Infants are exposed to human milk oligosaccharides (HMOs) already in utero

Monday, Mar 11, 2019

This is the first study to find that human milk oligosaccharides (HMOs) is present in amniotic fluid and that the fetus is exposed to HMOs in utero already.


Wise A, Robertson B, Choudhury B, Rautava S, Isolauri E, Salminen S, Bode L. Infants are exposed to human milk oligosaccharides already in utero. Front Pediatr. 2018;6:270.
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Literature Library – Human milk oligosaccharides (HMOs) and immunity development


  • HMOs are complex carbohydrates found in high abundance in human milk, which have prebiotic, antimicrobial and antiadhesive effects that contribute to shape the infant gut microbiome and modify immune system responses. There is evidence suggesting the exposure to HMOs in the postnatal period may impact positively on infant health and development
  • This study aimed to determine whether HMOs can also be found in amniotic fluid during the pregnancy stage



  • 48 pregnant women were enrolled and the below were collected
    • Urine before delivery (n = 48)
    • Human milk 4 days after birth  (n = 48)
    • Amniotic fluid during planned c-section or after spontaneous rupture of membrane (n = 8)
      • HMOs from these 8 samples were isolated by solid phase extraction chromatography and analysed


Key Findings

  • The below 4 HMOs were identified in human milk, maternal urine, as well as amniotic fluid in differing concentration between these sample types
    • 2’-fucosyllactose (2’-FL), 3-fucosyllactose (3-FL), difucosyllactose (DFLac), 6’-sialyllactose (6’-SL)
  • On average, 2’-FL was the dominant HMO in all three sample types



  • This is the first report to show that HMOs are present in amniotic fluid and that the fetus is exposed to HMOs in utero already



  • HMO effects have been described for after birth, and with findings from this study, it suggests HMOs can also possibly act as prebiotics, helping to shape the amniotic fluid microbiome and optimising the environment
  • They may also serve as antimicrobials and antiadhesives to help fight infections and inflammation, with the possibility to reduce the risk of preterm delivery


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