The first 1000 days of life, from conception up until 2 years of age, provides a narrow window of opportunity to establish a healthy and resilient microbiome for your growing baby.  This vast yet invisible ecosystem that lives in and on the body, plays an important role in supporting the growth and development of your child, both now and in the future.[1]  Just like earths ecosystem sustains a healthy planet, our microbiome sustains a healthy ‘us’.

Research has shown the establishment of your infant’s microbiome heavily relies on your own microbial health. The sharing of ecosystems between mother and baby can occur through various pathways, including the birthing process, skin-to-skin contact and a relatively new discovery known as the gut-breast axis.[2]

This precious microbial bond between you and your child highlights the importance of taking care of your microbes, throughout pregnancy, breastfeeding and beyond.[1] 

Yet, despite this important discovery, many expecting mothers are unaware of their microbiome, what it is and how to care for it.

Therefore, we have broken down this important information to help you better prepare for this special and important time in your (and your babies) life.


What is the gut-breast axis?

It seems like every other day there is a new discovery that puts the gut microbiome at the centre of our health.  Research has recently uncovered several pathways that exist between the gut microbiome and different systems of the body, including:

And it is likely that many more gut-organ axes are yet to be discovered. 

In each of these pathways the gut can communicate with distant organs, sending messages that can influence health and function.[3]

The gut-breast axis is no different.

Hormonal changes throughout pregnancy prepare both the gut and the breast for the needs of the growing infant. Changes in the gut help to increase nutrient uptake and absorption, while changes in the breast allow for the delivery of these nutrients to the baby via breast milk.[1][4]

Together, the gut and breast form a close partnership with a common goal; to replace the role of the placenta and provide nourishment to the baby after birth.


Breast milk: A shared ecosystem[5]

Breast milk is a complex and nutritious food source.  In addition to providing an ideal balance of nutrients, breast milk also contains many other bio-active components such as immune cells, hormones and microbes that collectively support early growth and development of the baby.  With its rich supply of human milk oligosaccharides (HMO’s), a preferred food source for beneficial microbes, breast milk makes the ideal habitat.[6]  


The journey from gut to breast

In addition to microbes sourced from local skin and breast tissue, microbes present in breast milk are also believed to originate from the mother’s gut.[2]

Recent research has identified a unique pathway via which microbes may travel from the mother’s gut straight through to the breast milk, essentially by hitch-hiking a ride on maternal immune cells. This pathway forms part of the gut-breast axis and explains how gut microbes are often found in breast milk samples .[7]


Mastitis: An imbalanced ecosystem? [8]

A balanced breast milk microbiome allows for the delivery of a diverse mix of beneficial microbes straight to the infant gut, with added benefits for the baby’s oral microbiome along the way.

However, a combination of factors including genetics, cracked nipples and blocked ducts, can lead to an imbalanced breast microbiome. This, in turn, can result in a condition known as mastitis.[8]

What is mastitis?

    Mastitis is a condition which causes pain and swelling of the breast making it difficult to breastfeed. It is a common condition which can affect between 5-33% of  breastfeeding women and is associated with early weaning, a potentially distressing experience for both mother and baby.[8][9]

    How do you treat mild mastitis?

      Mild mastitis can resolve through self-management techniques, including:

      • Self-massage
      • Feeding on the affected side
      • Cold compress – such as the traditional remedy of cold cabbage leaves [9][10]

        For moderate-severe mastitis, it is best to speak to your health professional.

        Can you prevent mastitis?

          While genetics can play a role, mastitis is also linked with lifestyle factors including high stress, tight clothing and missed feeds.[8][9] Seeking support for breastfeeding, as well as taking care of your general physical and mental health may help to prevent recurrent episodes of mastitis.


          The role of probiotics

          A probiotic is defined as a live microorganism that provides health benefits, similar to those provided by the beneficial microorganisms that naturally inhabit the human body.[1] 

          Lactobacillus fermentum CECT5716 is a particular strain of probiotic bacteria native to breast milk, that can also provide health benefits when supplemented as a probiotic.  Research has shown Lactobacillus fermentum CECT5716 can help relieve symptoms of mild mastitis while breastfeeding.[4][11]


          Putting it all together

          Taking care of your microbial health during pregnancy, breastfeeding and beyond, not only helps to keep you healthy, but your newborn as well.

          A combination of a healthy diet and lifestyle, in addition to probiotic supplements, may help support a healthy breast-feeding experience, so that you and your baby can enjoy this precious journey while laying the foundations to support health and wellbeing. 

          [1] Robertson RC, Manges AR, Finlay BB, Prendergast AJ. The human microbiome and child growth–first 1000 days and beyond. Trends in Microbiology. 2019 Feb 1;27(2):11-47.

          [2] Rodríguez JM, Fernández L, Verhasselt V. The gut‒breast axis: Programming health for life. Nutrients. 2021 Feb;13(2):606.

          [3] Ahlawat S, Sharma KK. Gut–organ axis: a microbial outreach and networking. Letters in applied microbiology. 2021 Jun;72(6):636-68.

          [4] Mesa MD, Loureiro B, Iglesia I, Fernandez Gonzalez S, Llurba Olivé E, Garcia Algar O, Solana MJ, Cabero Perez M, Sainz T, Martinez L, Escuder-Vieco D. The evolving microbiome from pregnancy to early infancy: A comprehensive review. Nutrients. 2020 Jan;12(1):133.

          [5] Pannaraj PS, Li F, Cerini C, Bender JM, Yang S, Rollie A, Adisetiyo H, Zabih S, Lincez PJ, Bittinger K, Bailey A. Association between breast milk bacterial communities and establishment and development of the infant gut microbiome. JAMA pediatrics. 2017 Jul 1;171(7):647-54.

          [6] Wiciński M, Sawicka E, Gębalski J, Kubiak K, Malinowski B. Human Milk Oligosaccharides: Health Benefits, Potential Applications in Infant Formulas, and Pharmacology. Nutrients. 2020;12(1):266. Published 2020 Jan 20. doi:10.3390/nu12010266

          [7] Hurtado JA, Maldonado-Lobón JA, Díaz-Ropero MP, Flores-Rojas K, Uberos J, Leante JL, Affumicato L, Couce ML, Garrido JM, Olivares M, Fonollá J. Oral administration to nursing women of Lactobacillus fermentum CECT5716 prevents lactational mastitis development: A randomized controlled trial. Breastfeeding Medicine. 2017 May 1;12(4):202-9.

          [8] Contreras GA, Rodríguez JM. Mastitis: comparative etiology and epidemiology. Journal of mammary gland biology and neoplasia. 2011 Dec;16(4):339-56.

          [9] Wilson E, Woodd SL, Benova L. Incidence of and risk factors for lactational mastitis: A systematic review. Journal of Human Lactation. 2020 Nov;36(4):673-86.

          [10] Kataria K, Srivastava A, Dhar A. Management of lactational mastitis and breast abscesses: review of current knowledge and practice. Indian Journal of Surgery. 2013 Dec;75(6):430-5.

          [11] Maldonado-Lobón, Jose A., Miguel A. Díaz-López, Raffaele Carputo, Pilar Duarte, Maria Paz Díaz-Ropero, Antonio D. Valero, Ana Sanudo et al. "Lactobacillus fermentum CECT 5716 reduces Staphylococcus load in the breastmilk of lactating mothers suffering breast pain: A randomized controlled trial." Breastfeeding Medicine 10, no. 9 (2015): 425-432.