Diet during Pregnancy and Infancy and the Infant Intestinal Microbiome

J Pediatr. 2018 Dec;203:47-54.e4. doi: 10.1016/j.jpeds.2018.07.066. Epub 2018 Aug 30.


Objectives: To determine the association between diet during pregnancy and infancy, including breastfeeding vs formula feeding, solid food introduction, and the infant intestinal microbiome.

Study design: Infants participating in the Vitamin D Antenatal Asthma Reduction Trial were included in this study (n = 323). Maternal and infant diets were assessed by questionnaire. Infant stool samples were collected at age 3-6 months. Stool sequencing was performed using the Roche 454 platform. Analyses were stratified by race/ethnicity.

Results: Breastfeeding, compared with formula feeding, was independently associated with infant intestinal microbial diversity. Breastfeeding also had the most consistent associations with individual taxa that have been previously linked to early-life diet and health outcomes (eg, Bifidobacterium). Maternal diet during pregnancy and solid food introduction were less associated with the infant gut microbiome than breastfeeding status. We found evidence of a possible interaction between breastfeeding and child race/ethnicity on microbial composition.

Conclusions: Breastfeeding vs formula feeding is the dietary factor that is most consistently independently associated with the infant intestinal microbiome. The relationship between breastfeeding status and intestinal microbiome composition varies by child race/ethnicity. Future studies will need to investigate factors, including genomic factors, which may influence the response of the microbiome to diet.

Trial registration: NCT00920621.

Keywords: breast milk; formula; solid food.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Bacteroides / genetics
  • Bacteroides / isolation & purification
  • Bifidobacterium / genetics
  • Bifidobacterium / isolation & purification
  • Breast Feeding
  • Clostridium / genetics
  • Clostridium / isolation & purification
  • Diet*
  • Feces / microbiology
  • Female
  • Gastrointestinal Microbiome*
  • Humans
  • Infant
  • Infant Formula
  • Male
  • Pregnancy
  • RNA, Ribosomal, 16S
  • Race Factors
  • Sequence Analysis, RNA
  • Surveys and Questionnaires


  • RNA, Ribosomal, 16S

Associated data