This summary has been adapted from Prebiotics in infant formula. Gut Microbes (2014) by Vandenplas et al.
Prebiotic oligosaccharides are a major component of human breast milk (1) and have been reported to affect the growth of gastrointestinal microbiota, which can have benefits for the infant’s health. The bacterial profiles of breast-fed babies are known to differ from those of babies fed with standard formulas (2), so as a result, research has investigated the effects of supplementing formulas with different combinations of galacto-oligosaccharides (GOS), fructo-oligosaccharides (FOS) and polydextrose (PDX), to try to emulate the gold standard of breast milk. Researchers in Belgium performed a review of the latest scientific research to highlight the findings related to supplementing infant formulas.
Effects on gastrointestinal microbiota
Formula with added prebiotics have a greater chance of affecting gut microbes when their administration begins earlier in infancy (3). There is also evidence to suggest that prebiotics can reduce adverse effects of antibiotics on the gastrointestinal microbiota (4). With respect to pre-term babies, formula supplemented with FOS, specifically, can be beneficial for gut microbiota (5). Different studies have investigated various concentrations of prebiotics in formulas and report similar stimulation of intestinal bifido and lacto to breast-fed infants (6-8).
Effects on faecal pH and metabolic activity
The pH levels in the gut effect the bacteria that can grow there, with lower pH values decreasing the amount of pathogenic bacteria (9). Supplementary prebiotics have been reported to decrease intestinal pH levels (19), reduce pH levels lower compared to standard formula (10) and even bring pH levels in-line with those observed in breast-fed infants (8). Metabolic activity in the gut of infants feed with GOS/FOS supplemented formula has been shown to be comparable to that of babies fed with breast milk (11, 12).
Effects on immunity
There is evidence to suggest a potential association between prebiotics and immune system development (13) but other research has found no significant effect (14). One study found prebiotics affected intestinal microbiota after the study intervention, which suggested a modulating effect on the immune system (15). While further investigation is warranted, it is likely that prebiotic oligosaccharides are likely to enhance the immune system.
Effects on stool consistency and frequency
Prebiotics added to formula can bring the frequency of bowel movements in-line with that of breast-fed infants (6, 7, 16). Different supplement mixtures have been shown to soften the consistency of stools (17, 18), bringing it closer to that of breast-fed babies (19), without increasing fussiness or gassiness (18).
Other areas of study
Prebiotic supplements in infant formulas are unlikely to have an effect on growth (16), while the influences on general health (20), infection reduction (8, 21) and atopic dermatitis (22, 23) remain unclear and warrant further examination.
- Kunz C, Rudloff S, Baier W, Klein N, Strobel S. Oligosaccharides in human milk: structural, functional, and metabolic aspects. Annu Rev Nutr 2000; 20:699-722
- Harmsen HJ, Wildeboer-Veloo AC, Raangs GC, Wagendorp AA, Klijn N, Bindels JG, Welling GW. Analysis of intestinal flora development in breast-fed and formula-fed infants by using molecular identification and detection methods. J Pediatr Gastroenterol Nutr 2000; 30:61-7
- 9 Nakamura N, Gaskins HR, Collier CT, Nava GM, Rai D, Petschow B, Russell WM, Harris C, Mackie RI, Wampler JL, et al. Molecular ecological analysis of fecal bacterial populations from term infants fed formula supplemented with selected blends of prebiotics. Appl Environ Microbiol 2009; 75:1121-8
- Ladirat SE, Schuren FH, Schoterman MH, Nauta A, Gruppen H, Schols HA. Impact of galacto-oligosaccharides on the gut microbiota composition and metabolic activity upon antibiotic treatment during in vitro fermentation. FEMS Microbiol Ecol 2014; 87:41-51
- Kapiki A, Costalos C, Oikonomidou C, Triantafyllidou A, Loukatou E, Pertrohilou V. The effect of a fructo-oligosaccharide supplemented formula on gut flora of preterm infants. Early Hum Dev 2007; 83:335-9
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- Ben XM, Zhou XY, Zhao WH, Yu WL, PanW, Zhang WL, Wu SM, Van Beusekom CM, Schaafsma A. Supplementation of milk formula with galacto-oligosaccharides improves intestinal micro-flora and fermentation in term infants. Chin Med J (Engl) 2004; 117:927-31
- Ortuño I, Espín B, Vasallo MI, Gil D, Vidal ML, Infante D, Leis R, Maldonado J, Moreno JM, Roman E. Prebiotic effect during the first year of life in healthy infants fed formula containing GOS as the only prebiotic: a multicentre, randomised, double-blind and placebo-controlled trial. Eur J Nutr 2014;
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- Arslanoglu S, Moro GE, Schmitt J, Tandoi L, Rizzardi S, Boehm G. Early dietary intervention with a mixture of prebiotic oligosaccharides reduces the incidence of allergic manifestations and infections during the first two years of life. J Nutr 2008; 138:1091-5
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- Scalabrin DM, Mitmesser SH, Welling GW, Harris CL, Marunycz JD, Walker DC, Bos NA, Tölkkö S, Salminen S, Vanderhoof JA. New prebiotic blend of polydextrose and galacto-oligosaccharides has a bifidogenic effect in young infants. J Pediatr Gastroenterol Nutr 2012; 54:343-52
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- Vos AP, Haarman M, Buco A, Govers M, Knol J, Garssen J, Stahl B, Boehm G, M’Rabet L. A specific prebiotic oligosaccharide mixture stimulates delayed-type hypersensitivity in a murine influenza vaccination model. Int Immunopharmaco 2006; 6:1277-86
- Muraro A, Halken S, Arshad SH, Beyer K, Dubois AE, Du Toit G, Eigenmann PA, Grimshaw KE, Hoest A, Lack G, et al. EAACI food allergy and anaphylaxis guidelines. Primary prevention of food allergy. Allergy 2014; 69:590-601
- Foolad N, Armstrong AW. Prebiotics and probiotics: the prevention and reduction in severity of atopic dermatitis in children. Benef Microbes 2014; 5:151-60