Prebiotic Effect Of Fructo-Oligosaccharide Supplemented Term Infant Formula at Two Concentrations Compared with Unsupplemented Formula and Human Milk

• Published in: Journal of pediatric gastroenterology and nutrition Vol. 40; no. 2; pp. 157 - 164
• Main Authors: Euler, Arthur R, Mitchell, Douglas K, Kline, Randi, Pickering, Larry K
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins, Inc 01.02.2005; Lippincott
• Subjects: Bifidobacterium - drug effects; Bifidobacterium - growth & development; Biological and medical sciences; Colony Count, Microbial; Cross-Over Studies; Diseases of the digestive system; Dose-Response Relationship, Drug; Enterotoxins - analysis; Enterotoxins - isolation & purification; Feces - microbiology; Female; Humans; Infant; Infant Formula; Infant, Newborn; Male; Medical sciences; Milk, Human - chemistry; Milk, Human - microbiology; Oligosaccharides - administration & dosage; Probiotics - administration & dosage; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Diet therapy; Oligosaccharide; Human milk; Concentration; Infant formula; Comparative study; Prebiotics
• ISSN: 0277-2116; 1536-4801
• DOI: 10.1097/00005176-200502000-00014

BACKGROUND:Human milk components, including oligosaccharides, affect the gastrointestinal flora of infants. Previous studies in adults have demonstrated that fructo-oligosaccharides increase potentially beneficial fecal bacteria, including bifidobacteria. The purpose of this study was to determine the prebiotic effect of infant formula supplemented with fructo-oligosaccharides. METHODS:Healthy term infants 2 to 6 weeks of age were enrolled in a 5-week, prospective, randomized, crossover, single-site study with a nonrandomized human milk comparator group. Washout weeks preceded and followed a week of feeding with fructo-oligosaccharide-supplemented formula (1.5 or 3.0 g/L). Stool specimens were quantitatively cultured weekly for bacteroides, lactobacilli, bifidobacteria, clostridia and enterococci and were tested for Clostridium difficile toxin. RESULTS:Seventy-two of 87 infants completed the trial; 58 were formula fed and 14 were human milk fed. Mean counts of bifidobacteria and lactobacilli were similar in all groups at entry and no group experienced a significant change in counts with fructo-oligosaccharide supplementation. After 7 days of fructo-oligosaccharide supplementation the bifidobacteria counts were greater in the 1.5 g/L fructo-oligosaccharide formula group than in the human milk fed or 3.0 g/L fructo-oligosaccharide formula groups. Formula-fed infants had higher counts of enterococci and bacteroides before fructo-oligosaccharide supplementation, and these counts did not change after supplementation. Clostridium counts increased 7 days after supplementation in the 1.5 g/L fructo-oligosaccharide formula group (P = 0.0356). No human milk fed infants had C. difficile toxin in stools. Fructo-oligosaccharide (3.0 g/L) supplementation resulted in more frequent and significantly softer stools. CONCLUSIONS:Infant formula supplemented with 1.5 or 3.0 g/L fructo-oligosaccharides was safe but had minimal effect on fecal flora and C. difficile toxin.