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Early Effect of Supplemented Infant Formulae on Intestinal Biomarkers and Microbiota: A Randomized Clinical Trial
Mireille Castanet1, Christos Costalos2, Nadja Haiden3
1CIC INSERM U1404, Department of Pediatric, Rouen University Hospital Charles Nicolle, 76031 Rouen, France.
Insights
Supplementing infant formula with Bovine Milk-derived Oligosaccharides (BMOS) promoted gut maturation markers and microbiota development similar to breastfed infants. This suggests BMOS can support infant gut health and maturation.
Area of Science:
- Infant nutrition and gut health
- Microbiome research
- Pediatric gastroenterology
Background:
- Post-natal gut maturation involves morphology, digestive, immunological functions, and microbiota development.
- Early life gut health is crucial for infant development.
- Understanding infant formula effects on gut maturation is important.
Purpose of the Study:
- To explore microbiota development and gut barrier maturation markers in healthy term infants.
- To assess the interconnection of gut functions under different infant formula regimens.
- To evaluate the impact of specific nutrient supplementation on infant gut maturation.
Main Methods:
- A randomized double-blind controlled trial with 203 infants, including a breastfed reference group.
- Infants received starter formulas supplemented with lactoferrin, probiotics, and Bovine Milk-derived Oligosaccharides (BMOS), followed by a control formula.
- Stool microbiota profiles and gut maturation biomarkers (calprotectin, elastase, α-1 antitrypsin, neopterin) were measured at multiple time points.
Main Results:
- Formula supplemented with BMOS showed lower calprotectin levels in early weeks compared to other formulas.
- Elastase and α-1 antitrypsin levels in supplemented groups approached those of breastfed infants.
- Microbiota profiles in the BMOS group overlapped with breastfed infants, dominated by bifidobacteria, and were associated with calprotectin levels.
Conclusions:
- A significant correlation exists between gut microbiota composition and the maturation marker calprotectin.
- Supplementation with BMOS appears to promote gut maturation closer to that observed in breastfed infants.
- This study highlights the potential of specific formula components in supporting infant gut development.
Background:
Post-natal gut maturation in infants interrelates maturation of the morphology, digestive, and immunological functions and gut microbiota development. Here, we explored both microbiota development and markers of gut barrier and maturation in healthy term infants during their early life to assess the interconnection of gut functions during different infant formulae regimes.
Methods:
A total of 203 infants were enrolled in this randomized double-blind controlled trial including a breastfed reference group. Infants were fed starter formulae for the first four weeks of life, supplemented with different combination of nutrients (lactoferrin, probiotics (Bifidobacterium animal subsp. Lactis) and prebiotics (Bovine Milk-derived Oligosaccharides-BMOS)) and subsequently fed the control formula up to eight weeks of life. Stool microbiota profiles and biomarkers of early gut maturation, calprotectin (primary outcome), elastase, α-1 antitrypsin (AAT) and neopterin were measured in feces at one, two, four, and eight weeks.
Results:
Infants fed formula containing BMOS had lower mean calprotectin levels over the first two to four weeks compared to the other formula groups. Elastase and AAT levels were closer to levels observed in breastfed infants. No differences were observed for neopterin. Global differences between the bacterial communities of all groups were assessed by constrained multivariate analysis with hypothesis testing. The canonical correspondence analysis (CCA) at genus level showed overlap between microbiota profiles at one and four weeks of age in the BMOS supplemented formula group with the breastfed reference, dominated by bifidobacteria. Microbiota profiles of all groups at four weeks were significantly associated with the calprotectin levels at 4 (CCA, p = 0.018) and eight weeks of age (CCA, p = 0.026).
Conclusion:
A meaningful correlation was observed between changes in microbiota composition and gut maturation marker calprotectin. The supplementation with BMOS seems to favor gut maturation closer to that of breastfed infants.
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