Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland.
Nestle Nutr Inst Workshop Ser. 2021;96:149-159. doi: 10.1159/000519388. Epub 2022 May 10.
The benefits of breastfeeding, such as reduced risk of gastrointestinal and respiratory tract infections, depend largely on the presence of bioactive compounds in breast milk, including human milk oligosaccharides (HMOs). The presence of HMOs represents one of the largest differences in composition between breast milk and infant formula. Currently, progress in biotechnology allows the production of selected HMOs such as 2'-fucosyllactose (2'-FL) and lacto-N-neotetraose (LNnT), which are increasingly being added to infant formulas to narrow the difference between breast milk and formula. It is important to differentiate HMOs naturally occurring in human breast milk from those biotechnologically produced, which, while identical to HMOs in breast milk, do not originate from breast milk. This chapter summarizes basic facts about HMOs, findings from observational studies assessing the relationship between specific HMOs and clinical effects, and evidence from randomized controlled trials with structures identical to HMOs in breast milk added to infant formulas. Overall, the findings from some recently published trials provide reassurance that infant formulas supplemented with selected structures identical to HMOs, specifically 2'-FL with/out LNnT, are safe and well tolerated, and may have favorable effects on some health outcomes and medication usage. Further studies are needed.
母乳喂养的益处，如降低胃肠道和呼吸道感染的风险，在很大程度上取决于母乳中生物活性化合物的存在，包括人乳寡糖（HMOs）。HMOs 的存在代表了母乳和婴儿配方奶之间成分的最大差异之一。目前，生物技术的进步允许生产选定的 HMOs，如 2'-岩藻糖基乳糖（2'-FL）和乳-N-新四糖（LNnT），这些 HMOs 越来越多地被添加到婴儿配方奶粉中，以缩小母乳和配方奶之间的差距。区分母乳中天然存在的 HMOs 和生物技术生产的 HMOs 非常重要，虽然这些 HMOs 与母乳中的 HMOs 完全相同，但它们并非源自母乳。本章总结了 HMOs 的基本事实、观察性研究评估特定 HMOs 与临床效果之间关系的结果，以及在婴儿配方奶粉中添加与母乳中 HMOs 结构相同的随机对照试验的证据。总的来说，一些最近发表的试验结果令人放心，即添加与 HMOs 结构相同的选定物质（特别是 2'-FL 加/不加 LNnT）的婴儿配方奶粉是安全且耐受良好的，并且可能对一些健康结果和药物使用有有利影响。还需要进一步的研究。
