Timing of Full Enteral Feeding and Longitudinal Gut Microbiome Development in Infants Admitted to the Neonatal Intensive Care Unit
- 1Department of Pediatrics, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea
Abstract
Background/Objectives: Delayed achievement of full enteral feeding (FEF) is common in neonatal intensive care unit (NICU) infants but is closely linked to gestational age (GA). We examined whether time to FEF is associated with gut microbiome development from birth to 6 months of corrected age (CA) beyond GA. Methods: We profiled 694 stool samples from 328 NICU infants, collected at first stool, discharge, and 4- and 6-month CA, by 16S rRNA gene sequencing. Infants were classified as Early FEF (<14 days, n = 293) or Delayed FEF (≥14 days, n = 35), and time to FEF was also analyzed continuously. Linear mixed models and PERMANOVA were adjusted for GA. Results: Composition at first stool did not differ between groups. At discharge, the Delayed group had higher Proteobacteria, lower Firmicutes, lower Streptococcus (q = 0.028), and a different community structure in unadjusted analyses, but none of these differences remained after GA adjustment. No phylum showed a GA-adjusted trajectory difference, and alpha diversity did not differ. In an exploratory continuous analysis, longer time to FEF was associated with higher Bacteroidetes at discharge and 4-month CA. Conclusions: Most microbiome differences associated with delayed FEF were not independent of GA. Time to FEF may reflect maturity and illness severity rather than act as an independent determinant of the gut microbiome.
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BibTeX
@article{shin2026timing,
title = {{Timing of Full Enteral Feeding and Longitudinal Gut Microbiome Development in Infants Admitted to the Neonatal Intensive Care Unit}},
author = {Jeongmin Shin and Hyun Ho Kim and Sae Yun Kim and Hyun Mi Kang and Young-Ah Youn},
journal = {Nutrients},
year = {2026},
month = oct,
doi = {10.3390/nu18193262},
url = {https://www.mdpi.com/2072-6643/18/19/3262},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Timing of Full Enteral Feeding and Longitudinal Gut Microbiome Development in Infants Admitted to the Neonatal Intensive Care Unit
AU - Jeongmin Shin
AU - Hyun Ho Kim
AU - Sae Yun Kim
AU - Hyun Mi Kang
AU - Young-Ah Youn
PY - 2026
DA - 2026/10/02
JO - Nutrients
DO - 10.3390/nu18193262
UR - https://www.mdpi.com/2072-6643/18/19/3262
AB - Background/Objectives: Delayed achievement of full enteral feeding (FEF) is common in neonatal intensive care unit (NICU) infants but is closely linked to gestational age (GA). We examined whether time to FEF is associated with gut microbiome development from birth to 6 months of corrected age (CA) beyond GA. Methods: We profiled 694 stool samples from 328 NICU infants, collected at first stool, discharge, and 4- and 6-month CA, by 16S rRNA gene sequencing. Infants were classified as Early FEF (<14 days, n = 293) or Delayed FEF (≥14 days, n = 35), and time to FEF was also analyzed continuously. Linear mixed models and PERMANOVA were adjusted for GA. Results: Composition at first stool did not differ between groups. At discharge, the Delayed group had higher Proteobacteria, lower Firmicutes, lower Streptococcus (q = 0.028), and a different community structure in unadjusted analyses, but none of these differences remained after GA adjustment. No phylum showed a GA-adjusted trajectory difference, and alpha diversity did not differ. In an exploratory continuous analysis, longer time to FEF was associated with higher Bacteroidetes at discharge and 4-month CA. Conclusions: Most microbiome differences associated with delayed FEF were not independent of GA. Time to FEF may reflect maturity and illness severity rather than act as an independent determinant of the gut microbiome.
SN - 2072-6643
ER -