Nutrición Hospitalaria 03084 / http://dx.doi.org/10.20960/nh.03084
Resumen| PDF (ENGLISH)

Trabajo Original

Real-world study in infants fed with an infant formula with two human milk oligosaccharides


Enriqueta Román, José Manuel Moreno Villares, Francisco Domínguez Ortega, Alfonso Carmona Martínez, Leandro Picó Sirvent, Luz Santana Sandoval, Jose Casas Rivero, Ayham Alshweki, Colin Cercamondi, Samir Dahbane, Maria Luisa Vidal Guevara

Prepublicado: 2020-07-23
Publicado: 2020-08-07

Logo Descargas   Número de descargas: 16617      Logo Visitas   Número de visitas: 8575      Citas   Citas: 5

Compártelo:


Introduction: human milk oligosaccharides (HMOs) are an important component of human milk supporting the development of a balanced intestinal microbiota and immune protection in breastfed infants. Randomized controlled trials (RCTs) have demonstrated that infant formulas supplemented with the HMOs 2’-fucosyllactose (2’FL) and lacto-N-neotetraose (LNnT) are safe, well-tolerated, and support normal growth. This Real-World Evidence (RWE) study aimed to evaluate growth and tolerance in infants consuming a formula supplemented with 1 g/L of 2’FL and 0.5 g/L of LNnT, and included a mixed-feeding group never studied before in RCTs. Participants and methods: this open-label, prospective study was conducted at six centers in Spain, and included healthy, exclusively breastfed infants (BF group), an exclusively formula-fed group (FF) who received a milk-based formula with 2’ FL and LNnT, and a group mixed fed with both formula and human milk (MF), for 8 weeks. Co-primary outcomes were growth (anthropometry) and gastrointestinal tolerance (Infant Gastrointestinal Symptom Questionnaire, IGSQ). Secondary outcomes included formula satisfaction and adverse events (AEs). Results: 159 infants completed the study (66 FF, 48 MF, and 45 BF). Mean z-scores for growth were similar between all groups and within ± 0.5 of WHO medians at week 8. Composite IGSQ scores demonstrated low GI distress in all groups, with no significant group differences at baseline, week 4, or week 8. Incidence of AEs was low overall, and comparable across groups. Conclusions: in this RWE study examining a HMO-supplemented infant formula, growth and tolerance outcomes were similar to RCT findings, supporting the effectiveness of this early feeding option.

Palabras Clave: Infant formula. Human milk oligosaccharides. 2′-fucosyllactose. Lacto-N-neotetraose. Gastrointestinal tolerance.



