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Potential Benefits of adding Human Milk Oligosaccharides to Infant Formulae

Potential Benefits of adding Human Milk Oligosaccharides to Infant Formulae

Human breast milk is nature’s most perfect source of nutrition, providing everything a baby needs to grow and develop healthily. Moreover, breast milk supports the development of a healthy gut microbiota and provides many short-term and long-term health benefits for babies.
Surprisingly, in the mix of many different elements of breast milk, the third most common solid component – human milk oligosaccharides (HMOs) – has virtually no nutritive benefits. HMOs are synthesised by the mammary gland and about 200 structures have been identified, to date. HMOs are unique to human milk, they are either absent or in very low amounts in cow’s milk or any milk from farmed animals.Growing evidence suggests that HMOs provide unique benefits to babies, including protection against infection at a time when they are most vulnerable.Hence, the difference in oligosaccharide content among breast milk and cow’s milk-based infant formulae may be partially responsible for the differences in health outcomes between formula-fed and breastfed infants.

Due to breakthrough advances in biotechnology, 2′-fucosyllactose (2′FL) and lacto-N-neotetraose (LNnT) – 2 of the most abundant and researched HMOs – can now be produced structurally identical to those in breast milk.More importantly, these HMOs are recognised as safe to be added to infant formulae.

A first, randomised, controlled clinical study showed that infants receiving infant formula with 2′FL and LNnT had higher levels of beneficial bifidobacteria in the gut closer to that of breastfed infants and were less susceptible to parent-reported respiratory infections and bronchitis.This resulted in a less frequent use of antipyretic and antibiotic medication in babies, which was also noticed by the parents. Another randomised, controlled clinical study in infants reported that 2′FL, when added to an infant formula, reached systemic circulation beyond the gut and helped lower several inflammatory cytokines to be more like levels in breastfed infants.

Professor Hania Szajewska, Department of Paediatrics of the Medical University of Warsaw, Poland

The administration of currently evaluated HMO-supplemented formulae (with 2′FL and LNnT) to healthy infants does not raise safety concerns with regard to growth and adverse effects. Some favourable clinical effects are possible. Among them, the reduced use of antibiotics is noteworthy. Infants’ exposure to antibiotics is considered to be one of the strongest modulating factors of microbiota in early life, leading to an altered gut microbiota composition and/or activity (dysbiosis). Numerous studies suggest that such changes in the gut microbiota may contribute to the pathogenesis of various diseases, including allergy and obesity. Any intervention that would reduce antibiotic administration is worth considering. However, further high-quality randomised clinical trials are needed to document this, and other clinical effects of infant formulae supplemented with HMOs. These trials should assess outcomes validated by experts in the field of infant nutrition, over a longer period of time. Future research should also examine the optimal composition and dosage for HMO interventions and consider effectiveness in different settings/populations. Stay tuned for future publications.

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