An Overview of the Influence of Breastfeeding on the Development of Inflammatory Bowel Disease

Abstract

The first 1000 days of life is a critical period that contributes significantly to the programming of an individual's future health. Among the many changes that occur during this period early in life, there is growing evidence that the establishment of healthy gut microbiota plays an important role in the prevention of both short- and long-term health problems. Numerous publications suggest that the quality of the gut microbiota colonisation depends on several dietary factors, including breastfeeding. In this respect, a relationship between breastfeeding and the risk of inflammatory bowel disease (IBD) has been suggested. IBDs are chronic intestinal diseases, and perinatal factors may be partly responsible for their onset. We review the existence of links between breastfeeding and IBD based on experimental and clinical studies. Overall, despite encouraging experimental data in rodents, the association between breastfeeding and the development of IBD remains controversial in humans, partly due to the considerable heterogeneity between clinical studies. The duration of exclusive breastfeeding is probably decisive for its lasting effect on IBD. Thus, specific improvements in our knowledge could support dietary interventions targeting the gut microbiome, such as the early use of prebiotics, probiotics or postbiotics, in order to prevent the disease.

Keywords: breastfeeding; early life; immune system; inflammatory bowel diseases; microbiota; milk.

Figure 1

Composition of gut microbiota in early life in relation to child’s diet. Bifidobacterium predominates in exclusively breastfed infants, while, in formulae-fed infants, the composition is less uniform and notably enriched with Bacteroides, Streptococcus or Clostridium. The introduction of solid foods leads to a wider range of microorganisms with greater microbial α-diversity and abundance. The establishment of interactions between the host immunity and the microbiota may result in susceptibility to or protection against the onset of IBD later in life. It is relevant to consider the first months of life as a window of opportunity for preventive dietary intervention to promote early protective effects.