Effects of a new mixture of prebiotics on fecal flora and stools in term infants

Center for Infant Nutrition, Macedonio Melloni Maternity Hospital, Postgraduate School of Paediatrics, Milan, Italy.
Acta paediatrica (Oslo, Norway: 1992). Supplement 09/2003; 441:77-9. DOI: 10.1080/08035320310018664
Source: PubMed


A double-blind, randomized, controlled study was performed in 90 full term infants to evaluate dose-related bifidogenic effects of a new synergistic mixture of galacto-oligosaccharides (GOS) and fructo-oligosacharides (FOS). The GOS/FOS mixture showed a dose-dependent stimulatory effect on the intestinal growth of bifidobacteria. Also stool consistency and faecal pH were positively affected.

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Available from: Vito Leonardo Miniello, Mar 18, 2014
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    • "The three studies were considered as one study and are referred to as Moro 2006 [32]. Another study was also published in two reports; and is referred as Moro 2002 [35,36]. Twenty five studies (3 synbiotic, 10 probiotic and 12 prebiotic studies) and three on-going studies were included in this review [21,24,25,37-56]. "
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    ABSTRACT: Background Synbiotics, probiotics or prebiotics are being added to infant formula to promote growth and development in infants. Previous reviews (2007 to 2011) on term infants given probiotics or prebiotics focused on prevention of allergic disease and food hypersensitivity. This review focused on growth and clinical outcomes in term infants fed only infant formula containing synbiotics, probiotics or prebiotics. Methods Cochrane methodology was followed using randomized controlled trials (RCTs) which compared term infant formula containing probiotics, prebiotics or synbiotics to conventional infant formula with / without placebo among healthy full term infants. The mean difference (MD) and corresponding 95% confidence intervals (CI) were reported for continuous outcomes, risk ratio (RR) and corresponding 95% CI for dichotomous outcomes. Where appropriate, meta-analysis was performed; heterogeneity was explored using subgroup and sensitivity analyses. If studies were too diverse a narrative synthesis was provided. Results Three synbiotic studies (N = 475), 10 probiotics studies (N = 933) and 12 prebiotics studies (N = 1563) were included. Synbiotics failed to significantly increase growth in boys and girls. Use of synbiotics increased stool frequency, had no impact on stool consistency, colic, spitting up / regurgitation, crying, restlessness or vomiting. Probiotics in formula also failed to have any significant effect on growth, stool frequency or consistency. Probiotics did not lower the incidence of diarrhoea, colic, spitting up / regurgitation, crying, restlessness or vomiting. Prebiotics in formula did increase weight gain but had no impact on length or head circumference gain. Prebiotics increased stool frequency but had no impact on stool consistency, the incidence of colic, spitting up / regurgitation, crying, restlessness or vomiting. There was no impact of prebiotics on the volume of formula tolerated, infections and gastrointestinal microflora. The quality of evidence was compromised by imprecision, inconsistency of results, use of different study preparations and publication bias. Authors’ conclusions There is not enough evidence to state that supplementation of term infant formula with synbiotics, probiotics or prebiotics does result in improved growth or clinical outcomes in term infants. There is no data available to establish if synbiotics are superior to probiotics or prebiotics.
    Full-text · Article · Oct 2012 · Nutrition Journal
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    • "The stool softening effect demonstrated with the blend of PDX and GOS or GOS alone may potentially help manage hard stools that could affect formula-fed infants [37]. In general, softer, looser stools are characteristic of both breastfed infants and infants who receive formula supplemented with prebiotics when compared to those who receive unsupplemented formulas [11,38,39]. In healthy, term infants we previously reported that use of routine formulas supplemented with PDX and GOS produced a bifidogenic effect closer to breast milk compared to formula without PDX and GOS [12]. "
