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Infant Milk Study Holds Out the Promise of Protection from Allergy and Infection in University of Milan Study


7/11/2008 11:56:17 AM

WebitPR -- Adding prebiotic oligosaccharides* to infant formula may substantially reduce the incidence of allergies and infections in newborn babies and young children, claim researchers in the Journal of Nutrition[1]. The benefits lasted long after the babies had stopped having formula and had been weaned and were still evident after two years.

Child healthcare specialists hailed the new study as very promising, building on earlier evidence that this specific mixture of prebiotic oligosaccharides can encourage the balance of healthy bacteria in the gut and so enhance the development of the immune system in early life.

“Our hypothesis was that this mixture of prebiotic oligosaccharides could mimic the immune modulatory function of human milk, leading to a reduction in the incidence of allergic manifestations, such as atopic dermatitis, and infections in formula-fed infants,” said Dr Guido Moro, Professor of Neonatology at the Centre for Infant Nutrition, University of Milan, Italy.

The results show that, compared to placebo, this prebiotic oligosaccharide-enriched milk:
• halved the cumulative incidence of atopic dermatitis (AD) (from 27.9 per cent to 13.6 per cent)
• reduced total infections by 30 per cent (from 5.9 episodes per infant to 4.1 per infant)
• reduced antibiotic prescriptions by a third (from 2.7 courses of antibiotics per infant to 1.8 per infant)
• reduced episodes of fever by 43 per cent (3.9 episodes per infant to 2.1 per infant).

The results clearly demonstrate that the protective effect of this prebiotic mixture is lasting beyond the intervention period, suggesting that an immune modulating effect through the intestinal flora modification may be the principal mechanism of action.

“Although these oligosaccharides are not identical to those present in human milk, when added to formula milk and fed to pre-term[2] and term babies[3], [4], [5] they have been shown to result in softer and more frequent stools, and create an intestinal flora similar to that found in breast-fed infants[6], [7]” concluded Professor Moro.

The study also shows a 63 per cent reduction in recurrent wheezing (from 20.6 per cent to 7.6 per cent), an 85 per cent reduction in allergic urticaria (from 10.3 per cent to 1.5 per cent) and a reduction by a third in upper respiratory tract infections (URTIs) (3.2 per infant to 2.1 per infant).

Breastfeeding remains the best form of nutrition for infants, providing natural insurance against the risk of allergy and common childhood infections. But for many mothers who cannot, or choose not to breastfeed, this research suggests that using formula milk enriched with prebiotic oligosaccharides can help boost their babies’ resistance to common allergic reactions and infections.

John Collard, clinical director, Allergy UK, commented:

“This study certainly appears to reinforce the importance of the right gut flora in the prevention of the development of some allergies, and the importance of prebiotics in the development of the desirable gut flora.

“For mothers who cannot or choose not to breast feed, the use of appropriate prebiotics to establish healthy gut flora could well help in minimising the risk of atopic dermatitis developing in susceptible infants using formula feeds. Reducing the risk of AD at this early stage can only be beneficial in terms of minimising infection and allergen entry, both of which can lead to increasing allergy problems later on. The burden of allergic disease is considerable, both in terms of the numbers of children affected and, in many cases, the severity of their problems. We must welcome any measures that have the potential to reduce the likelihood of allergic disease developing in infants.”

Allergies and infections are extremely common among young children, cause significant morbidity and distress to the individual and are an expensive burden on healthcare resources. For instance, atopic dermatitis is estimated to affect one in five babies aged between 0 and six months[8], that is around 150,000 of new births annually[9].

Children experience, on average, between four and six upper respiratory tract infections each year[10] and 10 to 15 per cent of children suffer at least 12 colds per year[10]. Over 40 per cent of children who suffer from cold symptoms are prescribed antibiotics[11]. The cost to the NHS of caring for childhood tonsillitis, just one aspect of URTIs, for example, has been estimated at £60m per year[12].

“This is an exciting and promising study. The beneficial effect shown on the long-term risk of atopy could potentially improve the health of formula-fed infants,” said Dr Atul Singhal, Deputy Director of the MRC Childhood Nutrition Research Centre at the Institute of Child Health in London.

“This simple and easy intervention has the potential to stem the tide of allergic symptoms and reduce childhood infections, which represent a constant cause for concern for parents and healthcare professionals. However further research is needed to confirm the findings and I look forward to seeing more studies in this area.”

The patented prebiotic oligosaccharide used in the study, IMMUNOFORTIS, contains a unique mixture of short-chain galacto-oligosaccharides (GOS) and long-chain fructo-oligosaccharides (FOS) that have been shown to encourage the growth of beneficial bacteria in the gut2, 3, 5. It is believed that a healthy balance of bifidobacteria and lactobacilli is crucial for the development of the immune system in early life.

