Should I choose an infant formula with prebiotics?

While the prebiotics found in breast milk may be beneficial in reducing common infections in healthy children, many health experts continue to question whether prebiotic additives in infant formula deliver on claims of benefitting digestion and an infant’s immune system. According to the American Academy of Pediatrics (AAP), prebiotics added to infant formula do not appear to be harmful to healthy infants, but there is currently not enough evidence to support the routine use of prebiotics in formula.

What are prebiotics and probiotics? 

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. Prebiotics in infant formula are modeled after the oligosaccharides (carbohydrates with 3–10 simple sugars linked together) found 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 live bacteria and yeast found in some foods and supplements that mirror the good bacteria naturally found in your body. Probiotics are especially beneficial for your digestive health because they help to push food through your gut, which will keep the digestive tract healthy. Research suggests they can help treat conditions such as irritable bowel syndrome, inflammatory bowel disease, diarrhea, colic and eczema. Probiotics may also help prevent necrotizing enterocolotis (NEC), a rare infection in preterm infants that can damage the intestines. However, there are many strains of probiotics and only a small number have proven benefits. 

While the two are distinguishable, they are related in that probiotics feed on prebiotics to help keep your gut healthy.

Which additives are in your child’s infant formula? 

Unfortunately, product labels often fail to disclose the specific strains of probiotics and prebiotics they contain since manufacturers are not required to provide such information. Even if parents know which strains of prebiotics they want their baby to have, they cannot tell from the product package which strain has been added. 

Similarly, there is no way to know whether the additives are still active when the foods are consumed. A study of 20 probiotic supplements found that only 12 contained the amount of live bacteria listed by their own manufacturers on the product labels, and some had less than 10 percent of what they claimed to contain. 

This lack of regulation is what concerns authors of a study published in the Journal of Perinatology. Although the researchers found that use of prebiotic and probiotic supplements reduced the incidence of NEC in preterm infants, they nevertheless cautioned against widespread use due to concerns over lack of regulation. While studies on the use of prebiotics have yielded conflicting results, all agree on the need for more data

Until more data is available, parents should be cautious about 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. 

Last updated November 21, 2020

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