title: Prebiotic effect of fructo-oligosaccharide supplemented term infant formula at two concentrations compared with unsupplemented formula and human milk.
abstract: BACKGROUND
  Human milk components, including oligosaccharides, affect the gastrointestinal flora of infants. Previous studies in adults have demonstrated that fructo-oligosaccharides increase potentially beneficial fecal bacteria, including bifidobacteria. The purpose of this study was to determine the prebiotic effect of infant formula supplemented with fructo-oligosaccharides.
  
  
  METHODS
  Healthy term infants 2 to 6 weeks of age were enrolled in a 5-week, prospective, randomized, crossover, single-site study with a nonrandomized human milk comparator group. Washout weeks preceded and followed a week of feeding with fructo-oligosaccharide-supplemented formula (1.5 or 3.0 g/L). Stool specimens were quantitatively cultured weekly for bacteroides, lactobacilli, bifidobacteria, clostridia and enterococci and were tested for Clostridium difficile toxin.
  
  
  RESULTS
  Seventy-two of 87 infants completed the trial; 58 were formula fed and 14 were human milk fed. Mean counts of bifidobacteria and lactobacilli were similar in all groups at entry and no group experienced a significant change in counts with fructo-oligosaccharide supplementation. After 7 days of fructo-oligosaccharide supplementation the bifidobacteria counts were greater in the 1.5 g/L fructo-oligosaccharide formula group than in the human milk fed or 3.0 g/L fructo-oligosaccharide formula groups. Formula-fed infants had higher counts of enterococci and bacteroides before fructo-oligosaccharide supplementation, and these counts did not change after supplementation. Clostridium counts increased 7 days after supplementation in the 1.5 g/L fructo-oligosaccharide formula group (P = 0.0356). No human milk fed infants had C. difficile toxin in stools. Fructo-oligosaccharide (3.0 g/L) supplementation resulted in more frequent and significantly softer stools.
  
  
  CONCLUSIONS
  Infant formula supplemented with 1.5 or 3.0 g/L fructo-oligosaccharides was safe but had minimal effect on fecal flora and C. difficile toxin.
authors.affiliation: Wyeth Nutrition, Collegeville, Pennsylvania, USA. a.euler@insightbb.com
authors.forename: Arthur R
authors.initials: AR
authors.lastname: Euler
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Mitchell
authors.forename: Randi
authors.initials: R
authors.lastname: Kline
authors.forename: Larry K
authors.initials: LK
authors.lastname: Pickering
mesh_terms: D001644:Bifidobacterium / Q000187:drug effects / Q000254:growth & development*; D015169:Colony Count, Microbial; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004768:Enterotoxins / Q000032:analysis* / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology*; D005260:Female; D006801:Humans; D007223:Infant; D041943:Infant Formula; D007231:Infant, Newborn; D008297:Male; D008895:Milk, Human / Q000737:chemistry / Q000382:microbiology; D009844:Oligosaccharides / Q000008:administration & dosage*; D019936:Probiotics / Q000008:administration & dosage*; D011446:Prospective Studies
chemical_list: D004768:Enterotoxins; D009844:Oligosaccharides; C035598:enterotoxin, Clostridium; C116580:fructooligosaccharide