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    ABSTRACT: To ensure the suitability of an infant formula as the sole source of nutrition or provide benefits similar to outcomes in breastfed infants, advancements in formula composition are warranted as more research detailing the nutrient composition of human milk becomes available. This study was designed to evaluate growth and tolerance in healthy infants who received one of two investigational cow's milk-based formulas with adjustments in carbohydrate, fat, and calcium content and supplemented with a prebiotic blend of polydextrose (PDX) and galactooligosaccharides (GOS) or GOS alone. In this multi-center, double-blind, parallel-designed, gender-stratified prospective study 419 infants were randomized and consumed either a marketed routine cow's milk-based infant formula (Control; Enfamil® LIPIL®, Mead Johnson Nutrition, Evansville, IN) (n = 142) or one of two investigational formulas from 14 to 120 days of age. Investigational formulas were supplemented with 4 g/L (1:1 ratio) of a prebiotic blend of PDX and GOS (PDX/GOS; n = 139) or 4 g/L of GOS alone (GOS; n = 138). Anthropometric measurements were taken at 14, 30, 60, 90, and 120 days of age. Daily recall of formula intake, tolerance, and stool characteristics was collected during study weeks 1 and 2 and 24-h recall was collected at 60, 90, and 120 days of age. Medically-confirmed adverse events were recorded throughout the study. There were no group differences in growth rate from 14 to 120 days of age. Discontinuation rates were not significantly different among study groups. No differences in formula intake or infant fussiness or gassiness were observed. During study weeks 1 and 2 and at 60 days of age stool consistency ratings were higher (i.e. softer stools) for infants in the PDX/GOS and GOS groups versus Control and remained higher at 120 days for the PDX/GOS group (all P < 0.05). The overall incidence of medically-confirmed adverse events was similar among groups. Investigational routine infant formulas supplemented with 4 g/L of either a prebiotic blend of PDX and GOS or GOS alone were well-tolerated and supported normal growth. Compared to infants who received the unsupplemented control formula, infants who received prebiotic supplementation experienced a softer stooling pattern similar to that reported in breastfed infants. Identifier: NCT00712608.
    Full-text · Article · Jun 2012 · Nutrition Journal
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    • "With highly restricted intakes of breast milk and standard infant formula being the cornerstone of the management of PKU, it is important to identify whether infants with PKU are at a higher risk of developing a less than optimal intestinal microbiota, through decreased intake of prebiotic oligosaccharides. Studies have demonstrated that standard infant formula supplemented with short-chain galactooligosaccharides (scGOS) and longchain fructooligosaccharides in the ratio 9:1 increases bifidobacteria and lactobacilli levels and decreases fecal pH [12] [13] [14] [15] [16]. Clinical studies have also reported that these changes to the gastrointestinal microbiota may be associated with better gastrointestinal transit (stool frequency and consistency) and a reduced risk of infection [12,17–25]. "
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    ABSTRACT: This exploratory study investigated the influence of adding a patented, specific mixture of prebiotic oligosaccharides (scGOS/lcFOS [9:1 ratio], Danone Research) to a protein substitute suitable for infants with Phenylketonuria (PKU); PKU Anamix Infant (Nutricia). This was an 8-week open-label, single-arm, pilot intervention study in 9 infants (8-week median age) diagnosed with PKU. On study entry, infants were prescribed PKU Anamix Infant to replace an infant phenylalanine-free protein substitute without prebiotics (IPS). Blood phenylalanine concentrations were monitored and stool samples analyzed for pH/bacterial groups. PKU Anamix infant was well tolerated and accepted with no adverse events reported. Overall, plasma phenylalanine and tyrosine concentrations were maintained within target ranges throughout the study (120-360 μmol/l phenylalanine, 30-100 μmol/l tyrosine). All infants exhibited microbiota dominated by bifidobacteria (median 58.97% at Week 8), although no statistically significant change from baseline was observed at study endpoint. No infants showed abnormally high levels of Clostridium histolyticum/lituseburense or potentially pathogenic enterobacteriaceae at any point during the study. A significant reduction in median stool pH versus baseline was observed at Week 4 (pH reduced from 6.79 to 5.83), but this significance was not present at Week 8 (pH = 6.61). PKU Anamix Infant maintains phenylalanine control in line with established IPS without prebiotics and maintains levels of bifidobacteria and lowers stool pH. In exclusively breast-fed infants the latter two factors have been associated with a reduced risk of infection and may be of particular importance in infants with PKU.
    Full-text · Article · Sep 2011 · Molecular Genetics and Metabolism
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