Indian experts say findings is not applicable universally, caution against directly extrapolating its conclusions to local populations.
Published Aug 11, 2025 | 11:51 PM ⚊ Updated Aug 11, 2025 | 11:51 PM
According to the researchers, babies exclusively breastfed for the first half of life may still fall short on key nutrients like iron, zinc, and vitamin D, even when the mother’s nutrition is adequate.
Synopsis: Experts warned that the study’s conclusions could be misinterpreted and potentially exploited by infant formula companies. Doctors are concerned that such research may lead to a wave of misleading marketing, undermining breastfeeding, and confusing caregivers about what their babies truly need.
A new study has raised questions about whether exclusive breastfeeding meets all the nutritional needs of infants under six months, a claim that contradicts long-standing global health guidelines.
The study, “Bifidobacterium Deficit in United States Infants Drives Prevalent Gut Dysbiosis”, by John B Jarman and others, was published in Communications Biology, a Nature Portfolio journal, on 24 June.
According to the researchers, babies exclusively breastfed for the first half of life may still fall short on key nutrients like iron, zinc, and vitamin D, even when the mother’s nutrition is adequate.
The findings have prompted debate within the medical community, especially in countries like India, where public health messaging has strongly promoted exclusive breastfeeding as both sufficient and ideal.
Experts warned that the study’s conclusions could be misinterpreted and potentially exploited by infant formula companies. Doctors are concerned that such research may lead to a wave of misleading marketing, undermining breastfeeding, and confusing caregivers about what their babies truly need.
The My Baby Biome study examined stool samples from 412 infants across the United States to understand how early gut bacteria develop in real-world conditions. Using metagenomics and metabolomics, researchers tracked microbial patterns across different types of births and feeding methods. The infants came from diverse racial and ethnic backgrounds, making the findings more broadly representative.
“Across birth mode and feeding groups, approximately 25% of infants lacked detectable Bifidobacterium,” the study noted. This challenges long-held beliefs that vaginal birth and exclusive breastfeeding alone are enough to establish a healthy gut microbiome.
While the study does not pinpoint a single cause, it suggests that modern factors, possibly including environmental conditions and generational loss of protective maternal bacteria, may be interfering with how infants acquire these key microbes.
One of the most striking results of the study was how commonly Bifidobacterium, a group of helpful bacteria found in healthy babies, was missing. The study reported that “approximately 25% of US infants lacked detectable Bifidobacterium”.
This absence wasn’t tied to one specific factor like formula feeding or C-section delivery, it showed up across the board. Babies who did have Bifidobacterium-rich microbiomes were found to have fewer genes related to disease-causing bacteria and antibiotic resistance.
In babies born through C-section, the study found that other, possibly harmful bacteria were taking over the space normally used by Bifidobacterium.
“Bifidobacterium tended to be replaced in the human milk oligosaccharide utilization niche with potentially pathogenic species,” the authors said. This means that even if babies are fed breast milk, they might not benefit fully from it if the right gut bacteria are missing to process its complex sugars.
Looking at long-term health outcomes, the researchers saw signs that missing Bifidobacterium could lead to higher risk of allergies and other immune problems. “The disappearance of key Bifidobacterium may contribute to the development of atopy,” the study referred to conditions like eczema or asthma.
While the researchers did not claim that breast milk was insufficient, they did suggest that shifts in the modern environment may be interfering with how infants naturally build a healthy gut.
While the My Baby Biome study draws attention to a widespread Bifidobacterium deficit in US infants, regardless of birth mode or feeding method, Indian experts caution against directly extrapolating its conclusions to local populations.
Dr. Asha Doddamane Benakappa, Head of Department at Dr Chandramma Dayananda Sagar Institute of Medical Education and Research in Ramanagar, challenged the study’s assertion that even breastfed infants may lack adequate gut-friendly bacteria.
“Breastfeeding initiated within one hour of birth will flood the gut with breast milk microbiome, which is in trillions,” she told South First while disagreeing with the notion that exclusive breastfeeding may not ensure sufficient microbial colonization.
According to her, foundational differences in genetics, nutrition, and environment make it inappropriate to apply such findings to Indian infants. “It will not apply to Indian infants as our genetics and epigenetics (environment and nutrition) are different. The US is battling insulin resistance, obesity pandemic for consuming ultra-processed foods,” she added.
The study further highlighted that C-section infants often show replacement of Bifidobacterium by potentially pathogenic species that occupy the same metabolic niche. Dr. Asha acknowledged the altered microbial exposure in cesarean births, pointing out that these babies do not pass through the vaginal canal, a source rich in Bifidobacterium. She also noted ongoing interest in fecal microbiome transfer (FMT) as a restorative strategy in such cases.
Importantly, she argued that gut dysbiosis may stem more from maternal health and environmental exposures than from feeding methods alone. Factors such as poor maternal nutrition during pregnancy, use of antibiotics, exposure to pesticide-laden crops, and the type of cooking oils used can all impact the infant microbiome.
“There is no alternative to breastfeeding to get healthy gut microbiomes,” she said, underscoring the role of early and exclusive breastfeeding not just as a feeding choice, but as a foundational intervention for long-term health.
In light of the recent study raising questions about exclusive breastfeeding sufficiency, Dr. Nupur Bidla, Central Coordinator of the Breastfeeding Promotion Network of India (BPNI), highlighted the ongoing challenge posed by misleading formula advertisements. She concurred with Kerala’s health department stance that many formula promotions are “false campaigns” violating the Infant Milk Substitutes (IMS) Act, 1992 (amended 2003).
Speaking to South First, she said, companies often resort to indirect marketing tactics such as sponsoring events and using influencers, which “mislead parents by portraying formula as equivalent to or better than breastfeeding,” a claim that is both scientifically and ethically incorrect. She pointed out that such misinformation risks undermining public health progress made through sustained breastfeeding advocacy.
Dr. Bidla also warned that selective scientific studies, like the one from the US, can create confusion among parents and dilute public confidence in breastfeeding. She stressed that in India, where exclusive breastfeeding rates are improving but not yet optimal, it is crucial to protect supportive messaging.
“Scientific nuances must not be twisted into generalized public messages,” she said, emphasizing that when true exceptions to breastfeeding adequacy arise, clinical judgment, not corporate marketing, should guide infant feeding decisions. This perspective echoes earlier expert caution against misapplying study findings outside their original contexts.
Regarding regulatory measures, Dr. Bidla advocated for stronger enforcement of the IMS Act and more rigorous oversight of media and scientific communications. She recommended that health authorities, including the Ministry of Health and Food Safety and Standards Authority of India (FSSAI), proactively issue advisories to counteract misleading claims.
Additionally, she highlighted the importance of collaboration between public health bodies and organizations like BPNI to disseminate clear, evidence-based information promoting breastfeeding as the gold standard for infant nutrition.
Finally, Dr. Bidla underscored the need to monitor evolving marketing strategies, particularly digital and influencer promotions, which may covertly erode breastfeeding confidence. She advocated capacity building among media, healthcare workers, and civil society to critically analyze and challenge industry-driven narratives.
For mothers facing uncertainty, she stressed that official advice should reaffirm exclusive breastfeeding for six months as sufficient for nearly all infants, while cautioning against commercial exploitation of parental fears. “The best immunity, nutrition, and bonding come through breastfeeding,” she affirmed, “and complementary feeding should begin only after six months, alongside continued breastfeeding.”
(Edited by Majnu Babu).