Liu, Shuang, Mao, Yingyi, Wang, Jin, Tian, Fang, Hill, David R., Xiong, Xiaoying, Li, Xiang, Zhao, Yanrong, Wang, Shuo (2023) Lactational and geographical variation in the concentration of six oligosaccharides in Chinese breast milk: a multicenter study over 13 months postpartum. Frontiers in Nutrition
Bosheva, Miroslava, Tokodi, Istvan, Krasnow, Aleksander, Pedersen, Helle Krogh, Lukjancenko, Oksana, Eklund, Aron C., Grathwohl, Dominik, Sprenger, Norbert, Berger, Bernard, Cercamondi, Colin I. (2022) Infant Formula With a Specific Blend of Five Human Milk Oligosaccharides Drives the Gut Microbiota Development and Improves Gut Maturation Markers: A Randomized Controlled Trial. Frontiers in Nutrition
Zakharova, Irina N., Orobinskaia, Iana V., Sugian, Narine G., Kovtun, Tatiana A., Tabulovich, Elena V. (2022) Breast milk oligosaccharides: what do we know today?. Pediatrics. Consilium Medicum
Schönknecht, Yannik Bernd, Moreno Tovar, María Virginia, Jensen, Stina Rikke, Parschat, Katja (2023) Clinical Studies on the Supplementation of Manufactured Human Milk Oligosaccharides: A Systematic Review. Nutrients
Ge, Hongda, Zhu, Wenxiu, Zhang, Jing, Wang, Zijing, Shi, Huijing, Sun, Jie, Shi, Ming (2024) Human milk microbiota and oligosaccharides in colostrum and mature milk: comparison and correlation. Frontiers in Nutrition
Ninonuevo MR, Lebrilla CB. Mass spectrometric methods for analysis of oligosaccharides in human milk. Nutr Rev 2009;67(Suppl 2):S216-26.
DOI: 10.1111/j.1753-4887.2009.00243.x
Gabrielli O, Zampini L, Galeazzi T, Padella L, Santoro L, Peila C, et al. Preterm milk oligosaccharides during the first month of lactation. Pediatrics 2011;128(6):e1520-31.
DOI: 10.1542/peds.2011-1206
Zivkovic AM, German JB, Lebrilla CB, Mills DA. Human milk glycobiome and its impact on the infant gastrointestinal microbiota. Proc Natl Acad Sci U S A 2011;108(Suppl 1):4653-8.
DOI: 10.1073/pnas.1000083107
Hale TW, Hartmann PE, eds. Textbook of Human Lactation. New York (USA): Springuer Publishing; 2007.
Urashima T, Oftedal OT. Oligosaccharides in the milk of other mammals. In: McGuire MK, McGuire MA, Bode L, eds. Prebiotics and Probiotics in Human Milk: Origins and Functions of Milk-Borne Oligosaccharides and Bacteria 2016:45-139.
DOI: 10.1016/B978-0-12-802725-7.00003-8
Coppa GV, Pierani P, Zampini L, Carloni I, Carlucci A, Gabrielli O. Oligosaccharides in human milk during different phases of lactation. Acta Paediatr Suppl 1999;88(430):89-94.
DOI: 10.1111/j.1651-2227.1999.tb01307.x
Bao Y, Chen C, Newburg DS. Quantification of neutral human milk oligosaccharides by graphitic carbon high-performance liquid chromatography with tandem mass spectrometry. Anal Biochem 2013;433(1):28-35.
DOI: 10.1016/j.ab.2012.10.003
Thurl S, Munzert M, Henker J, Boehm G, Müller-Werner B, Jelinek J, et al. Variation of human milk oligosaccharides in relation to milk groups and lactational periods. Br J Nutr 2010;104(9):1261-71.
DOI: 10.1017/S0007114510002072
Chaturvedi P, Warren CD, Altaye M, Morrow AL, Ruiz-Palacios G, Pickering LK, et al. Fucosylated human milk oligosaccharides vary between individuals and over the course of lactation. Glycobiology 2001;11(5):365-72.
DOI: 10.1093/glycob/11.5.365
Erney RM, Malone WT, Skelding MB, Marcon AA, Kleman-Leyer KM, O'Ryan ML, et al. Variability of human milk neutral oligosaccharides in a diverse population. J Pediatr Gastroenterol Nutr 2000;30(2):181-92.
DOI: 10.1097/00005176-200002000-00016
