Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, Western Cape, South Africa.
Nutr J. 2012 Oct 4;11:81. doi: 10.1186/1475-2891-11-81.
Synbiotics, probiotics or prebiotics are being added to infant formula to promote growth and development in infants. Previous reviews (2007 to 2011) on term infants given probiotics or prebiotics focused on prevention of allergic disease and food hypersensitivity. This review focused on growth and clinical outcomes in term infants fed only infant formula containing synbiotics, probiotics or prebiotics.
Cochrane methodology was followed using randomized controlled trials (RCTs) which compared term infant formula containing probiotics, prebiotics or synbiotics to conventional infant formula with / without placebo among healthy full term infants. The mean difference (MD) and corresponding 95% confidence intervals (CI) were reported for continuous outcomes, risk ratio (RR) and corresponding 95% CI for dichotomous outcomes. Where appropriate, meta-analysis was performed; heterogeneity was explored using subgroup and sensitivity analyses. If studies were too diverse a narrative synthesis was provided.
Three synbiotic studies (N = 475), 10 probiotics studies (N = 933) and 12 prebiotics studies (N = 1563) were included. Synbiotics failed to significantly increase growth in boys and girls. Use of synbiotics increased stool frequency, had no impact on stool consistency, colic, spitting up / regurgitation, crying, restlessness or vomiting. Probiotics in formula also failed to have any significant effect on growth, stool frequency or consistency. Probiotics did not lower the incidence of diarrhoea, colic, spitting up / regurgitation, crying, restlessness or vomiting. Prebiotics in formula did increase weight gain but had no impact on length or head circumference gain. Prebiotics increased stool frequency but had no impact on stool consistency, the incidence of colic, spitting up / regurgitation, crying, restlessness or vomiting. There was no impact of prebiotics on the volume of formula tolerated, infections and gastrointestinal microflora. The quality of evidence was compromised by imprecision, inconsistency of results, use of different study preparations and publication bias.
AUTHORS' CONCLUSIONS: There is not enough evidence to state that supplementation of term infant formula with synbiotics, probiotics or prebiotics does result in improved growth or clinical outcomes in term infants. There is no data available to establish if synbiotics are superior to probiotics or prebiotics.
在婴儿配方奶粉中添加合生剂、益生菌或益生元是为了促进婴儿的生长和发育。之前的综述（2007 年至 2011 年）关注的是给予益生菌或益生元的足月婴儿预防过敏疾病和食物过敏。本综述专注于仅用含有合生剂、益生菌或益生元的婴儿配方奶粉喂养的足月婴儿的生长和临床结局。
采用随机对照试验（RCT）的 Cochrane 方法，比较含有益生菌、益生元或合生剂的婴儿配方奶粉与含有安慰剂的常规婴儿配方奶粉在健康足月婴儿中的差异。对于连续性结局，报告了均值差（MD）和相应的 95%置信区间（CI），对于二分类结局，报告了风险比（RR）和相应的 95%CI。在适当的情况下进行了 meta 分析；使用亚组和敏感性分析探索异质性。如果研究差异太大，则提供叙述性综合分析。
纳入了 3 项合生剂研究（N=475）、10 项益生菌研究（N=933）和 12 项益生元研究（N=1563）。合生剂并未显著增加男孩和女孩的生长。使用合生剂增加了粪便频率，但对粪便稠度、绞痛、溢奶/反流、哭闹、不安或呕吐没有影响。配方奶粉中的益生菌也没有对生长、粪便频率或稠度产生任何显著影响。益生菌并不能降低腹泻、绞痛、溢奶/反流、哭闹、不安或呕吐的发生率。配方奶粉中的益生元确实增加了体重增加，但对身长或头围增加没有影响。益生元增加了粪便频率，但对粪便稠度、绞痛、溢奶/反流、哭闹、不安或呕吐的发生率没有影响。益生元对配方奶耐受量、感染和胃肠道微生物群没有影响。证据质量因不精确、结果不一致、使用不同的研究制剂和发表偏倚而受到损害。
没有足够的证据表明在婴儿配方奶粉中添加合生剂、益生菌或益生元会导致足月婴儿生长或临床结局的改善。目前尚无数据表明合生剂优于益生菌或益生元。
