GOS/FOS Supplement Prevents Intestinal and Extra-intestinal Infections: An Observational Study
This Clinical Summary captures that the prebiotic supplemented feed augments immunity building within the crucial first year of infant growth.
Background
Breast-fed infants are generally less prone to infectious diseases, than formula-fed infants, due to the unique pattern of microbial colonization of mother’s milk. The addition of prebiotics like of galacto- and fructo-oligosaccharides (GOS:FOS) to the infant feed improves the composition of intestinal microflora comparable to that found in breast-fed infants. Moreover, evidence suggests that intestinal microflora are in symbiotic relation with the host and have profound impact on the immune system.
Aim
To test the hypothesis that prebiotics reduce the incidence of intestinal and respiratory infections in healthy infants.
Methods
- A multicenter prospective, randomized, placebo-controlled, open trial.
- In collaboration with the family pediatricians.
|
Inclusion
Criteria |
Exclusion
Criteria |
|
·
Gestational age of 37-42 weeks ·
Birth weight >2500g ·
Feed introduced at least after 15 days of
exclusive maternal milk feed |
·
Twins ·
Clinically significant illness of the mother ·
Congenital immunodeficiency ·
Chronic/progressive diseases ·
Proven or suspected allergy ·
Previous intake of pre-or probiotics |
- A total of 342 infants (mean age 53.7 ± 32.1 days) were enrolled.
- Enrolled infants were randomized either to prebiotic-supplemented formula (addition GOS/FOS)
(n=96) or to a control formula (n=105). - Parameters were recorded at 3, 6, 9, and 12 months after the enrolment.
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Primary outcome measures |
Secondary outcome measures |
|
·
Incidence of acute diarrhea/gastroenteritis ·
Upper and lower respiratory tract infections
rate ·
Number of antibiotic courses prescribed for
respiratory infections |
·
Weight ·
Length ·
Head circumference |
Results
Primary Outcomes:
1. Gastroenteritis: The prebiotic-supplemented group showed lower incidence of gastroenteritis as
compared to the control group (0.12 ± 0.04 vs. 0.29 ± 0.05 incidence/infant/year; p = 0.015) (Figure 1).
Figure 1: Mean number of episodes of acute gastroenteritis was significantly lower in the GOS/FOS. (Adapted from Bruzzese E et al., 2009)
2. Upper respiratory tract infection: At the end of 12 months, the prebiotic-supplemented group had lower number of infants having more than 3 episodes of URTI (17/60 vs. 29/65; p = 0.06) compared to the control group (Figure 2).
Figure 2:. Reduced incidence of Upper respiratory tract infections in children receiving GOS/FOS enriched formula and in controls. (Adapted from Bruzzese E et al., 2009)
3. Antibiotic courses: The number of infants with multiple antibiotic courses/year was lower in prebiotic-supplemented group (24/60 vs. 43/65; p = 0.004) compared to the control group (Figure 3).
Figure 3: Reduced incidence of antibiotic coverage required in children receiving GOS/FOS enriched formula and in controls. (Adapted from Bruzzese E et al., 2009)
Secondary Outcomes: During the first 6 months of follow-up, a transient increase in body weight was observed in prebiotic-supplemented infants compared to the control group.
Conclusion
There is a positive association between the administration of prebiotics like GOS:FOS (9:1) in infants and reduced incidence of gastrointestinal and respiratory infections in infants during the first year of life.
References:
- Bruzzese E, et al. A formula containing galacto- and fructo-oligosaccharides prevents intestinal and extra-intestinal infections: An observational study. Clin Nutr. 2009 Apr;28(2):156-61.
IMPORTANT NOTICE:
Breast milk is best for babies. At Danone, we support breast feeding and believe that breast milk is the best food for babies as the sole source of nutrition for the first 6 months of life and is recommended to be continued until 2 years with the introduction of appropriate complementary foods after 6 months of age.
MOTHER’S MILK IS BEST FOR YOUR BABY
The World Health Organization (WHO)* has recommended that pregnant women and new mothers be informed of the benefits and superiority of breast-feeding, in particular, the fact that it provides the best nutrition and protection from illness for babies. Mothers should be given guidance on the preparation for and maintenance of lactation, with special emphasis on the importance of the well-balanced diet both during pregnancy and after delivery. Unnecessary introduction of partial bottle feeding, or other foods and drinks should be discouraged since it will have a negative effect on breast-feeding. Similarly, mothers should be warned of the difficulty of reversing a decision not to breastfeed. Before advising a mother to use an infant formula, she should be advised of the social and ¬financial implications of her decision. For example, if a baby is exclusively bottle-fed, more than one can (500g) per week will be needed, so the family circumstances and cost should be kept in mind. Mother should be reminded that breast milk is not only the best but also the most economical food for babies. If a decision to use infant formula is taken, it is important to give instruction on correct preparation methods, emphasizing that unboiled water, unsterilized bottles or incorrect dilution can lead to illness.
*See: International Code of Marketing of Breast Milk Substitutes, adopted by the World Health Assembly in Resolution WHA 34.22, May 1981.
Importance of Breastfeeding:
(i)Immediately after delivery, breast milk is yellowish and sticky. This milk is called colostrum, which is secreted during the first week of delivery. Colostrum is more nutritious than mature milk because it contains more protein, more anti-infective properties which are of great importance for the infant's defense against dangerous neonatal infections. It also contains higher levels of, Vitamin 'A', (ii) breast miIk- A) is, a complete and balanced food and provides all the nutrients needed by the infant [for the ¬first six months of life] (B) has anti-infective properties that protect the infants from infection in the early months (C) is always available; (D) needs no utensils or water (which might, carry germs) or fuel for its preparation, (iii) breastfeeding is much cheaper than feeding infant milk substitutes as the cost of the extra food needed by the mother is negligible compared to the cost of feeding infant milk substitutes, (iv) mothers who breast-feed usually have longer periods of infertility after child birth than non-lactators; (b) details of management of breast feeding, as under:- (i) breast-feeding- (A) immediately after delivery enables the contraction of the womb and helps the mother to regain her -figure quickly; (B) is successful when the infant suckles frequently and the mother wanting to breast-feed is confident in her ability to do so (ii) in order to promote and support breast-feeding the mother’s natural desire to breast feed should always be encouraged by giving, where needed, practical advice and making sure that she has the support of her relatives. (iii) adequate care for the breast and nipples should be taken during pregnancy. (iv) it is also necessary to put the infant to the breast as soon as possible after delivery, (v) let the mother and the infant stay together after the delivery, the mother and her infant should be allowed to stay together (in hospital, this is called "rooming-in"); (vi) give the infant colostrum as it is rich in many nutrients and anti-infective factors protecting the infants from infections during the few days of its birth; (vii) the practice of discarding colostrum and giving sugar water, honey water, butter or other concoctions instead of colostrum should be very strongly discouraged; (viii) let the infants suckle on demand; (ix) every effort should be made to breast-feed the infants whenever they cry; (x) mother should keep her body and clothes and that of the infant always neat and clean. Breast-feeding is the best form of nutrition for babies and provides many benefits to babies and mothers. It is important that, in preparation for and during breast-feeding, you eat a healthy, balanced diet. Combined breast and bottle-feeding in the ¬first weeks of life may reduce the supply of your own breast-milk and reversing the decision not to breast-feed is difficult. Always consult your Healthcare Professional for advice about feeding your baby. The social and financial implications of using infant formula should be considered. Improper use of an infant formula or inappropriate foods or feeding methods may present a health hazard. If you use infant formula, you should follow manufacturer's instructions for use carefully - failure to follow the instructions may make your baby ill.
Published by:
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