New research from the University of Chicago Medical Center on the microbiomes of premature babies could have a major impact on the health of infants with necrotizing enterocolitis.  

Necrotizing enterocolitis (NEC) is an inflammatory bowel disorder that affects 10 percent of premature infants. These babies, born with underdeveloped organs, are susceptible to a host of complications. NEC can be devastating, with a mortality rate between 30 and 50 percent. Babies who survive may develop long-term developmental problems such as cerebral palsy.  

Erika Claud, a neonatologist specializing in endocrinology, has been comparing the microbiomes of healthy premature babies with those of babies who contracted NEC in an attempt to isolate the role of the gut microbiome, a term that refers to the collections of bacteria within the intestines. The popularity of microbiome research surged in 2007, and according to Claud, many scientists at the University believed that the microbiome was the key to discovering what causes NEC. When this approach did not yield conclusive results, Claud changed her focus. 

“Instead of looking at what bacteria perhaps cause NEC, I’ve been looking at the role of bacteria in intestinal development. Since we know that preterm infants are the babies that are [more] susceptible, it makes sense that their fundamental immaturity may be what is predisposing them to the disease,” she said.  

The hypothesis Claud has been pursuing suggests that environmental factors in the first days of an infant’s life affect the microbiome and allow infants to develop resistance to NEC. Accordingly, changing aspects of the neonatal intensive care unit (NICU) environment may be essential to understanding healthy microbiome development and preventing NEC.  

Many precautions in the NICU, such as feeding and breathing tubes, are vital for infants’ survival. However, Claud said other practices can be implemented that keep the premature microbiome in mind. These include encouraging breastfeeding to build the infant’s microbiome from the mother's, limiting the use of antibiotics to protect healthy bacteria, and incorporating “kangaroo care,” or skin-to-skin contact that is known to contribute to development.  

For adults to maintain a healthy microbiome, the natural option is probiotics. Claud, however, pointed out that the solution to NEC is not as easy as eating yogurt.  

“There are certainly a lot of studies looking at probiotics; I think premature infants are a little bit different because they’re still going through development and so it’s not as simple as giving probiotics,” Claud said.  

Looking to the future, Claud commented that microbiome intervention could start as early as in utero. “In my lab, we are actually doing animal experiments where we give them probiotics—to the pregnant dam, to the pregnant mouse, and seeing how [the effects transfer] to the pups that are born, but that’s still very much at the bench.”