Randomised controlled trial demonstrates that fermented infant formula with short‐chain galacto‐oligosaccharides and long‐chain fructo‐oligosaccharides reduces the incidence of infantile colic

Abstract

AimWe examined the effects on gastrointestinal (GI) tolerance of a novel infant formula that combined specific fermented formula (FERM) with short‐chain galacto‐oligosaccharides and long‐chain fructo‐oligosaccharides (scGOS/lcFOS), with a 9:1 ratio and concentration of 0.8 g/100 mL.MethodsThis prospective, double‐blind, randomised, controlled trial comprised 432 healthy, term infants aged 0–28 days whose parents decided to not start, or discontinued, breastfeeding. Infant formula with scGOS/lcFOS+50%FERM, scGOS/lcFOS+15%FERM, 50%FERM and scGOS/lcFOS were tested. Parents completed standardised seven‐day diaries on GI symptoms, crying, sleeping and stool characteristics each month until the infants were 17 weeks.ResultsAll the formulas were well tolerated. At four weeks, the overall incidence of infantile colic was significantly lower (8%) with scGOS/lcFOS+50%FERM than scGOS/lcFOS (20%, p = 0.034) or 50%FERM (20%, p = 0.036). Longitudinal modelling showed that scGOS/lcFOS+50%FERM‐fed infants also displayed a persistently lower daily crying duration and showed a consistent stool‐softening effect than infants who received formula without scGOS/lcFOS.ConclusionThe combination of fermented formula with scGOS/lcFOS was well tolerated and showed a lower overall crying time, a lower incidence of infantile colic and a stool‐softening effect in healthy term infants. These findings suggest for the first time that a specific infant formula has a preventive effect on infantile colic in formula‐fed infants.

Review shows that parental reassurance and nutritional advice help to optimise the management of functional gastrointestinal disorders in infants

“…From birth to 6 months of age, approximately one infant out of two shows at least one FGID or related signs and symptoms 1, 3. Regurgitation, infantile colic and functional constipation are the most common FGIDs in infancy, and it has been shown that more than one FGID often coexist in the same infant 3, 4. Functional diarrhoea, dyschezia, rumination syndrome and cyclic vomiting syndrome occur less frequently 1, 5.…”

“…Parents can be reassured that crying peaks at about 4–6 weeks after birth and then steadily diminishes until 12 weeks 4, 24. If there is no evidence of cows’ milk protein allergy or warning signs of organic disease, the feeding technique should be evaluated and the caregivers should be reassured and supported 22.…”

Prenatal and postnatal administration of prebiotics and probiotics

“…In the first, infants receiving formula supplemented with GOS had less colic than did infants receiving standard formula, and, among the infants with colic, those receiving the prebiotic formula had lower fecal clostridia and higher fecal lactobacilli and bifidobacteria [41]. In the second, infants receiving a fermented milk formula with added oligosaccharides (synbiotic) had a lower incidence of colic than infants receiving either a fermented milk formula (probiotic) or a formula containing a combination of oligosaccharides (prebiotic) [42]. …”

Multiple functional gastrointestinal disorders are frequent in formula‐fed infants and decrease their quality of life

“…FGIDs are generally described as separate entities, but there is evidence that these disorders occur in different combinations 6, 7, 8. Alterations in gut microbiota have been linked with several gastrointestinal findings, such as delayed gut maturation, infantile colic 9 or excess gas and bloating 10, providing a clear indication that these symptoms are interconnected.…”