Supplementation of a bovine milk formula with an oligosaccharide mixture increases counts of faecal bifidobacteria in preterm infants

Abstract

Background: The establishment of a balanced intestinal microflora which may protect against infection is desirable for the preterm infant. Objective: To investigate the effect of a preterm formula milk supplement consisting of oligosaccharides in similar proportions to human milk on the faecal flora and stool characteristics of preterm infants. Study design: To resemble the effect of human milk, an oligosaccharide mixture consisting of 90% galacto-oligosaccharides and 10% fructo-oligosaccharides was used to supplement a standard preterm formula at a concentration of 10 g/l. This supplemented formula was studied in 15 preterm infants, and the results were compared with those found in 15 infants fed a formula supplemented with maltodextrin as placebo. A group fed fortified mother's milk was investigated as a reference group (n = 12). On four days during a 28 day feeding period (1, 7, 14, and 28), the faecal flora was investigated, and stool characteristics, growth, and possible side effects were recorded. Results: During the study period, the number of bifidobacteria in the group fed the oligosaccharide supplemented formula increased to the upper range of bifidobacteria counts in the reference group. The difference between the supplemented and non-supplemented groups was highly significant (p = 0.0008). The stool characteristics were also influenced by the supplement: the stool frequency after 28 days was significantly lower in the control group than in the oligosaccharide supplemented group (p = 0.0079) and the reference group (p < 0.0001). Over the study period, the stool consistency in the control group became harder, but remained fairly stable in the other two groups. There was no effect of the different diets on the incidence of side effects (crying, regurgitation, vomiting) or on weight gain or length gain. Conclusion: Supplementing preterm formula with a mixture of galacto-and fructo-oligosaccharides at a concentration of 10 g/l stimulates the growth of bifidobacteria in the intestine and results in stool characteristics similar to those found in preterm infants fed human milk. Therefore prebiotic mixtures such as the one studied may help to improve intestinal tolerance to enteral feeding in preterm infants.

Yoghurt containing galacto-oligosaccharides, prunes and linseed reduces the severity of mild constipation in elderly subjects

“…The importance of fibre in alleviating constipation is well known (Taylor, 1990). In addition, GOS are reported to have a bifidogenic effect (Ito et al, 1990;Bouhnik et al, 1997;Boehm et al, 2002;Moro et al, 2002;Knol et al, 2005;Rinne et al, 2005), and here they may have altered bowel function through an increase in bifidobacteria and a change in the colonic environment. However, there were some subjects on whom the GOS had no effect; in fact, their constipation even became more severe.…”

“…GOS have been found to relieve constipation in Japanese studies, too (Deguchi et al, 1997;Shitara, 1988). GOS are in general well-tolerated (van Dokkum et al, 1999;Boehm et al, 2002;Moro et al, 2002). However, because of fermentation, symptoms such as abdominal bloating and flatulence may occur in sensitive subjects when large quantities of GOS are ingested (Ito et al, 1990;.…”

Low level of galacto-oligosaccharide in infant formula stimulates growth of intestinal Bifidobacteria and Lactobacilli

“…These values have been adopted by the Scientific Committee on Food (SCF: April, 2003) of the European Commission and probably will be implemented in European regulations. In preterm infants, the same mixture of oligosaccharide (1.0 g/100 mL) could stimulate growth of Bifidobacteria and result in stool characteristics as seen in human milk-fed infants [12] . Recently, however, a rat study [14] showed that the intestinal cell wall is irritated and the risk of bacterial translocation increases (following orally Salmonella enteritidis infection) when fructooligosaccharides are provided at a high (3% and 6% of dry matter), but not an unrealistic amount (maximum level adopted by the SCF is about 6% of dry matter).…”

“…GOS stimulates intestinal probiotics growth 6565 formula [12,13] , and there is no study using only GOS in infant formula.…”

Probiotics, Prebiotics and Synbiotics for Infant Feeding

“…Infants ingesting a standard formulae containing FOS+ GOS (0.8g / 100g) induced an increase in faecal bifidobacteria population from 54.8 ± 9.8 to 73.4 ± 4.0 % [68] with a diversity of bifidobacteria species similar to breast-fed infants [127] and stool characteristics identical to those recorded for pre-term infants with human milk [128]. Other infant feeding trials reported an increase in bifidobacteria population by 43-57 % [129] or 59.6 % [130] and the population reached to a level of 10.0 ± 2.05 log cfu/g [131] or 9 x 10 12 cfu/g faeces [115].…”