title: Effect of Infant Formula Containing a Low Dose of the Probiotic Bifidobacterium lactis CNCM I-3446 on Immune and Gut Functions in C-Section Delivered Babies: A Pilot Study.
abstract: BACKGROUND
  In the absence of breast-feeding and its immunomodulatory factors, supplementation of starter infant formula (IF) with probiotics is currently used to support immune functions and gut development.
  
  
  OBJECTIVE
  To assess whether immune-related beneficial effects of regular dose (10(7) CFU/g of powder) of the probiotic Bifidobacterium lactis CNCM I-3446 (hereafter named B. lactis) in starter IF supplementation can be maintained with starter IF containing a low dose (10(4) CFU/g of powder) of B. lactis.
  
  
  METHODS
  This trial was designed as a pilot, prospective, double-blind, randomized, single-center clinical trial of two parallel groups (n = 77 infants/group) of C-section delivered infants receiving a starter IF containing either low dose or regular dose of the probiotic B. lactis from birth to six months of age. In addition, a reference group of infants breast-fed for a minimum of four months (n = 44 infants), also born by C-section, were included. All groups were then provided follow-up formula without B. lactis up to 12 months of age. Occurrence of diarrhea, immune and gut maturation, responses to vaccinations, and growth were assessed from birth to 12 months. The effect of low-dose B. lactis formula was compared to regular-dose B. lactis formula, considered as reference for IF with probiotics, and both were further compared to breast-feeding as a physiological reference.
  
  
  RESULTS
  Data showed that feeding low-dose B. lactis IF provides similar effects as feeding regular-dose B. lactis IF or breast milk. No consistent statistical differences regarding early life protection against gastrointestinal infections, immune and gut maturation, microbiota establishment, and growth were observed between randomized formula-fed groups as well as with the breast-fed reference group.
  
  
  CONCLUSIONS
  This pilot study suggests that supplementing C-section born neonates with low-dose B. lactis-containing starter formula may impact immune as well as gut maturation similarly to regular-dose B. lactis, close to the breast-feeding reference.
authors.affiliation: Neonatal Department, Alexandra Hospital, University of Athens, Greece.
authors.forename: L
authors.initials: L
authors.lastname: Baglatzi
authors.affiliation: Neonatal Department, Alexandra Hospital, University of Athens, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Gavrili
authors.affiliation: Neonatal Department, Alexandra Hospital, University of Athens, Greece.
authors.forename: K
authors.initials: K
authors.lastname: Stamouli
authors.affiliation: Neonatal Department, Alexandra Hospital, University of Athens, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Zachaki
authors.affiliation: Nestlé Research Center, Lausanne, Switzerland.
authors.forename: L
authors.initials: L
authors.lastname: Favre
authors.affiliation: Nestlé Nutrition, Vevey, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Pecquet
authors.affiliation: Nestlé Research Center, Lausanne, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Benyacoub
authors.affiliation: Neonatal Department, Alexandra Hospital, University of Athens, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Costalos
keywords: B. lactis; c-section babies; diarrhea; immune maturation; infant formula; probiotic dose; vaccine responses