| Objective: Breastfeeding was considered as the best mode for infants, it wasalso thought to be one of the most important source of intestinal flora. Infantperiod was a key stage of the colonization of gut microbiota, and the patternsof which could influence the risk of subsequent obesity and allergic diseasesby disturbing the development of gastrointestinal physiology and the maturityof the immune system. In this study, we analyzed the relationship between thechange of intestinal microflora and the incidence of overweight and obesity andthe development of neuropsychological of infants feeding differently, in orderto illuminate the effect of early intervention with probiotics on the incidence ofoverweight and obesity and the neuropsychological development by modifyingthe composition of intestinal microbiota from the perspective of intestinalmicroecology, and form the basis of early intervention of probiotics as part ofthe dietary strategies using which to improve the ability of converting nutrientsinto active compounds of flora, so as to keep fit in the future.Methods:134full-term infants were selected in the obstetrics departmentof the Third Hospital of Hebei Medical University and the Fourth Hospital ofShijiazhuang City from Jan2012to Dec2013,44newborns which could insistbreastfeeding beyond four to six months after birth were enrolled in group A(breastfeeding group).90infants who couldn’t adhere to breastfeeding fitingfor the selecting criteria were selected randomly according to the principle ofrandomized, double-blind by the designer of this study, the former47numbercorresponding numbers of infants were selected to group B(probiotic-intervention group), the later48random number correspondingnumbers were enrolled in group C (control group). Group A contained44infants,23boys and21girls, among them4cases in the follow-up processwere retreat due to poor compliance, so the actual cases was40,21boys and 19girls; Group B47infants, all of them were fed with formula containingprobiotic,22boys and25girls, among them6cases were retreat due to poorcompliance in the following-up process, so the actual cases was41,20boysand21girls; Group C enrolled in43newborns, all of them were fed withformula without probiotics,20boys and23girls,5of which were lost duringthe following-up period, so the actual cases was38, with18boys and20girls.Infants in all the three groups were vaginally deliverd, and were directed toinstruct of solid food at the fifth month, the infants and their parents of threegroups were living in Shijiazhuang city or its surrounding counties. Theclimate environment, living environment, living habits in three group weresimilar. All subjects signed informed consent prior to the start of this study,and were accepted by the Ethics Committee of the Third Hospital of HebeiMedical University. This study is divided into two parts to carry on: the indexof clinical observation and the quantitative analysis of intestinal flora. For allthe infants, the parameters of feeding times, the intake of each time, theintroduction of solid food, stool frequency, the times of vomiting, restlessnessand crying were recorded by their mothers, experts of this study gathering theabove information. The weight, length, head circumference, chestcircumference, subcutaneous fat and upper arm circumference of infants onthe first day of birth,1st month,3rd month,6th month and12th month weremeasured by trained medical personnel at the consulting room of the ThirdHospital of Hebei Medical University, and calculate the BMI of the infants.According to "The inspection table of neuropsychological development forchildren aged0~6years" compiled by the capital institute of pediatrics,professional medical staff evaluate the developmental quotient of infants at theage of12months from the gross motor, fine motor, adaptive capacity,language and social behavior five areas. Using the WHO growth standards ofBMI in2006as the reference standard for judging overweight and obesity.Adopting the technique flurogenic quantitative polymerase chain reaction(FQ-PCR) to dynamically detect the amount of bifidobacteria, Lactobacillus,Enterococcus and Escherichia coli in fecal samples at the time of3day,7day, 1month,3month,6month and12month after birth. Statistical analysis wasperformed with SPSS13.0statistical software. Measurement data waspresented as mean±standard deviation (x±ｓ). Count data was presented aspercentage (%). All data should make homogeneity of variance and normaldistribution tests. Difference between several groups was analyzed byone-way ANOVA or crosstabs. Setting α=0.05, there was statisticalsignificance if P <0.05for the difference.Results:1The dynamic change of intestinal flora of infants with different feedingmode after birth: early colonizationers with a higher amount were facultativeanaerobes such as E.coli and Enterococcus. When these organisms havedepleted the initial oxygen supplies, the gut becomes an anaerobicenvironment, favoring the development of strictly anaerobic bacteria such asBifidobacterium, Lactobacillus were apeared at about3days after birth, thenpresented a growing trend of Bifidobacterium numbers, and then maintaininga relatively stable state at about12th month. The amount of lactobacilli inthree groups was increasing since colonized, there was a decrease of thenumber at the time of6month, comparing the3rd month and12th month withno statistical difference (both P>0.05), there existed statistically significant atother time points of lactobacillus quantity (both P<0.05). At the time of3days,7days,1month and6month, the number of lactobacilli in group A andgroup B were higher than that of group C, with statistically significant (bothP<0.05), there was no statistical difference between group A and B (P>0.05);At the3rd month and12th months, the amount of lactobacilli in the babys’feces of group A, B, C with no statistical significance (P>0.05). There was agrowing trend of Bifidobacterium numbers after birth, at the time of3days,7days,1month,3month,6month and12month, the number ofBifidobacterium in group A and group B were higher than that