Intestinal Dysbiosis in the Infant and the Future of Lacto-Engineering to Shape the Developing Intestinal Microbiome

Lida I. Zeinali, Shayne Giuliano, Satyan Lakshminrusimha, Mark A. Underwood

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Purpose: The goal of this study was to review the role of human milk in shaping the infant intestinal microbiota and the potential of human milk bioactive molecules to reverse trends of increasing intestinal dysbiosis and dysbiosis-associated diseases. Methods: This narrative review was based on recent and historic literature. Findings: Human milk immunoglobulins, oligosaccharides, lactoferrin, lysozyme, milk fat globule membranes, and bile salt–stimulating lipase are complex multifunctional bioactive molecules that, among other important functions, shape the composition of the infant intestinal microbiota. Implications: The co-evolution of human milk components and human milk–consuming commensal anaerobes many thousands of years ago resulted in a stable low-diversity infant microbiota. Over the past century, the introduction of antibiotics and modern hygiene practices plus changes in the care of newborns have led to significant alterations in the intestinal microbiota, with associated increases in risk of dysbiosis-associated disease. A better understanding of mechanisms by which human milk shapes the intestinal microbiota of the infant during a vulnerable period of development of the immune system is needed to alter the current trajectory and decrease intestinal dysbiosis and associated diseases.

Original languageEnglish (US)
JournalClinical Therapeutics
StateAccepted/In press - 2021
Externally publishedYes


  • Bile salt stimulated lipase
  • Human milk immunoglobulins
  • Human milk oligosaccharides
  • Lactoferrin
  • Lysozyme
  • Milk fat globule membrane

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)


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