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Infections in infants fed formula supplemented with bovine milk fat globule membranes
Niklas Timby1, Olle Hernell, Outi Vaarala
1*Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden †Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland ‡Department of Nutrition, University of California, Davis.
Objectives:
Observational studies have shown that even in high-income countries formula-fed infants have a higher incidence of acute otitis media (AOM), and gastrointestinal and respiratory tract infections during the first year of life compared with breast-fed infants. We hypothesized that components of the milk fat globule membrane (MFGM) may be responsible for some of these differences and that supplementation with bovine MFGM would decrease the infectious morbidity in formula-fed infants.
Methods:
In a double-blind randomized controlled trial, 160 formula-fed infants received experimental formula (EF) supplemented with bovine MFGM (EF) or unsupplemented standard formula (SF) from <2 months until 6 months of age. A breast-fed reference group consisted of 80 infants. Disease symptoms, health care contacts, and medication were recorded by the parents until 12 months of age. Serum immunoglobulin G for 10 pneumococcal serotypes was analyzed at 6 months of age.
Results:
The cumulative incidence of AOM during the intervention was lower in the EF group than in the SF group (1% vs 9%, P = 0.034), and did not differ from the breast-fed reference group (0%, P = 1.0). The incidence (25% vs 43%, P = 0.021) and longitudinal prevalence (P = 0.012) of antipyretic use were significantly lower in the EF group than in the SF group. Serum immunoglobulin G concentrations against pneumococcal serotypes 1, 5, and 14 were lower in the EF group than in the SF group.
Conclusions:
Supplementation of formula with bovine MFGM reduces the risk of AOM, decreases antipyretics use in formula-fed infants, and has immunomodulatory effects on humoral response against pneumococcus vaccine.
Insights
Supplementing infant formula with milk fat globule membrane (MFGM) reduced acute otitis media (AOM) and antipyretic use in formula-fed infants, mirroring benefits seen in breast-fed infants.
Area of Science:
- Pediatric Nutrition
- Immunology
- Infectious Disease Epidemiology
Background:
- Formula-fed infants exhibit higher rates of infections like acute otitis media (AOM) compared to breast-fed infants.
- Milk fat globule membrane (MFGM) components are hypothesized to confer protective benefits against infections.
Purpose of the Study:
- To investigate if bovine MFGM supplementation in infant formula can decrease infectious morbidity in formula-fed infants.
- To compare the incidence of infections and immune responses in formula-fed infants receiving MFGM-supplemented formula versus standard formula.
Main Methods:
- A double-blind, randomized controlled trial involving 160 formula-fed infants receiving either experimental formula (EF) with bovine MFGM or standard formula (SF).
- A reference group of 80 breast-fed infants was included for comparison.
- Data on disease symptoms, healthcare contacts, and medication use were collected until 12 months; serum immunoglobulin G (IgG) levels against pneumococcal serotypes were analyzed at 6 months.
Main Results:
- The cumulative incidence of AOM was significantly lower in the EF group (1%) compared to the SF group (9%), and comparable to the breast-fed group (0%).
- Antipyretic use was significantly reduced in the EF group (25%) versus the SF group (43%).
- Serum IgG concentrations against specific pneumococcal serotypes (1, 5, 14) were lower in the EF group than in the SF group.
Conclusions:
- Bovine MFGM supplementation in infant formula effectively reduces the risk of AOM in formula-fed infants.
- MFGM supplementation leads to decreased antipyretic use and demonstrates immunomodulatory effects on the humoral immune response to pneumococcal vaccines.
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