A study published in the journal Nutrients, in which researchers from the Ordesa Laboratories R&D Center in the Barcelona Science Park participated, has revealed that supplementing infant formula with the prebiotic Orafti®Synergy1, a mixture of short- and long-chain inulin-type oligosaccharides, modulates the gut microbiota of babies towards higher levels of Bifidobacterium, similar to what happens in breastfed babies, and which does not occur when a standard formula is used. This prebiotic has also been shown to have a beneficial effect on both the immune system and gastrointestinal function of children and is well tolerated in the long term.

Food is one of the primary factors that influences the intestinal colonisation process, and, therefore, the formation of the microbiota, which plays an important role in modulating the immune system. When breastfeeding is not possible, one of the strategies for modulating the composition of the gut microbiota of the formula-fed infant and make it more similar to that of breastfed infants is to enrich the formula with prebiotics, as is the case with Orafti®Synergy1, which in previous studies has already demonstrated its ability to modulate the composition of the gut microbiota and the characteristics of stools.

‘The stimulating effect of bifidobacteria has been attributed to the presence in breast milk of oligosaccharides, carbohydrates that have prebiotic effects. The results of this study have shown that, when added to infant formula, it achieves a similar result to breast milk, which is maintained in the long term and is well tolerated,’ explains Dr Cristina Campoy, director of the Euristikos Excellence Centre for Paediatric Research, member of the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN), and director of the Ordesa Chair.

Shorter infections and softer stools

In general, the total number of infections, as well as the days with fever, was very low throughout the study period. However, although the total number of infections was not influenced by the intake of prebiotics, the overall duration of infections was significantly shorter in the group that received the Orafti®Synergy1-enriched formula compared to the group that received the standard formula. ‘This reveals that the prebiotics included in infant formula could have induced a modulation of certain immune processes, presumably as a result of modifications of the microbiota and related gastrointestinal immunological parameters,’ adds Dr José Antonio Moreno, head of Basic Research in the Pediatric Area at Ordesa, who also participated in the study.

Stool consistency was also observed to be smoother with the prebiotic-supplemented formula compared to the standard formula. Owing to the prebiotic nature of Orafti®Synergy1, its fermentation may benefit bowel habits and stool characteristics in formula-fed babies. In addition, the prebiotic group was found to have higher Bifidobacterium counts in the babies’ sixth month, as well as a higher proportion of these bacteria at two and six months. “In summary, it has been possible to demonstrate how supplementation with inulinic prebiotic oligosaccharides during the first year of life beneficially modulates the infant’s gut microbiota and is associated with a reduced duration of infections”, concludes Dr Campoy.

“Laboratorios Ordesa is a pioneer in the domestic market in the symbiotic use of prebiotics and probiotics in infant formulas and cereals in its Blemil® and Blevit®brand name products. These results reinforce the benefits of this combination to prevent possible infections and favour the formation of a varied microbiota” says Dr José Antonio Moreno.

In breastfed babies, bifidobacteria are the predominant microorganisms and the development of the gut microbiota occurs more slowly compared to infants fed a standard infant formula. In addition, they develop a more varied microbiota with higher proportions of other bacteria related to various pathologies, such as Escherichia coli, Clostridium or Bacteroides, among others.

First long-term study

The beneficial effects of supplementing infant formulas with the prebiotic Orafti®Synergy1 had already been demonstrated, but this new study sought to evaluate this long-term addition and verify its effects both on the immune system and on gastrointestinal function and well-being of breastfed infants during the first year of life.

A prospective, multi-site, randomised, double-blind, prospective study was conducted on a population of 160 healthy infants under 4 months of age. Growth, fever and infections were regularly monitored by a paediatrician. Digestive symptoms, stool consistency, as well as crying and sleeping patterns were also recorded during one week of each study month.

» Reference article: Neumer, F.; Urraca, O.; Alonso, J.; Palencia, J.; Varea, V.; Theis, S.; Rodriguez-Palmero, M.; Moreno-Muñoz, J.A.; Guarner, F.; Veereman, G.; Vandenplas, Y.; Campoy, C. “Long-Term Safety and Efficacy of Prebiotic Enriched Infant Formula—A Randomized Controlled Trial”. Nutrients 2021, 13, 1276. https://doi.org/10.3390/nu13041276