Section 1 Human Nutrition

**3**

these components (symbiotics).

**Chapter 1**

**Abstract**

**1. Introduction**

Formulae

*José Maldonado*

Probiotics and Prebiotics in Infant

Human breast milk provides all necessary nutrients for the development of term infants. In addition to its universally recognized nutrients, human breast milk contains a number of non-nutritive components that play a potential role in supporting infant growth. Human breast milk also contains bioactive compounds exerting a wide range of beneficial effects, such as promoting immune system maturation and exerting protection against infections. Supplementation of infant formulae with oligosaccharides and bacteria with proven beneficial health effects seems to be well-founded. The purpose of supplementation is to mimic the functional effects of oligosaccharides and bacteria found in human breast milk. Oligosaccharides with prebiotic functions and bacteria strains with probiotic functions have recently been added to infant formulae in the European Union and other countries. However, a systematic review conducted by the Committee on Nutrition of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition revealed that there is no conclusive evidence supporting the routine use of probiotic- and/or prebiotic-fortified infant formulae. The aim of this review is to analyze the scien-

tific basis for supplementation of infant formula with these compounds.

**Keywords:** intestinal microbiota, infant formulae, probiotic, prebiotic, symbiotic

Human breast milk (HBM) is a complex physiological fluid uniquely suited to nourish infants. Its composition is specifically adapted to the digestive system and nutritional and growth needs of infants. HBM does not only contain essential nutrients, but also a vast array of non-nutritional bioactive components and microbes (microbiota) that confer benefits to the health of infants in the short and long terms. The microbiota mediates bacterial colonization of the newborn gut and supports immune system maturation and metabolic and cognitive development. Protective constituents such as cytokines, oligosaccharides, and bacteria facilitate newborn's adaptation to the extrauterine environment [1, 2]. HBM has been long known to protect neonates and infants from infections. It has been suggested that this protective role could be regulated by the action of a group of components that might inactivate bacteria and viruses individually, additively, and synergistically [3].

Gut microbiota has effects on health, and HBM contributes decisively to its composition via its bacteria and oligosaccharides supply. In order to achieve the same health effects, infant formulae are supplemented with live bacteria (probiotics), which favor bifidobacteria and lactobacilli growth (prebiotics) or a combination of
