Human milk oligosaccharides and infant growth: a global health approach (2024)

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Pediatric Research volume96,pages 277–278 (2024)Cite this article

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Human milk oligosaccharides (HMOs) represent an important component of breast milk, specifically, they are the third largest part, with a concentration fluctuating from 12.9 g/L in mature milk and 20.9 g/L at 4 days postpartum. There are over 200 different types of HMOs known and they provide multiple health benefits: they act as prebiotics, promoting digestive health; modulating immune responses; and enhancing cognitive development.

Their production depends primarily on the mother’s genotype, in particular, according to specific transferase enzymes expressed in the lactocytes and related to the Secretor and Lewis blood group genes. The Secretor gene encodes for the enzyme α[1,2]-fucosyltransferase (FUT2); the enzyme FUT3 is encoded for by the Lewis blood group gene.1 According to the polymorphism of mothers, newborns naturally receive milk with different amounts and types of oligosaccharides and this could consequently lead to differences in terms of specific infant morbidity, growth, and development.2 The association between HMO and child growth has been inadequately explored with conflicting results.3

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Funding

This paper was partially funded by a contribution from the Italian Ministry of Health (ricerca corrente).

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Authors and Affiliations

  1. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

    Alessandra Mazzocchi&Carlo Agostoni

  2. Pediatric Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy

    Carlo Agostoni

Authors

  1. Alessandra Mazzocchi

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  2. Carlo Agostoni

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Contributions

A.M. drafted the initial version of this manuscript and C.A. read and approved the final version of the manuscript.

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Correspondence to Carlo Agostoni.

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The authors declare no competing interests.

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Human milk oligosaccharides and infant growth: a global health approach (1)

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Mazzocchi, A., Agostoni, C. Human milk oligosaccharides and infant growth: a global health approach. Pediatr Res 96, 277–278 (2024). https://doi.org/10.1038/s41390-024-03037-2

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Human milk oligosaccharides and infant growth: a global health approach (2024)

FAQs

How do oligosaccharides in human milk help protect the infant from infection? ›

They can act as an antiviral through a number of mechanisms, which were described earlier. They promote the maturation of the immune system and create a more balanced Th1/Th2 cytokine response. They may stimulate the immune response and maturation of epithelial cells to protect the host against virus infection.

Can babies digest human milk oligosaccharides? ›

HMOs are unique complex sugars found in breastmilk, however infants can't digest them. Gut microbes can utilize HMOs, thus, breastfeeding shapes the infant microbiome.

Is HMO in formula good? ›

HMOs fulfil a variety of physiologic functions including potential support to the immune system, brain development, and cognitive function. Supplementing infant formula with HMOs is safe and promotes a healthy development of the infant revealing benefits for microbiota composition and infection prevention.

Are human milk oligosaccharides safe? ›

Major hMOSs of human milk are being tested as additives to infant formula. Trials of infant formulas containing one or two hMOS indicate safety and improved immune and metabolic benefits but no effect on infant growth.

What are the benefits of human milk oligosaccharides? ›

In breastfed babies, HMOs are scientifically shown to positively affect the microbiome. "HMOs help strengthen immunity because they feed the beneficial bacteria in your baby's gut where 70 percent of the immune system exists," says Rachael Buck, Ph. D., an Abbott researcher and immune expert.

What are the effects of human milk oligosaccharides in infant health based on gut microbiota alteration? ›

HMOs provide many benefits to infants, including regulating their metabolism, immune system, and brain development. Recent studies have emphasized that HMOs act as prebiotics by the metabolism of intestinal microorganisms to produce short-chain fatty acids, which are crucial for infant development.

What is another name for human milk oligosaccharides? ›

Human milk oligosaccharides (HMOs), also known as human milk glycans, are short polymers of simple sugars that can be found in high concentrations in human breast milk.

What is the most common human milk oligosaccharide? ›

Human milk oligosaccharides (HMOs) are the third most abundant component of breast milk, after lactose and lipids. Amongst the synthetized HMOs, 2′-fucosyllactose (2′-FL) and lacto-N-neotetraose (LNnT) are widely studied and are considered safe for infant nutrition.

Does human milk have more oligosaccharides than cow's milk? ›

Compared to human milk, oligosaccharide concentrations in the milk of farm animals, such as cows, goats, and sheep are 100–1000-fold lower. In fact, these unique complex carbohydrate structures in human milk are virtually absent in cow's milk or any other farmed animal milk, and their variety is much lower [10].

What are 2 disadvantages of choosing the HMO? ›

Disadvantages
  • If you need specialized care, you will need a referral from your primary care physician to an in-network provider.
  • Must see in-network providers for care-less flexibility than a PPO plan.

Which formulas have HMOs? ›

Similac Pro-Advance, Similac Pro-Sensitive and Similac Pro-Total Comfort all have 2'-FL HMO. The 2'-FL HMO in Abbott's formulas is bio-structurally identical to the 2'-FL HMO found in mother's milk and it is produced in a similar way to the way some vitamins are made.

What is the healthiest baby formula brand? ›

QUICK SUMMARY. The best baby formula is Enfamil, according to experts and parents from the What to Expect community, based on price, availability and ingredients. Other favorites include Kirkland, Aussie Bubs and Bobbie.

Why avoid oligosaccharides? ›

These organic compounds are difficult to digest, so consumption can lead to digestive symptoms like gas, bloating, abdominal cramping, diarrhea, or constipation.

Can infants digest oligosaccharides? ›

Human milk oligosaccharides (HMOs) are abundant in volume and in structural variety in human milk and yet the infant does not produce glycosidases capable of digesting these glycans raising the question of why the mother expends significant energy to create these structures.

What should be the first ingredient in baby formula? ›

Lactose should be the first baby formula ingredient

Most of the time, it should be lactose in a cow's milk formula. Lactose, or milk sugar, is the main source of carbohydrate nutrition in human breast milk. As such, your baby's formula should contain lactose as the first ingredient.

How do oligosaccharides in human milk provide the breastfed infants some immune protection? ›

Breast milk contains protective immune factors, including human milk oligosaccharides (HMOs) such as 2'-FL, that help build baby's developing immune system. HMOs are non-digestible carbohydrates that form the third most abundant solid component of breast milk.

What is the role of oligosaccharides in human milk? ›

The HMOs in mother's milk play key roles in the development of effective intestinal barrier function and the immune system, and certain HMOs may also play a role in the development of the baby's brain.

How do human milk glycoproteins protect infants against human pathogens? ›

Glycans in human milk contain oligosaccharide moieties in their free and conjugated form, and many function as competitive inhibitors of pathogen binding, thereby protecting infants against infection.

What are the oligosaccharides in baby milk? ›

What are HMOs? HMOs are complex carbohydrates, also known as targeted prebiotics. Unlike other commercial prebiotics such as GOS/FOS, HMOs are unique to breast milk and research suggests that they provide immune support to developing infants. HMOs have a unique structure which allows them to provide targeted benefits.

References

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