Introduction: While almost all Australian women (96%) initiate breastfeeding, by 4 months less than 40%, and by 6 months only 15% of babies are exclusively fed breast milk. Breast milk is a major modifier of the developing gut microbiome and early cessation may have adverse health consequences from infancy onwards. Large biobanks play a major role in understanding factors contributing to early breastfeeding cessation and related adverse health issues in infants, including perturbations to the gut microbiome. As the first longitudinal study of its kind, Generation Victoria (Gen V) has established an inclusive and diverse population-based biorepository spanning early pregnancy and infancy, that includes both early breast milk and stool samples. This will enable research into the identification of biomarker signatures in breast milk predictive of low breast milk supply and early breastfeeding cessation as well as the potential impact on the infant gut microbiome.
Methods: Parents of every child born in Victoria over a 2-year period (commenced 4 October 2021) are being offered the chance to participate in Gen V - providing access to a wide range of data and biospecimens. Beginning 5 October 2022, the Gen V biobank will be supplemented with breastmilk and infant stool samples collected in early infancy. Over 15,000 take-home kits will be distributed to GenV to achieve this goal, using stool and breast milk sampling systems that maintain sample integrity for days at room temperature.
Discussion: Studies on Human breast milk collection as well as the Gen V Vanguard Pilot study on infant stool collection confirm that participants are willing to consent, self-collect and return breast milk and stool biosamples. At this large scale, the breastmilk and stool samples will provide a myriad of unique opportunities for research investigation and collaboration both within Australia and internationally. Importantly it will facilitate research to support mothers in breastfeeding their infants, improve infant health outcomes, and reduce the incidence of preventable health consequences.