title: The very low birth weight infant microbiome and childhood health.
abstract: This review describes current understandings about the nature of the very low birth weight infant (VLBW) gut microbiome. VLBW infants often experience disruptive pregnancies and births, and prenatal factors can influence the maturity of the gut and immune system, and disturb microbial balance and succession. Many VLBWs experience rapid vaginal or Caesarean births. After birth these infants often have delays in enteral feeding, and many receive little or no mother's own milk. Furthermore the stressors of neonatal life in the hospital environment, common use of antibiotics, invasive procedures and maternal separation can contribute to dysbiosis. These infants experience gastrointestinal dysfunction, sepsis, transfusions, necrotizing enterocolitis, oxygen toxicity, and other pathophysiological conditions that affect the normal microbiota. The skin is susceptible to dysbiosis, due to its fragility and contact with NICU organisms. Dysbiosis in early life may resolve but little is known about the timing of the development of the signature gut microbiome in VLBWs. Dysbiosis has been associated with a number of physical and behavioral problems, including autism spectrum disorders, allergy and asthma, gastrointestinal disease, obesity, depression, and anxiety. Dysbiosis may be prevented or ameliorated in part by prenatal care, breast milk feeding, skin to skin contact, use of antibiotics only when necessary, and vigilance during infancy and early childhood.
authors.affiliation: Morsani College of Medicine, University of South Florida College of Nursing, Tampa, Florida.
authors.forename: Maureen W
authors.initials: MW
authors.lastname: Groer
authors.affiliation: Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.|Department of Nursing, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Gregory
authors.affiliation: Morsani College of Medicine, University of South Florida College of Nursing, Tampa, Florida.
authors.forename: Adetola
authors.initials: A
authors.lastname: Louis-Jacques
authors.affiliation: Ochsner Health System, New Orleans, Louisiana.
authors.forename: Shelley
authors.initials: S
authors.lastname: Thibeau
authors.affiliation: Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: W Allan
authors.initials: WA
authors.lastname: Walker
mesh_terms: D041981:Gastrointestinal Tract / Q000382:microbiology*; D006304:Health Status; D006801:Humans; D007223:Infant; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D064307:Microbiota / Q000502:physiology*
keywords: childhood diseases; microbome; preterm infant