Chemistry Reference
In-Depth Information
infant formulas with various prebiotics to obtain the protective benefits conferred
with the breast milk prebiotics.
The addition of GOS and FOS to formula has been shown to positively affect the
bifidobacteria content of the infant's feces,
20
as well as to induce a reduction of clini-
cally relevant pathogen germs in the feces of formula-fed preterm infants.
21
Stahl et
al.
22
found that GOS/FOS can be detected in stools of prebiotic-supplemented for-
mula-fed infants in amounts similar to those displayed in infants given human milk
oligosaccharides via breast milk. Furthermore, the pattern of fecal short-chain fatty
acids in infants fed an oligosaccharide mixture was found to be similar to that of
breastfed infants and significantly different from that of a group of infants fed with a
formula without added prebiotics.
23
A study by Euler et al.,
24
however, identified that
not only the amount but also the type and origin of prebiotic used in the formula are
key in obtaining demonstrable clinical benefits, as they were unable to demonstrate
any change in fecal flora with two different doses of FOS.
In a group of preterm infants, the addition of a combination of GOS/FOS to
the formula was shown in a double-blind, placebo-controlled study to reduce stool
viscosity and gastrointestinal transit time without any adverse events.
25
Boehm et
al.
26
tested in preterm infants a mixture of 90 percent GOS and 10 percent FOS,
with a distribution of molecules and a concentration of total oligosaccharides close
to human milk, added to a standard preterm formula. The supplementation resulted
in a clear bifidogenic effect, accompanied by more frequent softer stools. It was also
observed that the Ca/P ratio in the urine was similar to that observed in breastfed
infants, suggesting also an influence of prebiotics on calcium absorption.
Ziegler et al.
27
recently reported the use of a prebiotic supplemented formula in a
group of healthy term infants and found that the supplemented group had compara-
ble growth to the placebo group with no adverse events. The prebiotic-supplemented
group also had a stool pattern that more closely resembled breastfed infants than the
group fed the standard infant formula. A study with term infants has evaluated the
nutritional efficacy and bifidogenic characteristics of an infant formula containing
partially hydrolyzed whey proteins, modified fats, and prebiotics with starch and
reported satisfactory growth and higher counts of bifidobacteria in the feces with no
adverse side effects.
28
Another prospective study suggested that infants with “minor”
gastrointestinal symptoms (such as colic, regurgitation, and constipation) improved
within 2 weeks of feeding the same type of supplemented formula.
29
The use of oligofructose-supplemented infant cereal was found in a random-
ized, blinded trial to give fewer loose stools, fewer physician visits for diarrhea,
and fewer days missed from daycare because of diarrhea in the group receiving the
supplemented cereal.
30
However, there was no difference in the incidence of diarrhea
or other infections. More recently Duggan et al.
31
demonstrated that oligofructose-
supplemented cereal given to community-based infants in Peru also had no effect on
diarrhea incidence, use of healthcare resources, and response to
Haemophilus influ-
enzae
immunization. It was speculated that the high rate of breastfeeding in both the
control and treatment group may have negated the effect.
A study on oligofructose supplementation was performed in a group of healthy
7- to 19-month-olds attending daycare and found that compared to a placebo group