of group C,with statistically significant (both P<0.05), there was no statistical differencebetween group A and B (P>0.05). The B/E value of three groups presented avolatility change over time, at the time of3days,7days,1month,3month and12month, the B/E value of group A and B were higher than that of groupC (both P<0.05), there was no statistical difference of B/E value betweengroup A, B, and C at the6th month (both P>0.05). There was no statisticaldifference between group A and B (P>0.05).2The dynamic change of the physical growth and the development ofneuropsychological (DQ) of infants with different feeding mode after birth:the height of infants in three groups presented a growing trend over time, thereexisted statistically significant between each measuring points (both P<0.05).At the time of6month and12month, the length of infant in group A and Bwere higher than that of group C (both P<0.05), there was no differencebetween group A and B (P>0.05). The weight of babies in three groups existedstatistically significant at different measuring points increasing over time (bothP<0.05). At the time of12month, the weight of group A and B were lowerthan that of group C (both P<0.05), there was no difference between group Aand B (P>0.05). There was no statistical difference of BMI between theinfants of three groups of at the time of3month,6month and12month (bothP<0.05). At the time of6month and12month, the BMI of children in group Aand B were lower than that of group C(both P<0.05), there existed nodifference between group A and B(P>0.05). The totle value of DQ of infantsin group A and B were higher than group C at12months after birth (bothP<0.05), there was no statistical difference between group A and B (P>0.05).3The physical growth and neuropsychological development indicators ofbreastfeeding are superior to that of artificial feeding infant. Early interventionwith probiotics could have made the physical growth and neuropsychologicaldevelopment indicators close to that of breastfeeding infant, which shows thatearly estabilish and maintain the stability of intestinal microecology canpromote the long-term physical and mental health of the infant.4The change of bifidobacteria amount and B/E value in the gut ofoverweight and obese infant: the quantity of bifidobacteria in the feces of waslower than normal weight infants at the time of6month and12month (both P<0.05), while the bifidobacterium quantity in feces of obese infant at6month and12month were lower than normal weight infants (both P<0.05). The B/Evalue in feces of overweight and normal weight children were both higherthan obese children (both P<0.05); Comparing the B/E value betweenoverweight and normal weight infants, there was no difference (P>0.05). TheB/E value in feces of obese infants was lower than that of normal weightinfants (P<0.05).5The correlation with B/E value and BMI: at the time of6month and12month, there was a negative linear correlation between the B/E value in fecesand the BMI of infants (P <0.05).Conclusion:1The colonization of gut microbiota in infants was a complex progress,owing to the abundant oxygen in the gut of newborn after birth, earlycolonizationer were represented by facultative anaerobes, such asenterococcus and E. coli, with the number of organisms increasing, they havedepleted the initial oxygen supplies, and which have changed the intestinalmicroecology,the surroundings of the gut becomes an anaerobic environment,favoring the development of strictly anaerobic bacteria such asBifidobacterium, this pattern of ecology with the dominance of anaerobicbacteria tends to be stable at the time of12month.2The type of feeding was one of the main factors which influencing themain factors influencing the colonization and transition of gut microbiota, thecolonization of bifidobacterium and lactobacillus in breastfeeding infantsoccurred early, and the time was shorter to optimize than the infants withartificial feeding, and then maintain a stable composition with regnantbifidobacterium in the gut. Early intervention with probiotics have made thecomposition of intestinal flora close to that of breastfeeding infants, alsoformed the pattern of ecology with bifidobacteria dominantly.3The incidence of overweight and obesity of infants with differentfeeding mode: at the6month after birth, the incidence of overweight ofchildren in group A, B, C was12.5%,17.1%,28.9%, respectively, thereexisted no statistical difference between three groups(both P>0.05); At the12 month after birth, the incidence of overweight of children in group A, B, Cwas17.5%,22.0%,42.1%, respectively, group A and B were lower than thatof group C(both P<0.05), there was no difference between group A andB(P>0.05); At the6month after birth, the incidence of obesity of children ingroup A, B, C was7.5%,9.8%,21.1%, respectively, there existed no statisticaldifference among three groups(both P>0.05); At the12month after birth, theincidence of obesity of children in group A,B,C was10.0%,12.2%,34.2%,respectively, group A and B were lower than that of group C(both P<0.05),there was no difference between group A and B (P>0.05).4From our long-term following-up study, we found that the incidence ofoverweight and obesity in ordinary formula feeding infants was highercomparing with breastfeeding infants and formula containing probioticsfeeding infants, the results suggest that changes of intestinal flora in the gut ofinfants were correlate with the subsequent risk of overweight and obesity fromthe perspective of clinical.5The quantity of bifidobacterium in feces of overweight and obeseinfants was lower compared with the infants with normal weight, and thebifidobacteria/E.coli value in feces of obese children was lower than that ofnormal weight infants, the results suggested that there were changes in thecomposition of intestinal flora of overweight and obese children.6Early intervention of probiotics could help establishing a stable patternof ecology as soon as possible, which was important to keep children’s healthyand reduce the risk of overweight and obesity in the future. |
PDF Full Text Request