About half of babies born prematurely struggle to grow, putting them at risk for health problems that can last a lifetime. Now, a new study at URMC may be able prevent that risk in preemies before leaving the NICU.

Welcoming your baby into the world weeks, or even months, before they were expected can be scary. Anna Shults’ twin sons came at just 25-weeks-old.

“They held up Everett’s foot and it was about the size of my thumbnail. And I was like, ‘Oh my gosh, they’re so small. How are they going to survive?”

Everett was one pound, seven ounces. Jack was two pounds, one ounce. A new study at URMC is helping preemies like Everett and Jack get a stronger start to life. By investigating their gut microbiome, microorganisms that improve health and prevents disease.

“Knowing what their phase of microbiome is, we can customize what their nutrition is to better target what their baby needs in that moment of development,” said Kristin Scheible, neonatologist.

They collected stool samples weekly from nearly 100 preterm babies while in the NICU.

“We learned from that data alone the microbiome in these preterm infants develop in three different phases and those three phases are critical,” says Steven Gill, associate professor of microbiology. “If they don’t reach the third phase, those are babies that are failed to thrive and they have long-term consequences in terms of health.”

The team found that infants with higher levels of good bacteria in their guts generally grew faster and nutrition played a big part.

“We can manipulate the babies microbiome by nutrition so we can decide how we supplement the formulas with particular components like proteins, carbohydrates of fats.”

Ideally, tailoring the nutrients and feeding patterns to exactly what premature babies need in that moment.

“They look so much bigger, that’s really reaffirming that they are growing and that they are getting better and that we will go home.”

Shults says her boys were scheduled to come home by Christmas. The URMC team sees a future where a personalized microbiome analysis is done for every baby in the NICU.

The next step is to investigate how these bacteria use the nutrients the baby is given, which could influence the formula given.