Guest Lecture of Professor Tuuli Metsvaht "Microbiome in NICU – Health Implications and Potential for Intervention" 

On May 15, 2024, OH-Boost hosted a guest lecture by Prof. Tuuli Metsvaht, Head of the Children's Clinic at Tartu University Hospital focusing on the crucial role of the microbiome in neonatal intensive care units (NICUs) and its implications for disease and treatment.

Prof. Metsvaht talked about the importance of the neonatal microbiome in shaping the health outcomes of newborns. "There is a lot for us in the microbiome; for both people working in the NICU and for small babies to do better" she said. The first few weeks of life are critical for the development of a baby's microbiome, and the NICU environment plays a crucial role in this process, which influences their long-term health. This shows why monitoring and managing microbial exposure in NICUs are important for us.

Several topics were discussed to alter microbial colonization and reduce disease risk. Such as:

• Using prebiotics and probiotics 

• Antibacterial treatments 

• Changes in treatment routines to minimize disruptions to the microbiome

• Family-centered NICU care such as skin-to-skin contact 

The lecture outlined the roles of gut microbiota in the development of the immune system, nutrient absorption, pathogen prevention, and overall growth. The stability of gut microbiota by age three resembles that of adults. Prof. Metsvaht presented detailed analyses showing the transmission of bacteria from mother to child during early life stages. It was noted that meconium (the first stool of a newborn) has low bacterial diversity, with few unique species. Additionally, it was observed that maternal bacterial strains tend to be retained later in life, highlighting the long-term impact of early microbial exposure.

Prof. Metsvaht emphasized the principles of family-centered NICU care, which include rooming-in with family members, promoting skin-to-skin contact, and feeding with the mother's own unpasteurized breast milk. These practices may reduce the incidence or severity of infections and transmission of multidrug-resistant organisms, despite some controversies about the introduction of gut microbes from room sources.

She also discussed the differences in gut microbiome development between late preterm (born slightly early) and full-term infants, with full-term infants showing higher diversity and stability in their gut microbiome. The lecture also emphasized the early development of microbiome might have a role in various health conditions, including immune response, metabolic and hormonal balance, and conditions like eczema, asthma, obesity, and autoimmune diseases.