An α-lactalbumin-enriched and symbiotic-supplemented v. a standard infant formula: a multicentre, double-blind, randomised trial

Abstract

The aim of the present study was to evaluate the safety, tolerance and preventive effect on atopic dermatitis of an experimental a-lactalbumin-enriched and symbiotic-supplemented infant formula. A total of ninety-seven non-breastfed term neonates were enrolled into a double-blind, multicentre, randomised controlled trial in which they received experimental (n 48) or standard formula (n 49) for 6 months. The primary outcome was weight at 6 months of age. Secondary outcomes were gastrointestinal tolerance and manifestation of atopic dermatitis. Faecal secretory IgA (SIgA) concentration and microbiota composition of forty-three infants were analysed at 1 and 6 months. Growth was similar in both groups. At 1 month, compared to those in the control group, infants in the experimental group exhibited less crying or agitation, and more quiet behaviour (P¼0·03). At 6 months, atopic dermatitis was less frequently observed in the experimental group (P,0·05). Decrease of faecal SIgA concentration between 1 and 6 months was mainly observed in the control group. This decrease was significantly associated with atopic dermatitis (P,0·014) and negatively correlated to the level of colonisation by bifidobacteria (P,0·005). In conclusion, compared to the control formula, the experimental formula guaranteed a similar growth, was better tolerated at 1 month and had a protective effect against the development of atopic dermatitis.

Energetic Efficiency of Infant Formulae: A Review

“…All but 2 studies included infants of both sexes, while Fomon et al [10] and Carnielli et al [11] enrolled male infants only. Ten of 14 studies aimed to investigate the suitability and safety of the formulae with a focus on protein and carbohydrate contents [2,10,12,13,14,15,16,17,18,19], while studies focused on fat composition aimed to investigate fat or mineral balances [11,20,21]. Schmelzle et al [17] and Lasekan et al [19] studied modified carbohydrate components in formulae.…”

“…The studies of Koo et al [20], Kennedy et al [21], and Carnielli et al [11] investigated formulae with modified fat contents. Most of the included studies focused on the protein component [2,10,12,13,14,15,16,17]. …”

“…The largest difference in EE between the intervention and control groups of one study (EE of IF minus EE of CF) was observed in 6 of 9 protein-focused studies [2,9,13,14,16,17] and in 1 study on fat modification [11]. …”

Usefulness of Probiotics for Neonates?

“…In particular, probiotic supplementations were shown to impact the intestinal maturation as reported with Bifidobacterium lactis supplementation of preterm infants which induced the maturation of the intestinal IgAs response [97]. Likewise, in fullterm neonates an infant formula containing two strains of probiotics allowed the preservation of high SIgA levels at 6 months compared to the control group [98]. Furthermore, such supplementation was suggested to have a synergistic effect on gut humoral immunity at 12 months of age, since it has shown that significant higher level of total IgM, IgA, and IgG titers was detected in infants who had been breastfed exclusively for at least 3 months and supplemented with probiotics compared with those breastfed receiving placebo [99].…”

“…Discrepancies between the observed effects could be linked to the various probiotics strains used. Indeed, the mechanism of their action could be through the maturation of the immune system, as suggested by the study of Roze et al where low levels of IgAs in the control group has been associated with atopy [98].…”