Breastfeeding Is Associated with Lower Likelihood of Helicobacter Pylori Colonization in Babies, Based on a Prospective USA Maternal-Infant Cohort

Shailja C. Shah, Leonid Tarassishin, Caroline Eisele, Alexa Rendon, Anketse Debebe, Kelly Hawkins, Christen Hillenbrand, Manasi Agrawal, Joana Torres, Richard M. Peek, Joanne Stone, Marla Dubinsky, Jean Frederic Colombel, Inga Peter, Jianzhong Hu

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Mother-to-child transmission of Helicobacter pylori (H. pylori) is the primary source of intrafamilial spread in early childhood in regions of high H. pylori prevalence. However, early-in-life H. pylori colonization and associated protective or risk factors have not been fully evaluated in lower prevalence regions, such as the USA. Aims: Therefore, from a well-characterized prospective US cohort, we selected women who provided fecal samples during pregnancy and had paired fecal samples from their babies up to 24 months postpartum. We evaluated maternal and baby factors associated with likelihood of H. pylori colonization in the babies. Fecal antigen testing was used to determine H. pylori status. We also evaluated the association between maternal breastmilk cytokines and H. pylori colonization in breastfed babies. Results: Among included mother-baby pairs (n = 66), H. pylori prevalence was 31.8% in mothers and 19.7% in their babies. Dominant breastfeeding (adjusted odds ratio [aOR] 0.17, 95% CI 0.03–0.98) and maternal IBD (aOR 0.05, 95% CI 0.01–0.27) were associated with significantly lower likelihood of H. pylori colonization among babies; no other clinical factors were associated with H. pylori colonization in the babies. Matrix metalloproteinase-10 (MMP-10) and tumor necrosis factor-related activation-induced cytokine expression were significantly higher in breastmilk of mothers with H. pylori positive vs negative babies. Conclusions: Consistent with data from high H. pylori prevalence regions, our findings suggest dominant breastfeeding may protect against early H. pylori colonization. Downregulation of pro-inflammatory cytokines such as MMP-10 may be relevant in mediating this protection among breastfed babies, but more data are needed.

Original languageEnglish
Pages (from-to)5149-5157
Number of pages9
JournalDigestive Diseases and Sciences
Volume67
Issue number11
DOIs
StatePublished - Nov 2022

Keywords

  • Antibiotics
  • Breastfeeding
  • Cytokines
  • Helicobacter pylori
  • Immunomodulation
  • Infectious diseases

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