Coppa GV, Gabrielli O, Zampini L, Galeazzi T, Ficcadenti A, Padella L, et al. Oligosaccharides in 4 different milk groups, Bifidobacteria, and Ruminococcus obeum. J Pediatr Gastroenterol Nutr 2011;53(1):80-7.
DOI: 10.1097/MPG.0b013e3182073103
Smilowitz JT, O'Sullivan A, Barile D, German JB, Lonnerdal B, Slupsky CM. The human milk metabolome reveals diverse oligosaccharide profiles. J Nutr 2013;143(11):1709-18.
DOI: 10.3945/jn.113.178772
Nakhla T, Fu D, Zopf D, Brodsky NL, Hurt H. Neutral oligosaccharide content of preterm human milk. Br J Nutr 1999;82(5):361-7.
DOI: 10.1017/S0007114599001609
McGuire MK, Meehan CL, McGuire MA, Williams JE, Foster J, Sellen DW, et al. What's normal? Oligosaccharide concentrations and profiles in milk produced by healthy women vary geographically. Am J Clin Nutr 2017;105(5):1086-100.
DOI: 10.3945/ajcn.116.139980
Sumiyoshi W, Urashima T, Nakamura T, Arai I, Saito T, Tsumura N, et al. Determination of each neutral oligosaccharide in the milk of Japanese women during the course of lactation. Br J Nutr 2003;89(1):61-9.
DOI: 10.1079/BJN2002746
Leo F, Asakuma S, Fukuda K, Senda A, Urashima T. Determination of sialyl and neutral oligosaccharide levels in transition and mature milks of Samoan women, using anthranilic derivatization followed by reverse phase high performance liquid chromatography. Biosci Biotechnol Biochem 2010;74(2):298-303.
DOI: 10.1271/bbb.90614
Asakuma S, Urashima T, Akahori M, Obayashi H, Nakamura T, Kimura K, et al. Variation of major neutral oligosaccharides levels in human colostrum. Eur J Clin Nutr 2008;62(4):488-94.
DOI: 10.1038/sj.ejcn.1602738
Kulinich A, Liu L. Human milk oligosaccharides: The role in the fine-tuning of innate immune responses. Carbohydr Res 2016;432:62-70.
DOI: 10.1016/j.carres.2016.07.009
Lewis ZT, Totten SM, Smilowitz JT, Popovic M, Parker E, Lemay DG, et al. Maternal fucosyltransferase 2 status affects the gut bifidobacterial communities of breastfed infants. Microbiome 2015;3:13.
DOI: 10.1186/s40168-015-0071-z
Bode L. The functional biology of human milk oligosaccharides. Early Hum Dev 2015;91(11):619-22.
DOI: 10.1016/j.earlhumdev.2015.09.001
Yu ZT, Chen C, Newburg DS. Utilization of major fucosylated and sialylated human milk oligosaccharides by isolated human gut microbes. Glycobiology 2013;23(11):1281-92.
DOI: 10.1093/glycob/cwt065
Marcobal A, Barboza M, Sonnenburg ED, Pudlo N, Martens EC, Desai P, et al. Bacteroides in the infant gut consume milk oligosaccharides via mucus-utilization pathways. Cell Host Microbe 2011;10(5):507-14.
DOI: 10.1016/j.chom.2011.10.007
Puccio G, Alliet P, Cajozzo C, Janssens E, Corsello G, Sprenger N, et al. Effects of Infant Formula With Human Milk Oligosaccharides on Growth and Morbidity: A Randomized Multicenter Trial. J Pediatr Gastroenterol Nutr 2017;64(4):624-31.
DOI: 10.1097/MPG.0000000000001520
Alliet P, Puccio, G, Janssens E, Cajozzo C, Corsello G, Berger B, et al. Term infant formula supplemented with human milk oligosaccharides (2′-fucosyllactose and lacto-N-neotetraose) shifts stool microbiota and metabolic signatures closer to that of breastfed infants. J Pediatr Gastroenterol Nutr 2016;63(1S):S55.
DOI: 10.1097/01.mpg.0000489632.17881.57
Coulet M, Phothirath P, Allais L, Schilter B. Pre-clinical safety evaluation of the synthetic human milk, nature-identical, oligosaccharide 2'-O-Fucosyllactose (2'FL). Regul Toxicol Pharmacol 2014;68(1):59-69.
DOI: 10.1016/j.yrtph.2013.11.005
