First clinical study to report on the effects of supplementation with 2 HMOs on establishing microbiota in newborn infants and link to less antibiotics use

Editor(s): Berger B. 11 / 2

Human milk is the sole and recommended nutrition for the newborn infant and contains one of the largest constituents of diverse oligosaccharides, dubbed human milk oligosaccharides (HMOs). Preclinical and clinical association studies indicate that HMOs have multiple physiological functions largely mediated through the establishment of the gut microbiome. Until recently, HMOs were not available to investigate their role in randomized controlled intervention trials. A recently published study is the first report on the effects of 2 HMOs on establishing microbiota in newborn infants In a randomized, double-blinded, controlled, multi-center, interventional clinical trial, healthy term infants received infant formula with or without 2 HMOs (2’FL and LNnT) up to 6 months.

This study provides a detailed description of the microbiota changes observed upon feeding a formula supplemented with HMOs in comparison to breastfed infants and associates the microbiota to later health, as assessed by prescribed antibiotic use.

HMO supplementation was shown to shift the microbiota, closer to that of breastfed infants: in its diversity, in its global composition at genus level and abundance of major genera typical for this age period. HMO supplemented formula also alleviated the altered microbiota profile observed in C-section born infants, shifting it to the profile of vaginally delivered infants. This shows a stronger normalization effect of HMOs on an altered microbiota, as is the case for C-section born infants.

HMO supplementation also increased the number of infants with fecal community types typical for breastfed infants. Formula-fed infants with such fecal community types were significantly less likely to require antibiotics during the first year of life compared to those with a fecal community type typical of the control formula-fed infants. Previously reported lower rates of infections (lower respiratory tract infection) and less medication use with HMO supplementation may therefore be linked to its modulation of the microbiota.