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Updated: Sep 15, 2025
Individualized Reconstitution of Human Milk Microbiota: A Feasible Approach in Real-World Settings
Published on: February 7, 2025
Immune development differs between preterm newborns fed mothers' own milk and donor milk
Ziyang Tan1, Wen Zhong2, Hanna Danielsson3,4
1Unit for Clinical Pediatrics, Department of Women's and Children's Health, Karolinska Institutet, 17165 Solna, Sweden.
Insights
Extremely preterm infants show slower immune development. Mother's own milk supports immune maturation, resembling that of term infants, potentially due to bioactive milk components.
Area of Science:
- Neonatal immunology
- Systems biology
- Developmental pediatrics
Background:
- Extremely preterm infants face risks of immune-mediated complications.
- Preterm infants possess distinct immunology at birth, converging with term infants over 3 months.
Purpose of the Study:
- To analyze immune development variations in extremely preterm infants.
- To identify factors influencing immune system maturation in early postnatal life.
Main Methods:
- Systems-level analysis of immune development.
- Study included 72 preterm infants born as early as 22 weeks gestation.
- Comparison of immune trajectories based on feeding (mother's own milk vs. donor milk).
Main Results:
- Immune development trajectories were similar but slower in infants born at 22-24 weeks.
- Preterm infants fed mother's own milk exhibited immune development closer to term-born infants.
- This normalization, particularly in NK cell development, was independent of microbial colonization.
Conclusions:
- Gestational age influences the pace of early immune development.
- Mother's own milk promotes immune maturation in extremely preterm infants.
- Bioactive milk molecules may directly impact immune cell development in preterm neonates.
Abstract:
Extremely preterm infants are at risk of immune-mediated complications such as infections and inflammatory conditions like bronchopulmonary dysplasia and necrotizing enterocolitis. Preterm infants are immunologically distinct from term infants at birth, but subsequently undergo adaptive postnatal changes resulting in immunological convergence during their first 3 months. Here, we performed a systems-level analysis of immune development in 72 preterm infants born as early as 22 weeks to investigate factors associated with variation. We find similar immune trajectories during early postnatal immune development but occurring more slowly in infants born at 22-24 weeks. Immune development showed a greater resemblance to that of term-born children in preterm infants fed mother's own milk compared to donor milk. This developmental normalization was manifested by NK cell development and was not explained by differences in microbial colonization between feeding groups, possibly suggesting direct effects of bioactive milk molecules on developing immune cells in extremely preterm infants.
