title: Effects of prebiotic-containing infant formula on gastrointestinal tolerance and fecal microbiota in a randomized controlled trial.
abstract: BACKGROUND
  Prebiotic-containing infant formula may beneficially affect gastrointestinal tolerance and commensal microbiota composition.
  
  
  OBJECTIVE
  Assess gastrointestinal tolerance and fecal microbiota, pH, and short-chain fatty acid (SCFA) concentrations of infants consuming formula with or without prebiotics.
  
  
  METHODS
  Full-term formula-fed infants were studied to a breastfed comparison group (BF). Formula-fed infants (FF) were randomized to consume a partially hydrolyzed whey formula with (PRE) or without (CON) 4 g/L of galacto-oligosaccharides and fructo-oligosaccharides (9:1). Fecal bacteria, pH, and SCFA were assessed at baseline, 3 weeks, and 6 weeks. Caregivers of patients recorded stool characteristics and behavior for 2 days before the 3- and 6-week visits.
  
  
  RESULTS
  Feces from infants fed PRE had a higher absolute number (P = .0083) and proportion (P = .0219) of bifidobacteria than CON-fed infants and did not differ from BF. BF had a higher proportion of bifidobacteria than CON (P = .0219) and lower number of Clostridium difficile than FF (P = .0087). Feces from formula-fed infants had higher concentrations of acetate (P < .001), butyrate (P < .001), propionate (P < .001), and total SCFAs (P = .0230) than BF; however, fecal pH was lower (P = .0161) in PRE and BF than CON. Prebiotic supplementation did not alter stool patterns, tolerance, or growth. BF had more frequent stools that were yellow (P < .0001) and more often liquid than FF (P < .0001).
  
  
  CONCLUSIONS
  Infant formula containing the studied oligosaccharides was well tolerated, increased abundance and proportion of bifidobacteria, and reduced fecal pH in healthy infants.
authors.affiliation: Department of Food Science and Human Nutrition, Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, 443 Bevier Hall, 905 South Goodwin Ave, Urbana, IL 61801, USA.
authors.forename: Hannah D
authors.initials: HD
authors.lastname: Holscher
authors.forename: Kristin L
authors.initials: KL
authors.lastname: Faust
authors.forename: Laura A
authors.initials: LA
authors.lastname: Czerkies
authors.forename: Richard
authors.initials: R
authors.lastname: Litov
authors.forename: Ekhard E
authors.initials: EE
authors.lastname: Ziegler
authors.forename: Herschel
authors.initials: H
authors.lastname: Lessin
authors.forename: Terry
authors.initials: T
authors.lastname: Hatch
authors.forename: Shumei
authors.initials: S
authors.lastname: Sun
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Tappenden
mesh_terms: D001644:Bifidobacterium / Q000254:growth & development / Q000302:isolation & purification; D016360:Clostridioides difficile / Q000254:growth & development / Q000302:isolation & purification; D019587:Dietary Supplements; D004311:Double-Blind Method; D005232:Fatty Acids, Volatile / Q000032:analysis; D005243:Feces / Q000737:chemistry / Q000382:microbiology*; D041981:Gastrointestinal Tract / Q000378:metabolism* / Q000382:microbiology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D017404:In Situ Hybridization, Fluorescence; D007223:Infant; D041943:Infant Formula / Q000008:administration & dosage* / Q000737:chemistry*; D054892:Metagenome / Q000187:drug effects; D009844:Oligosaccharides / Q000008:administration & dosage / Q000737:chemistry; D056692:Prebiotics / Q000032:analysis*; D011446:Prospective Studies; D014312:Trisaccharides / Q000008:administration & dosage / Q000737:chemistry
chemical_list: D005232:Fatty Acids, Volatile; D009844:Oligosaccharides; D056692:Prebiotics; D014312:Trisaccharides; C116580:fructooligosaccharide; C072242:4'-galactooligosaccharide