1.
Infant Formula Supplemented with Biotics: Current Knowledge and Future Perspectives.
Salminen, S, Stahl, B, Vinderola, G, Szajewska, H
Nutrients. 2020;(7)
Abstract
Breastfeeding is natural and the optimal basis of infant nutrition and development, with many benefits for maternal health. Human milk is a dynamic fluid fulfilling an infant's specific nutritional requirements and guiding the growth, developmental, and physiological processes of the infant. Human milk is considered unique in composition, and it is influenced by several factors, such as maternal diet and health, body composition, and geographic region. Human milk stands as a model for infant formula providing nutritional solutions for infants not able to receive enough mother's milk. Infant formulas aim to mimic the composition and functionality of human milk by providing ingredients reflecting those of the latest human milk insights, such as oligosaccharides, bacteria, and bacterial metabolites. The objective of this narrative review is to discuss the most recent developments in infant formula with a special focus on human milk oligosaccharides and postbiotics.
2.
Supplementation of infant formula with probiotics/prebiotics: lessons learned with regard to documenting outcomes.
Szajewska, H
Journal of clinical gastroenterology. 2012;:S67-8
Abstract
In 2011, the Committee on Nutrition of the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition systematically reviewed published evidence on the safety and health effects of the administration of formulae supplemented with probiotics and/or prebiotics compared with unsupplemented formulae. The document could serve as an example of problems relating to the choice and definition of outcomes assessing the addition of new ingredients to infant formulae. The studies were often too small with insufficient power to identify relevant effects, and the follow-up periods in the trials were too short. The clinical outcomes, even those relating to the same domain (eg, gastrointestinal infections) differed. Even if the same outcomes were measured, the definitions of the outcomes were heterogenous, often not widely agreed upon, or just lacking. The use of inappropriate outcome measures and/or their definitions may result in misleading conclusions. It may also lead to an overestimation or underestimation of potential benefits of the intervention or fail to reveal any potential benefits. There is a need for well-designed and carefully conducted randomized controlled trials, with relevant inclusion/exclusion criteria and adequate sample sizes. These studies should use validated clinical outcome measures.
3.
Supplementation of infant formula with probiotics and/or prebiotics: a systematic review and comment by the ESPGHAN committee on nutrition.
Braegger, C, Chmielewska, A, Decsi, T, Kolacek, S, Mihatsch, W, Moreno, L, Pieścik, M, Puntis, J, Shamir, R, Szajewska, H, et al
Journal of pediatric gastroenterology and nutrition. 2011;(2):238-50
Abstract
Infant formulae are increasingly supplemented with probiotics, prebiotics, or synbiotics despite uncertainties regarding their efficacy. The present article, developed by the Committee on Nutrition of the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition, systematically reviews published evidence related to the safety and health effects of the administration of formulae supplemented with probiotics and/or prebiotics compared with unsupplemented formulae. Studies in which probiotics/prebiotics were not administered during the manufacturing process, but thereafter, for example in capsules, the contents of which were supplemented to infant formula or feeds, were excluded.On the basis of this review, available scientific data suggest that the administration of currently evaluated probiotic- and/or prebiotic-supplemented formula to healthy infants does not raise safety concerns with regard to growth and adverse effects. The safety and clinical effects of 1 product should not be extrapolated to other products. At present, there is insufficient data to recommend the routine use of probiotic- and/or prebiotic-supplemented formulae. The Committee considers that the supplementation of formula with probiotics and/or prebiotics is an important field of research. There is a need in this field for well-designed and carefully conducted randomised controlled trials, with relevant inclusion/exclusion criteria and adequate sample sizes. These studies should use validated clinical outcome measures to assess the effects of probiotic and/or prebiotic supplementation of formulae. Such trials should also define the optimal doses and intake durations, as well as provide more information about the long-term safety of probiotics and/or prebiotics. Because most of the trials were company funded, independent trials, preferentially financed jointly by national/governmental/European Union bodies and other international organisations, would be desirable.