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Beyond breastfeeding: a One Health Decalogue for nurturing the infant microbiota
Valentina Biagioli1,2, Mariarosaria Matera2,3, Ilaria Cavecchia2,4
1Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.
Frontiers in Nutrition
|March 23, 2026
Summary
For mothers unable to breastfeed, a One Health Decalogue offers 10 practical principles. This evidence-based guidance supports infant gut health, immune development, and overall well-being, promoting healthy growth beyond breastfeeding.
Area of Science:
- Pediatric Nutrition
- Microbiome Research
- Public Health
Background:
- Early-life nutrition critically impacts infant gut microbiota, immune system maturation, and long-term health.
- Breastfeeding is optimal, but many mothers cannot breastfeed, necessitating evidence-based alternatives.
- A One Health approach integrates diverse factors influencing maternal-infant health.
Purpose of the Study:
- To synthesize evidence on infant nutrition for non-breastfed infants.
- To develop practical, actionable guidance for mothers unable to breastfeed.
- To create a translational framework supporting infant health beyond breastfeeding.
Main Methods:
- A narrative literature review was performed using PubMed, Scopus, and Google Scholar (2020-2026).
- Evidence synthesis focused on maternal/infant nutrition, breast milk components, formula feeding, and infant health outcomes.
- A translational
- One Health Decalogue
- was developed based on interdisciplinary findings.
Main Results:
- Infant nutrition significantly affects gut microbiota, immune programming, metabolic regulation, and neurodevelopment in non-breastfed infants.
- Modifiable factors include formula composition, feeding practices, maternal health, environment, and support systems.
- The One Health Decalogue provides 10 principles for microbial resilience and healthy development.
Conclusions:
- Translating scientific evidence into practical tools is crucial for non-breastfed infants.
- The One Health Decalogue offers a comprehensive framework for healthcare professionals, families, and policymakers.
- This framework supports informed nutritional choices and holistic strategies to optimize infant health.
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