00:00Until many years ago, human milk was considered a fluid body, almost sterile, and although
00:17occasionally vital bacteria were detected in the milk taken by women in good health,
00:24it was believed that these microorganisms were nothing more than contaminating passengers,
00:32perhaps coming from the surrounding skin or from other environmental sources.
00:38Today, however, several studies support the idea that human milk hosts a complex microbial community,
00:47which in turn is a source of commercial and potentially probiotic bacteria for children in the development phase.
00:55It is estimated, in particular, that a milkman fed with 800 milliliters of breast milk a day
01:04receives between 100,000 and 1,000,000 bacteria on a daily basis.
01:10The idea of human milk as a host of a complex microbial community has become so much clarified and so much shared
01:23that breast milk is in fact considered as a prototype of mother nature of probiotic food.
01:32We know that breastfeeding is the most favorable solution for the feeding of the newborn
01:40and this is not only because human milk contains all the essential nutrients for the growth of the baby,
01:49but also because breast milk can in fact be considered as the first functional food,
01:57being endowed with a rich supply of useful substances in this sense,
02:04among which I remember, for example, molecules capable of activating the immune system,
02:10and then still proteins and protein fragments, that is, peptides endowed with antimicrobial action,
02:19and still fatty acids, hormones, nucleic acids, stamina cells, antioxidant substances,
02:26and then, last but certainly not least, that set of microorganisms that form what is called HMM,
02:39which stands for Human Milk Microbiome, and which means essentially microbiota of human milk.
02:48According to a review of the most recent studies carried out with molecular techniques
02:53of analysis of the bacterial DNA present in breast milk, Streptococcus, Staphylococcus and Propionibacterium
03:03seem to be the most abundant bacterial genes in human milk,
03:09although there are also so-called subdominant genes in the latter,
03:15in the sense that they are present in lower concentrations and sometimes not present,
03:21these last genes are mainly represented by bifidobacteria, lactobacilli, enterococci,
03:29escherichia coli, and other bacteria, if any, coming from the cuticle or the surrounding environment.
03:37Factors that could influence the composition of the Human Milk Microbiome are, for example,
03:44exposure to disinfectants or exposure to maternal or neonatal antibiotic therapies.
03:53There are also other conditions, such as the phase of breastfeeding,
03:59and it has been seen, for example, that the composition of the microbiota of breast milk
04:07in women who have given birth with vaginal delivery, this composition is definitely richer
04:15and also more biodiverse in terms of the number of microbial species present compared to what
04:21happens in the milk produced by women who instead gave birth with cesarean section,
04:29as it has been seen, that the composition of the Human Milk Microbiome is much richer
04:37in terms of the number of bacterial species and much more biodiverse in women who have not
04:45undergone antibiotic therapies compared to women in which a prolonged or antibiotic therapy
04:52has been prescribed in childbirth. In early childhood, the intestinal microbiota of a child
05:02born at the end of vaginal delivery and breastfed exclusively represents what we will call
05:10the gold standard, that is, the best possibility for a healthy child microbiota.
05:18What is different, however, happens with regard to intestinal colonization
05:25in preterm newborns. In fact, let's say, the structural and immunological immaturity of the intestine
05:33of a preterm born child together with the particular environmental conditions
05:39under which it is subjected, that is, birth mode, supply of antibiotics,
05:46duration of hospitalization or even different nutritional exposure, contribute to making
05:54abnormal the bacterial colonization of these preterm babies with a whole series of consequences
06:02that can derive from this abnormality. However, I would like to add that precisely the analyses
06:09that can currently be carried out on the intestinal microbiota of newborns
06:16allow a correction in the course of the intestinal microbiota of these babies
06:23so that a compensation can be achieved where the structural and immunological anomalies
06:30of an intestine can in some way compromise the normal composition of the microbiota.
06:37I would like to remind you that these rules also apply to mothers in the different phases
06:45of pregnancy, precisely to allow the newborn to benefit from an optimal microbiotic composition.
07:00you
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