Coulet M, Phothirath P, Constable A, Marsden E, Schilter B. Pre-clinical safety assessment of the synthetic human milk, nature-identical, oligosaccharide Lacto-N-neotetraose (LNnT). Food Chem Toxicol 2013;62:528-37.
DOI: 10.1016/j.fct.2013.09.018
Marriage BJ, Buck RH, Goehring KC, Oliver JS, Williams JA. Infants Fed a Lower Calorie Formula With 2'FL Show Growth and 2'FL Uptake Like Breast-Fed Infants. J Pediatr Gastroenterol Nutr 2015;61(6):649-58.
DOI: 10.1097/MPG.0000000000000889
Storm HM, Shepard J, Czerkies LM, Kineman B, Cohen SS, Reichert H, et al. 2'-Fucosyllactose Is Well Tolerated in a 100% Whey, Partially Hydrolyzed Infant Formula With Bifidobacterium lactis: A Randomized Controlled Trial. Glob Pediatr Health 2019;6:2333794X19833995.
DOI: 10.1177/2333794X19833995
Singal AG, Higgins PD, Waljee AK. A primer on effectiveness and efficacy trials. Clin Transl Gastroenterol 2014;5:e45.
DOI: 10.1038/ctg.2013.13
Cuadrón Andrés L, Samper Villagrasa MP, Álvarez Sauras ML, Lasarte Velillas JJ, Rodríguez Martínez G, Grupo Colaborativo CALINA. An Pediatr (Barc) 2013;79(5):312-8.
DOI: 10.1016/j.anpedi.2013.03.010
Karmaus W, Soto-Ramírez N, Zhang H. Infant feeding pattern in the first six months of age in USA: a follow-up study. Int Breastfeed J 2017;12:48.
DOI: 10.1186/s13006-017-0139-4
Zhang J, Himes JH, Guo Y, Jiang J, Yang L, Lu Q, et al. Birth weight, growth and feeding pattern in early infancy predict overweight/obesity status at two years of age: a birth cohort study of Chinese infants. PLoS One 2013;8(6):e64542.
DOI: 10.1371/journal.pone.0064542
Group WHOMGRS. WHO Child Growth Standards based on length/height, weight and age. Acta Paediatr Suppl 2006;450:76-85.
Riley AW, Trabulsi J, Yao M, Bevans KB, DeRusso PA. Validation of a Parent Report Questionnaire: The Infant Gastrointestinal Symptom Questionnaire. Clin Pediatr (Phila) 2015;54(12):1167-74.
DOI: 10.1177/0009922815574075
Alexander DD, Yan J, Bylsma LC, Northington RS, Grathwohl D, Steenhout P, et al. Growth of infants consuming whey-predominant term infant formulas with a protein content of 1.8 g/100 kcal: a multicenter pooled analysis of individual participant data. Am J Clin Nutr 2016;104(4):1083-92.
DOI: 10.3945/ajcn.116.130633
Meissner HC. Viral Bronchiolitis in Children. N Engl J Med 2016;374:62-72.
DOI: 10.1056/NEJMra1413456

Artículos más populares

Carta Editor: Revisión sistemática frente a “scoping review”: guía para una elección informada en las investigaciones

Publicado: 2024-05-19

Trabajo Original: Efectos del zinc y resveratrol como moduladores de la respuesta a la leptina en adultos con obesidad

Introducción: el tejido graso es un órgano con fun...

Publicado: 2024-02-09

Una cookie o galleta informática es un pequeño archivo de información que se guarda en su navegador cada vez que visita nuestra página web. La utilidad de las cookies es guardar el historial de su actividad en nuestra página web, de manera que, cuando la visite nuevamente, ésta pueda identificarle y configurar el contenido de la misma en base a sus hábitos de navegación, identidad y preferencias. Las cookies pueden ser aceptadas, rechazadas, bloqueadas y borradas, según desee. Ello podrá hacerlo mediante las opciones disponibles en la presente ventana o a través de la configuración de su navegador, según el caso. En caso de que rechace las cookies no podremos asegurarle el correcto funcionamiento de las distintas funcionalidades de nuestra página web. Más información en el apartado “POLÍTICA DE COOKIES” de nuestra página web.