by Amy Spangler
May 16, 2010

The expression “putting lipstick on a pig” was catapulted into public discourse during the 2008 presidential campaign when it was used by then-presidential candidate Barack Obama to describe the proposals of his opponents. He sought to convey that their proposals may be dressed up but were essentially, no different from previous proposals. In another context, the phrase “putting lipstick on a pig” is used by car salesmen to describe the act of adding a fresh coat of paint to a used car, enhancing its salability although not its performance. Generally, the expression aptly describes marketing efforts employed to convince consumers that a familiar product is new and improved–and is now worth a considerably higher cost.

As part of an ongoing effort to manufacture artificial milk (infant formula) that is more like human milk, Mead Johnson Nutrition, maker of Enfamil, recently announced the addition of prebiotics to its infant formula:

Improved formula — NOW! Natural Defense™ Dual Prebiotics for digestive health. Includes our patented blend of prebiotics to support the development of baby’s natural defenses.

In order to decide whether the added ingredients are worth the extra cost, parents need to understand the role of both prebiotics and probiotics in digestion.

What are prebiotics and probiotics?
As explained elsewhere on babygooroo, prebiotics are non-digestible ingredients found in certain foods that boost the growth of probiotics (beneficial bacteria) in the intestinal tract. Human milk, asparagus, bananas, leeks, onions, garlic, wheat, and tomatoes are natural sources of prebiotics, but prebiotics can also be added to foods and beverages. The prebiotics in infant formula are modeled after the oligosaccharides, carbohydrates with 3–10 simple sugars linked together, that naturally occur in human milk. They are designed to stimulate the growth of lactobacillus and bifidobacteria, the main probiotics found in the intestinal tract of breastfed babies.

Probiotics are touted for their ability to protect against gastrointestinal upsets, colds, and in some cases, even autism. Naturally-occurring probiotics in human milk are widely recognized for the health benefits they convey. Their presence in breast milk helps explain its ability to protect babies against diseases of the upper respiratory and gastrointestinal tracts, such as necrotizing enterocolitis (NEC), a severe bowel disease common in preterm infants.

Natural versus manufactured
While some probiotics have proven benefits, their effectiveness varies by strain. According to Mary Ellen Sanders, executive director of the International Scientific Association for Probiotics and Prebiotics, a non-profit group of scientists funded in part by probiotic manufacturers, “There are three parts to any bacterium’s name: the genus (like Lactobacillus), the species (like acidophilus), and the strain (like LA-5), and only a small number of strains have proven benefits.” In other words, all probiotics are not equal. And while knowledge about which prebiotics encourage beneficial probiotics is limited, we do know that not all prebiotics are equal, either.

Unfortunately, advertisements and product labels seem to suggest they are. Companies are not required to list the specific strains added to foods or supplements, so unless the companies decide to disclose the strain of their own volition, there is no way to know which probiotics have been added. Two similar products labeled as containing “probiotics” may contain radically different strains, but without more detailed labeling, consumers won’t know the difference.

In addition, there is no way to know if the probiotics added to foods are still active when the foods are consumed. Consumerlab.com, a supplement-testing website, recently analyzed 20 probiotic supplements. Their study found that only 12 contained the amount of live bacteria listed on the label. Nearly half failed to meet the amounts stated on their own product labels, and some had as little as seven percent of what they claimed to contain.

Although a study published in the Journal of Perinatology found that use of prebiotic and probiotic supplements reduced the incidence of NEC, the authors cautioned against their widespread use due to concerns over lack of regulation.  They weren’t the only ones to caution about the inclusion of such substances in infant diets. In 2007, a Cochrane review found “insufficient evidence to recommend the addition of prebiotics to infant feeds for prevention of allergic disease or food reactions.” While studies on the use of prebiotics have yielded conflicting results, all agree on the need for more data.

Until more data are available, parents need to exercise caution before feeding their young children products that contain untested additives such as prebiotics and probiotics. Unless the prebiotics added to the food boost the production of those strains of bacteria known to be beneficial to babies’ health, parents may simply be paying more without getting more. Mead Johnson might claim that its new prebiotic blend is “designed to act more like breast milk,” but those who think manufacturers have finally perfected a way to synthesize what is truly natural and patented—human milk—had better think again.