Human milk oligosaccharides are associated with protection against diarrhea in breast-fed infants

To determine the association between maternal milk levels of 2-linked fucosylated oligosaccharide and prevention of diarrhea as a result of Campylobacter, caliciviruses, and diarrhea of all causes in breast-fed infants. Data and banked samples were analyzed from 93 breast-feeding mother-infant pairs who were prospectively studied during 1988-1991 from birth to 2 years with infant feeding and diarrhea data collected weekly; diarrhea was diagnosed by a study physician. Milk samples obtained 1 to 5 weeks postpartum were analyzed for oligosaccharide content. Data were analyzed by Poisson regression. Total 2-linked fucosyloligosaccharide in maternal milk ranged from 0.8 to 20.8 mmol/L (50%-92% of milk oligosaccharide). Moderate-to-severe diarrhea of all causes (n = 77 cases) occurred less often ( P = .001) in infants whose milk contained high levels of total 2-linked fucosyloligosaccharide as a percent of milk oligosaccharide. Campylobacter diarrhea (n = 31 cases) occurred less often ( P = .004) in infants whose mother's milk contained high levels of 2′-FL, a specific 2-linked fucosyloligosaccharide, and calicivirus diarrhea (n = 16 cases) occurred less often ( P = .012) in infants whose mother's milk contained high levels of lacto- N-difucohexaose (LDFH-I), another 2-linked fucosyloligosaccharide. This study provides novel evidence suggesting that human milk oligosaccharides are clinically relevant to protection against infant diarrhea.