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

• DOI: 10.1007/s10620-021-07371-x
• Publication Date: 2022-02-04T15:02:43Z
• Authors: 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 Col...; Inga Peter; Jianzhong Hu
• Keywords: 0301 basic medicine; Helicobacter pylori; RANK Ligand; Infant; Infectious Disease Transmission, Vertical; Helicobacter Infections; 3. Good health; 03 medical and health sciences; Breast Feeding; Matrix Metalloproteinase 10; Pregnancy; Humans; Female; Prospective Studies

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.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.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.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.