Sialylated Human milk oligosaccharides (HMOs) in mothers’ breastmilk are twice as risky in developing severe acute malnutrition

A group from Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka, Bangladesh, etc. has reported that a higher relative abundance of sialylated Human milk oligosaccharides (HMOs) in mothers’ breastmilk may have a negative impact on young infants’ nutritional status.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9177541/

HMOs are not digestible by infants and arrive intact to the large intestine, where they exert prebiotic roles by supporting the development of selected beneficial groups of the gut microbiota, including Bifidobacterium sp and some Lactobacillus sp. by providing metabolic products for their existence, growth, and ultimate colonization in the gut of infant. In addition to helping in healthy gut microbiome, HMOs deliver a number of assistances to infants, including brain development, acting as decoys for harmful organism, and averting disease and infection.

Human milk oligosaccharides differ between secretor and non-secretor mothers, whereby fucosylation in the human milk oligosaccharides are a result of gene products that regulate Lewis and secretor blood group types.

In this study, a total of 45 breast milk samples, of which 26 were from the mothers of severe acute malnutrition (SAM) infants and 19 were from mothers of non-malnourished infants. Among the mothers of SAM infants, 14 were secretors and 12 were non-secretors.

It was found that sialylated HMOs were associated with higher odds of severe acute malnutrition status in age and sex adjusted model (AOR = 2.00, 90% CI 1.30, 3.06), in age, sex, secretor status adjusted model (AOR = 1.96, 90% CI 1.29, 2.98) and also among non-secretor mothers when age and sex adjusted model was used (AOR = 2.86, 90% CI 1.07, 7.62). All these different statistical models show statistically significant association with sialylated HMO and severe acute malnutrition among the young infants. Fucosylated HMOs were less likely associated with severe acute malnutrition but there was no significant association between these.


model 1: adjusted odds ratio (aOR) (90% CI) was adjusted for age and sex.
model 2: adjusted odds ratio (aOR) (90% CI) was adjusted for age and sex and secretor status.
model 3: it was for secretor mothers only and adjusted odds ratio (aOR) (90% CI) was adjusted for age and sex.
model 4: it was for non-secretor mothers only and adjusted odds ratio (aOR) (90% CI) was adjusted for age and sex.