The Art of Asking and Analyzing Sensitive Questions in Breast Milk Microbiome Research

Human milk includes, in addition to various bioactive molecules and microorganisms, that make up the “human milk microbiota (HMM)”. The breast milk microbiome is essential in gastrointestinal coloni¬zation of microbiome in children during the first 100 days of life. Microbial imbalance can be a starting point for necrotizing enterocolitis in premature infants, and can also contribute to the development of chronic diseases such as asthma and obesity later in life. In medical and biomedical research, particularly breast milk microbiome research, the use of surveys is often resorted to assess changes in the status of certain groups over a certain period. These questionnaires can focus on a specific sample and serve as an objective tool for professionals to acquire additional information. Creating a new questionnaire can be quite a challenge. The main difficulty lies in the development of an effective questionnaire for research and clinical use, meeting all legal frameworks, as well as the subsequent handling of sensitive data. The purpose of this study was to present the great need and difficulties in designing an effective survey for our research objectives. Research aimed at establishing the microbiome of breast milk and the associated pre¬diction of the gastrointestinal microbiome of the newborn has been of great importance recently. We have presented sample custom surveys that we have used to prepare and conduct various microbiome studies, and we believe that good preparation of an appropriate questionnaire contributes immensely to the overall completion of any biomedical study.