Leche materna: efectos de los oligosacáridos de la leche materna en el crecimiento y desarrollo de los lactantes (Parte 3) / Breast milk: effects of breast milk oligosaccharides on the growth and development of infants (Part 3)

Actualmente existe la capacidad de sintetizar oligosacáridos de leche materna (HMOs) en cantidades importantes a partir de hidratos de carbono simples para emplear en estudios en lactantes e incluso en adultos. En los lactantes las fórmulas que contienen HMOs mantienen velocidades normales de incremento del peso, largo corporal y perímetro cefálico con variaciones del largo corporal, el peso y las masas magra y grasa característicos de ciertos HMOs. Algunos HMOs estimulan in vitro en monocitos estimulan en sangre periférica marcadores de inflamación semejantes a los observados con estímulos iguales en lactantes amamantados. Los HMOs están asociados con disminuciones del riesgo de enterocolitis necrosante en prematuros y en ratones. En seguimientos por cuatro meses, lactantes alimentados con una fórmula con 2' fucosil lactosa (2'FL) y lacto-N- neotetraosa (LNnT), mostraron patrones de crecimiento del peso, el largo corporal y el perímetro cefálico comparables a los de un grupo control que recibió la misma fórmula sin HMOs; tampoco hubo diferencias en sus patologías intercurrentes. Las concentraciones de HMOs en la leche pueden variar dependiendo de la localidad geográfica donde fueron obtenidas o el estado de la nutrición materna estos factores deben ser tenidos en cuenta al planificar estudios en grupos de población.

Human milk oligosaccharides (HMOs) are currently synthesized in amounts allowing studies with large numbers and longer follow ups of infants and adults. HMOs have been administered to adults in amounts of up to 20 grams per day without associated symptoms of gastrointestinal fermentation. The microbiota of these individuals presents changes considered positive: increases of Bifidobacterium and decreases of Firmicutes and Proteabacteria. A recent study in infants showed that specific HMOs modulate the growth of lean and fat mass or, on the contrary, decrease adipose tissue mass through not well characterized mechanisms. A study in infants fed for 4 months a formula containing both 2'-O-Fucosyllactose (2'-FL) and Lacto-N-neotetraose (LNnT) with a follow up of 8 months showed that body length, weight gain and head perimeter increased at rates comparable to those of breastfed infants or those fed a control formula. No differences in the incidence of upper and lower respiratory tract infections, skin allergies or use of antibiotics was observed. In the planning of population studies it is important to consider that in ethnically different populations breast milk may contain different profiles of HMOs depending on the area where live, suggesting that some of these profiles may be influenced by consanguinity.

The Role of Two Human Milk Oligosaccharides, 2′-Fucosyllactose and Lacto-N-Neotetraose, in Infant Nutrition / 대한소아소화기영양학회지

Human breast milk contains numerous biomolecules. Human milk oligosaccharides (HMOs) are the third most abundant component of breast milk, after lactose and lipids. Amongst the synthetized HMOs, 2′-fucosyllactose (2′-FL) and lacto-N-neotetraose (LNnT) are widely studied and are considered safe for infant nutrition. Several studies have reported the health benefits of HMOs, which include modulation of the intestinal microbiota, anti-adhesive effect against pathogens, modulation of the intestinal epithelial cell response, and development of the immune system. The amount and diversity of HMOs are determined by the genetic background of the mothers (HMO secretors or non-secretors). The non-secretor mothers secrete lower HMOs than secretor mothers. The breastfed infants of secretor mothers gain more health benefit than those of non-secretor mothers. In conclusion, supplementation of infant formula with 2′-FL and LNnT is a promising innovation for infant nutrition.