid chromatography.
Main Results:
- No significant difference in rotavirus enteritis infection rates between breast-fed (20%) and bottle-fed (17%) infants.
- Breast-fed infants exhibited milder clinical manifestations of rotavirus illness.
- Breast-fed infants showed significantly higher levels of fecal bifidobacteria during lactation compared to bottle-fed infants.
Conclusions:
- Breastfeeding does not alter rotavirus infection rates but appears to reduce illness severity.
- The presence of bifidobacteria in the gut, promoted by breastfeeding, may be associated with milder rotavirus gastroenteritis.
- Alterations in enteric flora induced by breastfeeding may modulate the clinical course of rotavirus gastroenteritis through mechanisms mediated by human milk.
Abstract:
A cohort of 197 infants was followed up prospectively for a single rotavirus (RV) season, 1983 to 1984, to examine the effect of long-term feeding method on RV infection. The feeding classification distinguished breast vs formula milk intake over the long term, for at least 18 weeks from birth (approximately four months). During the follow-up period, relative numbers of RV particles in feces were compared by electron microscopy, and positive specimens were confirmed by an enzyme-linked immunosorbent assay. There was no apparent difference in the infection rates of rotavirus enteritis in breast-fed (20%) as compared with bottle-fed (17%) infants. However, clinical manifestation of illness was milder in breast-fed infants. Among the breast-fed subjects, fecal flora identified by bacterial cultures, biochemical reaction, and gas-liquid chromatography revealed a significant growth of bifidobacteria lasting as long as the period of lactation. Colonization by this organism above the detection level of log 10(5)/mL was not observed in the feces of bottle-fed infants. These data suggest that alterations in enteric flora induced by breast-feeding may be correlates of intraluminal events, mediated by human milk, that modulate the clinical course of RV gastroenteritis.