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Front. Immunol. | doi: 10.3389/fimmu.2018.00361

Mother’s milk: A purposeful contribution to the development of the infant microbiota and immunity

Kirsty Le Doare1,  Beth Holder1,  Aisha Bassett2 and  Pia Pannaraj2*
  • 1Imperial College London, United Kingdom
  • 2Pediatric Infectious Diseases, Children's Hospital of Los Angeles, United States

Breast milk is the perfect nutrition for infants, a result of millions of years of evolution. In addition to providing a source of nutrition, breast milk contains a diverse array of microbiota and myriad biologically active components that are thought to guide the infant’s developing mucosal immune system. It is believed that bacteria from the mother’s intestine may translocation to breast milk and dynamically transfer to the infant. Such interplay between mother and her infant is key to establishing a healthy infant intestinal microbiome. These intestinal bacteria protect against many respiratory and diarrhoeal illnesses, but are subject to environmental stresses such as antibiotic use. Orchestrating the development of the microbiota are the human milk oligosaccharides (HMO), the synthesis of which are partially determined by the maternal genotype. HMOs are thought to play a role in preventing pathogenic bacterial adhesion though multiple mechanisms, whilst also providing nutrition for the microbiome. Extracellular vesicles (EV), including exosomes, carry a diverse cargo, including mRNA, miRNA and cytosolic and membrane-bound proteins, and are readily detectable in human breast milk. Strongly implicated in cell-cell signalling, extracellular vesicles could therefore may play a further role in the development of the infant microbiome. This review considers the emerging role of breast milk microbiota, bioactive HMOs and EVs in the establishment of the neonatal microbiome and the consequent potential for modulation of neonatal immune system development.

Keywords: breast milk, microbiota, microbiome, human milk oligosaccharides, Exosomes, Extracellular vescicles, infant microbiome, breast milk microbiome

Received: 28 Oct 2017; Accepted: 08 Feb 2018.

Edited by:

Arnaud Marchant, Université libre de Bruxelles, Belgium

Reviewed by:

Sarah Rowland-Jones, Nuffield Department of Medicine, Medical Sciences Division, University of Oxford, United Kingdom
Valerie Verhasselt, University of Western Australia, Australia  

Copyright: © 2018 Le Doare, Holder, Bassett and Pannaraj. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Pia Pannaraj, Children's Hospital of Los Angeles, Pediatric Infectious Diseases, 4650 W. Sunset Blvd, MS#51, Los Angeles, 91011, CA, United States,