Editor(s): B. Hegar, Y. Wibowo, R.W. Basrowi, et al. .
According to a literature review published by Badriul Hegar from the University of Indonesia, Indonesia, Yvan Vandenplas from the Vrije Universiteit Brussel, Belgium, and their colleagues from various other institutes, the human milk oligosaccharides (HMOs), 2’fucosyllactose (2’FL) and lacto-N-neotetraose (LNnT) play an important role in infant nutrition.
Human milk is a highly complex fluid, in which HMOs are the third most abundant solid component. HMOs are a mixture of more than 200 non-digestible carbohydrates. The HMO composition varies among women and during the course of lactation. The amount and diversity of HMOs mainly depend on the genetic background of the mothers. HMOs are virtually absent in cow’s milk and infant formula.
Several studies have reported various beneficial effects of HMOs. HMOs support healthy gut microbiota development by promoting the growth of beneficial gut bacteria. 2’FL and LNnT showed increased growth of beneficial bifidobacteria and decreased growth of pathogenic bacteria. HMOs can serve as soluble decoy receptors that block the attachment of pathogens to the intestinal wall, which may aid in preventing infectious disease. In an in vitro study, 2’FL was found to reduce Campylobacter jejuni invasion by 80% and inhibit the release of mucosal pro-inflammatory signals. Another study reported that 2’FL reduced the number of C. jejuni-associated diarrhoea in breastfed infants. Further, 2’FL and LNnT may also have benefits against necrotising enterocolitis.
One of the important properties of HMOs is the immunomodulation. Feeding an infant formula supplemented with 2′FL and LNnT was associated with a reduction in the incidence of parent-reported bronchitis, lower respiratory tract infections, use of antipyretics and antibiotics, assessed as secondary outcomes of this controlled clinical study. Babies fed with 2′FL-supplemented formula exhibited lower plasma inflammatory cytokine profiles, similar to those of breastfed babies. 2’FL in breast milk also played a role in reducing the risk of developing immunoglobulin E-associated allergies in two-year-old children who were born through C-section. Preclinical studies reported that 2’FL was associated with a reduction in food allergy symptoms and inhibition of lipopolysaccharide-mediated inflammation. HMOs also have a role in brain development. 2’FL and L-fucose stimulate brain development in an experimental study. Dietary 2’FL has been found to affect cognitive domains and improve learning and memory in animal studies.
The HMOs, 2’FL and LNnT, have been regarded as safe by the US Food and Drug Administration and European Food Safety Authority to be added to infant and follow-on formulae. Clinical studies have shown that formula supplemented with 2’FL and/or LNnT are safe, well-tolerated, and supported a normal growth pattern.
Based on these observations, the authors concluded that supplementation of 2’FL and LNnT in infant formula is a promising innovation in infant nutrition.