{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:08:45Z","timestamp":1790284125407,"version":"4.1.0"},"reference-count":184,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early-life nutrition is a key determinant of infant gut microbiota development, immune maturation, and long-term health outcomes. Although breastfeeding is widely recognized as the optimal feeding strategy, many mothers are unable to breastfeed, underscoring the need for practical, evidence-based guidance to support infant health beyond breastfeeding. A One Health approach enables the integration of nutritional, microbial, clinical, environmental, and socio-cultural factors that influence maternal\u2013infant dyads.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A narrative review of the literature was conducted using PubMed, Scopus, and Google Scholar, focusing more on works published from 2020 to 2026. Evidence was synthesized on maternal and infant nutrition, breast milk bioactive components, infant formula feeding, gut microbiota development, and short- and long-term health outcomes in non-breastfed infants. Based on this interdisciplinary evidence, a translational \u201cOne Health Decalogue\u201d was developed for mothers who are unable to breastfeed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>The reviewed literature highlights that infant nutrition, particularly in the absence of breastfeeding, significantly influences gut microbiota composition, immune programming, metabolic regulation, and neurodevelopment. Key modifiable factors include formula composition, feeding practices, maternal health status, environmental exposures, caregiver education, and psychosocial support. The proposed One Health Decalogue synthesizes these elements into 10 actionable principles aimed at supporting microbial resilience, promoting healthy development, and reducing health inequalities when breastfeeding is not possible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Translating scientific evidence into practical tools is essential to support infants who cannot be breastfed. The One Health Decalogue presented in this review provides a comprehensive, interdisciplinary, and translational framework for healthcare professionals, families, and public health policies, fostering informed nutritional choices and holistic strategies to optimize infant health beyond breastfeeding.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1784544","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T13:52:42Z","timestamp":1772718762000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Beyond breastfeeding: a One Health Decalogue for nurturing the infant microbiota"],"prefix":"10.3389","volume":"13","author":[{"given":"Valentina","family":"Biagioli","sequence":"first","affiliation":[{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa","place":["Genoa, Italy"]},{"name":"Microbiota International Clinical Society","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariarosaria","family":"Matera","sequence":"additional","affiliation":[{"name":"Microbiota International Clinical Society","place":["Turin, Italy"]},{"name":"Department of Pediatric Emergencies, Misericordia Hospital","place":["Grosseto, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Cavecchia","sequence":"additional","affiliation":[{"name":"Microbiota International Clinical Society","place":["Turin, Italy"]},{"name":"Microbiomic Department, Koelliker Hospital","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariateresa","family":"Illiceto","sequence":"additional","affiliation":[{"name":"Department of Pediatrics-Unit of Pediatric Gastroenterology and Endoscopy, Santo Spirito Hospital","place":["Pescara, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Pennazzi","sequence":"additional","affiliation":[{"name":"Microbiota International Clinical Society","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaia","family":"Luongo","sequence":"additional","affiliation":[{"name":"I.P.S.I.A. Attilio Odero \u2013 State Professional Technical Institute","place":["Genoa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Lugli","sequence":"additional","affiliation":[{"name":"Microbiota International Clinical Society","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Striano","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa","place":["Genoa, Italy"]},{"name":"Pediatric Neurology and Muscular Diseases Unit, IRCCS Istituto \u201cGiannina Gaslini\u201d","place":["Genoa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-025-04458-3","article-title":"Human milk: insights on cell composition, organoids and emerging applications","author":"Majood","year":"2025","journal-title":"Pediatr Res"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2088","DOI":"10.1016\/s0140-6736(16)30536-0","article-title":"Breastfeeding in the 21st century","volume":"387","author":"Agranonik","year":"2016","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1126\/science.aad9378","article-title":"How colonization by microbiota in early life shapes the immune system","volume":"352","author":"Gensollen","year":"2016","journal-title":"Science"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"148","DOI":"10.3390\/life11020148","article-title":"When a neonate is born, so is a microbiota","volume":"11","author":"Coscia","year":"2021","journal-title":"Life"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"17774","DOI":"10.1021\/acs.est.2c04706","article-title":"The association between microplastics and microbiota in placentas and meconium: the first evidence in humans","volume":"57","author":"Liu","year":"2023","journal-title":"Environ Sci Technol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"400","DOI":"10.3390\/nu16030400","article-title":"The role of diet and nutritional interventions for the infant gut microbiome","volume":"16","author":"Catassi","year":"2024","journal-title":"Nutrients"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"4200","DOI":"10.3390\/nu13124200","article-title":"Term infant formulas influencing gut microbiota: an overview","volume":"13","author":"Fabiano","year":"2021","journal-title":"Nutrients"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/s12887-021-02539-w","article-title":"Preliminary evidence for an influence of exposure to polycyclic aromatic hydrocarbons on the composition of the gut microbiota and neurodevelopment in three-year-old healthy children","volume":"21","author":"Zhang","year":"2021","journal-title":"BMC Pediatr"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e35","DOI":"10.1017\/S2040174425100196","article-title":"Evaluating the bifidogenic effect of various infant formula supplementations: a systematic review and network meta-analysis of randomized controlled trials","volume":"16","author":"Mansouri","year":"2025","journal-title":"J Dev Orig Health Dis"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"604080","DOI":"10.3389\/fimmu.2021.604080","article-title":"Role of human milk bioactives on infants\u2019 gut and immune health","volume":"12","author":"Carr","year":"2021","journal-title":"Front Immunol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"946","DOI":"10.3390\/nu12040946","article-title":"The relationship between the infant gut microbiota and allergy. 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