The gut microbiome and the brain communicate bidirectionally via several host- and microbially-derived signaling mechanisms, forming a critical biological axis. This includes via the hypothalamic-pituitary-adrenal (HPA) axis, which is the principal regulator of stress responses in the body through the transient release of glucocorticoids (e.g., cortisol) to influence numerous physiological processes, such as inflammation. In experimental animal models, the microbiome has been causally implicated in HPA axis programming in early life; however, our understanding of how this translates in humans remains limited. Given the gut microbiome and the brain undergo periods of rapid development in parallel in early life, and the gut-brain axis is increasingly recognized as a key mechanism by which the microbiome influences host development and health outcomes, this suggests a direct relationship exists between gut microbial colonization patterns and the programming of stress physiology in early life. The relationship between the gut microbiome and stress response development is of particular interest in infants born prematurely, as they face intensified alterations to microbial colonization patterns due to their unique early-life circumstances (e.g., higher rates of C-section, antibiotic exposure, physiological immaturities at birth) and experience developmentally unexpected stress throughout their stay in the NICU. In this project, we aim to generate a better understanding of the relationship between the gut microbiome and stress physiology in preterm infants by leveraging the Alberta BLOOM Study - a longitudinal birth cohort of preterm infants - to examine the relationship between the gut microbiome and cortisol measurements in the first 8 weeks of life and how this relates to the degree of stress infants experience in the NICU.