Probiotics in infant nutrition – Focus on B lactis

Probiotics are live microorganisms, which when consumed in adequate amounts, confer a health effect on the host. One of the most well-researched probiotic stain is Bifidobacterium lactis, a probiotic bacterium found in the human gut, supported by strong clinical data in infants demonstrating its effects on gut colonisation, immune support, diarrhoea, and necrotising enterocolitis. No safety concerns have been reported even with prolonged consumption of formulas supplemented with probiotics.[1]

In formula-fed, vaginally born infants, B lactis supplementation induced a colonisation rate of bifidobacteria close to that observed in breastfed infants at day 31.[2] Similarly, in breastfed C-section born infants, B lactis supplementation led to a healthier gut microbiota, with increased the cell counts of bifidobacteria, and reduced the cell counts of pathogenic enterobacteria and clostridia.[3],[4]

B lactis supplementation has also been demonstrated to significantly enhance faecal anti-poliovirus-specific IgA and anti-rotavirus-specific IgA secretion following immunisation, suggesting enhanced immune response in B lactis-supplemented infants.[5]

Studies are ongoing to explore the potential of combining the probiotic B lactis with the human milk oligosaccharide 2'-fucosyllactose (2'FL) – a bioactive component naturally found in breast milk – in a 100% whey, partially hydrolysed infant formula. Current data suggest that partially hydrolysed infant formula with 2'FL and B lactis is tolerated well, with measures of stooling, vomiting, spit-up, crying, and fussing comparable to that seen with the same formula without 2'FL.[6] Data also suggest that 2’FL may be associated with a lower rate of infection, specifically lower respiratory infections; further studies with focus on infection are warranted to confirm these observations.[7]

In summary, the gut microbiota plays an important role in immune development during infancy; breastfeeding must be promoted to support the establishment of a healthy gut microbiota. In cases where breastfeeding is not possible, an infant formula with HMOs and probiotics may help positively influence the gut microbiota. Not all probiotics are the same; amongst the many probiotics, B lactis is one of the more well-researched strains that has been shown to confer clinically relevant benefits.[8]

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[1] Saavedra JM, et al. Am J Clin Nutr. 2004 Feb;79(2):261-7.

[2] Langhendries JP, et al. J Pediatr Gastroenterol Nutr. 1995 Aug;21(2):177-81.

[3] Mohan R, et al. J Clin Microbiol. 2006 Nov;44(11):4025-31.

[4] Yuniaty T, et al. Paediatr Indones 2013; 53:89-98.

[5] Holscher HD, et al. J Parenter Enteral Nutr. 2012 Jan;36(1 Suppl):106S-17S.

[6] Storm HM, et al. Glob Pediatr Health. 2019 Mar 15;6:2333794X19833995.

[7] Sprenger N, et al. Nestle Nutr Inst Workshop Ser. 2019;90:43-56.

[8] Thomas DW, et al. Pediatrics. 2010 Dec;126(6):1217-31.