Nature Review: Bode et al. Discovers New Reason to Breastfeed

Lars Bode, PhD

Nature Review Research Highlight, January 2012: Dr. Lars Bode, Assistant Professor in neonatal medicine and pediatric gastroenterology and nutrition at UC San Diego’s Department of Pediatrics, recently published in GUT that human milk oligosaccharides (HMO) significantly lowered the risk of Necrotizing Enterocolitis (NEC) in neonatal rats.

Necrotizing enterocolitis (NEC) is one of the most frequent and often fatal intestinal disorders in premature infants. Up to 5% of all premature infants with a very low birth weight develop NEC. More than a quarter of them die from this devastating disease and the survivors are often faced with severe long-term complications. Why and how NEC develops remains poorly understood and treatment is limited with surgical removal of the necrotic intestine often being the last option.

According to previous studies, breast-fed infants are at a 6- to 10-fold lower risk of developing NEC than formula-fed infants.

“Human milk oligosaccharides are complex sugars that are highly abundant in human milk, but not in infant formula,” explains Dr. Bode. “Previous studies had suggested that HMO affect the infant’s immune system as well as the composition of bacteria in the infant’s gut, and both seem to be involved in the development of NEC.”

In the GUT research paper, Bode et al. have found that out of the 150+ oligosaccharides that are unique to human milk, a single oligosaccharide, Disialyllacto-N-tetraose (DSLNT), is responsible for the beneficial effects of lowering the risk of NEC in neonatal rats. In addition, the published results show that galactooligosaccharides (GOS), which are currently used as HMO-like oligosaccharides to supplement infant formula, have no effect on NEC in neonatal rats.

The GUT research paper will be featured as a Nature Reviews Gastroenterology and Hepatology Research Highlight in early February 2012.

“It has been very exciting to be part of this project, especially since it may directly impact the lives of preterm infants”, says Dr. Evelyn Jantscher-Krenn, first author on the GUT paper and a postdoctoral fellow in Dr. Bode’s lab. “But this is only the beginning,” states Bode whose lab is now eager to find out how exactly the oligosaccharide prevents NEC from developing and how well these findings will translate from the animal model to human infants. “In the end, our goal is not to cure rats; we want to save lives!”

In discovering the correlation between DSLNT levels and its impact on reducing NEC in neonates, the study also suggests that low DSLNT concentrations in the mother’s milk might become a non-invasive biomarker to identify breast-fed infants at risk to develop NEC.

“While supplementing infant formula with DSLNT might protect the formula-fed infant from NEC, it is still an incredibly expensive and highly complex process,” says Bode. “Human milk is often the sole dietary source for the first few months in life. It contains all the nutrients necessary for the infant to thrive, but also ingredients such as HMO that may provide health benefits beyond those of traditional nutrients.”

The research study was conducted in collaboration with the UCSD Glycotechnology Center and Dr. Henri Ford’s Research Group, Children’s Hospital Los Angeles, and was funded by the NIH Pathway to Independence Award, NIH, and in part by Abbott Nutrition.

“Our ultimate goal is to encourage mothers to breastfeed their infants. People always think we do basic research with the goal to develop new drugs, but increasing the rate of breastfeeding would help the most,” says Bode.

ABOUT SPIN at UC San Diego

Premature infants who receive human breast milk have the best outcomes – medically, nutritionally, and developmentally. Within the Neonatology Division at UC San Diego’s Department of Pediatrics in the School of Medicine, the Supporting Premature Infant Nutrition (SPIN) program was developed to address the challenges of helping mothers produce sufficient breast milk for their premature infants, and to improve the manner in which neonatal intensive care unit (NICUs) support optimal nutrition and growth in their most vulnerable population of patients.

ABOUT THE BODE LAB

The Bode lab is part of the Division of Neonatology and Division of Pediatric Gastroenterology, Hepatology and Nutrition within the Department of Pediatrics at UC San Diego’s School of Medicine. Dr. Bode is the Chair of the Lactation Research Interest Section (RIS) for the American Society for Nutrition (ASN) and a Counsel Member on the Executive Committee for the International Society for Research in Human Milk and Lactation (ISRHML). Currently, Bode is developing a new research program at UC San Diego’s School of Medicine to investigate the functions and biosynthesis of Human Milk Oligosaccharides (HMO). A major challenge for the Bode Lab, and biomedical research in the 21st century at large, is to figure out how HMO are synthesized in the human mammary gland, and how they benefit the breast-fed infant.

www.bodelab.com

Written by: Shivani Singh, MS, Sr. Writer, Department of Pediatrics, UC San Diego and Rady Children’s Hospital, San Diego Scientific Contact: Lars Bode, PhD, Asst. Professor, Neonatology and Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, UC San Diego and Rady Children’s Hospital, San Diego lbode@ucsd.edu