Interactions between Bifidobacterium and Bacteroides and human milk oligosaccharides and their associations with infant cognition.

While ample research on independent associations between infant cognition and gut microbiota composition and human milk (HM) oligosaccharides (HMOs) has been reported, studies on how the interactions between gut microbiota and HMOs may yield associations with cognitive development in infancy are lacking. We aimed to determine how HMOs and species of and genera interact with each other and their associations with cognitive development in typically developing infants. A total of 105 mother-infant dyads were included in this study. The enrolled infants [2.9-12 months old (8.09 ± 2.48)] were at least predominantly breastfed at 4 months old. A total of 170 HM samples from the mothers and fecal samples of the children were collected longitudinally. Using the Mullen Scales of Early Learning to assess cognition and the scores as the outcomes, linear mixed effects models including both the levels of eight HMOs and relative abundance of and species as main associations and their interactions were employed with adjusting covariates; infant sex, delivery mode, maternal education, site, and batch effects of HMOs. Additionally, regression models stratifying infants based on the A-tetrasaccharide (A-tetra) status of the HM they received were also employed to determine if the associations depend on the A-tetra status. With species, we observed significant associations with motor functions, while showed a negative association with visual reception in the detectable A-tetra group both as main effect (value of  = 0.012) and in interaction with LNFP-I (value of  = 0.007). Additionally, 3-FL showed a positive association with gross motor ( = 0.027) and visual reception ( = 0.041). Furthermore, significant associations were observed with the interaction terms mainly in the undetectable A-tetra group. Specifically, we observed negative associations for species and LNT [ ( = 0.011) and ( = 0.022)], and positive associations for expressive language with 3'-SL and ( = 0.01), 6'-SL and ( = 0.019), and LNFP-I and ( = 0.048), respectively. Our findings suggest that gut microbiota and HMOs are both independently and interactively associated with early cognitive development. In particular, the diverse interactions between HMOs and and species reveal different candidate pathways through which HMOs, and species potentially interact to impact cognitive development in infancy.