IMMUNOFORTIS is the unique patented blend of prebiotic oligosaccharides used in this study. It is available in the UK in the Aptamil range of baby milks.

For further information on this story please contact: Jan Petherick/Miranda Askew, at Say Communications jpetherick@saycomms.co.uk/maskew@saycomms.co.uk. Tel: 020 8971 6400.

ABOUT THE STUDY

• The babies enrolled into the study were all healthy, full-term and born to parents with a history of atopic dermatitis, allergic rhinitis, or asthma. The babies’ mothers were all advised to breastfeed their infants. Those who switched to formula feeding within the first two weeks were eligible for the study.
• Over 200 infants completed the initial six-month study in which they were randomly assigned to be fed a standard hypoallergenic formula milk that was supplemented either with the prebiotic mixture or an inactive placebo. Of these infants, 134 were followed up for two years.
• Growth in both the study and placebo groups of infants was normal.

ABOUT APTAMIL

• While breastmilk is superior for the newborn infant, infant milks play an important role in infant nutrition when breastfeeding is not possible or desirable. The search for breastmilk substitutes has been conducted for centuries, and Aptamil has been at the forefront of the many advances made in recent years to bring the composition of infant milk closer to breastmilk. The brand’s final aim is not necessarily to mimic the composition of breastmilk in every respect, but to achieve similar long term outcomes for bottlefed infants as those shown for breastfed infants.
• For healthcare professionals requiring further information, please contact Aptamil for Healthcare Professionals on 08457 623 676 or visit www.aptamil4hcps.co.uk.

References

* Prebiotic oligosaccharides are a type of carbohydrate and are a major component of human breast milk. They help strengthen the baby’s immune system by encouraging good bacteria to flourish in the gut. IMMUNOFORTIS is the unique patented blend of prebiotic oligosaccharides used in this study. It is available in the UK in the Aptamil range of baby milks.
[1] Early Dietary Intervention with a Mixture of Prebiotic Oligosaccharides Reduces the Incidence of Allergic Manifestations and Infections during the First Two Years of Life. Sertac Arslanoglu, Guido E. Moro, Joachim Schmitt, Laura Tandoi, Silvia Rizzardi and Gunther Boehm, J. Nutr. 138: 1091–1095, 2008.
[2] Boehm G, Lidestri M, Casetta P, Jelinek J, Negretti F, Stahl B, Marini A. Supplementation of an oligosaccharide mixture to a bovine milk formula increases counts of faecal bifidobacteria in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2002;86:F178–81. 11. Moro G, Minoli I, Mosca M, Fanaro S, Jelinek J, Stahl B, Boehm G.
[3] Moro G, Minoli I, Mosca M, Fanaro S, Jelinek J, Stahl B, Boehm G. Dosage related bifidogenic effects of galacto- and fructo oligosaccharides in formula fed term infants. J Pediatr Gastroenterol Nutr. 2002; 34:291–5.
[4] Schmelzle H, Wirth S, Skopnik H, Radke M, Knol J, Bo¨ ckler HM, Bro¨ nstrup A, Wells J, Fusch C. Randomised double-blind study of the nutritional efficacy and bifidogenicity of a new infant formula containing partially hydrolyzed protein, a high beta palmitic acid level, and nondigestible oligosaccharides. J Pediatr Gastroenterol Nutr. 2003;36: 343–51.
[5] Knol J, Scholtens B, Kafka C, Steenbakkers J, Gro S, Helm K, Klarczyk M, Scho¨ pfer H, Bo¨ ckler HM, et al. Colon microflora in infant fed formula with galacto- and fructo-oligosaccharides: more like breast fed infants. J Pediatr Gastroenterol Nutr. 2005;40:36–42.
[6] Neu J, Douglas-Escobar M, Lopez M. Microbes and the developing gastrointestinal tract. Nutr Clin Pract. 2007;22:174–82.
[7] Corthe´sy B, Gaskins HR, Mercenier A. Cross-talk between probiotic bacteria and the host immune system. J Nutr. 2007;137:S781–90.
[8] Wadonda-Kabondo N et al. A prospective study of the prevalence and incidence of atopic dermatitis in children aged 0–42 months. British Journal of Dermatology 2003; 149: 1023-1028
[9] http://www.statistics.gov.uk/CCI/nugget.asp?ID=761&Pos=2&ColRank=2&Rank=336
[10] Family Practice 2006 23(3):286-290; doi:10.1093/fampra/cml001http://fampra.oxfordjournals.org/cgi/content/full/23/3/286
[11] Nyquist AC, Gonzales R, Steiner JF, Sande MA. Antibiotic prescribing for children with colds, upper respiratory tract infections and bronchitis. JAMA 1998; 11: 875–7
[12] JV West. Acute upper airway infections. British Medical Bulletin 2002:61: 215-230



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