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Until relatively recently, we assumed that milk was sterile unless it was produced by an infected mammary gland or contaminated after milk expression. However, use of molecular methods that allow the detection and identification of bacteria based on variation in DNA sequences (rather than growth on defined media) has resulted in a paradigm shift in this regard. Indeed, we now know that all milk contains a rich diversity of bacteria. In fact, each woman appears to have a somewhat unique profile of bacteria in her milk, and different populations of women may also have relatively different milk microbiomes. Currently, almost nothing is known about factors (e.g., maternal diet, environmental exposures, breastfeeding practices) that influence what bacteria will be in a woman's milk although limited studies suggest that maternal obesity and delivery mode might be important. Similarly, how these bacteria arrive to the mammary gland and get encorporated into milk are areas of active research and debate. Ultimately, however, understanding the human milk microbiome will likely lead to improved health of both women and infants.
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