Synbiotic supplements support healthy gut development in C-section delivered infants
Synbiotic mixture of oligosaccharides and Bifidobacterium breve (B. breve) M-16V probiotic strain in infant formula restores gut colonisation by B. breve and supports healthy gut development in infants delivered by Caesarean-section (C-section), according to a study presented at the recent European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) annual meeting held in Athens, Greece.
C-section delivery can delay bacterial colonisation in infant gut which is important for a healthy gut development.
“The way we are born has life-long consequences,” said study principal investigator Dr. Chua Mei Chien, head of Special Care Nursery and senior consultant at the Department of Neonatology in KK Women's and Children's Hospital in Singapore.
Infants delivered by C-section are more likely to develop immune and metabolic disorders such as asthma, obesity, and type 1 diabetes later in life, said Chua, who attributed this to the lack of exposure to microbes, in particular B. breve, from vaginal delivery.
“Our results confirm the delayed colonization of bifidobacteria from the first days of life.”
The multi-country, double-blind study randomized 153 infants delivered by C-section to receive infant formula supplemented with either prebiotic or synbiotic, or non-supplemented control formula from birth to 4 months old. [ESPGHAN 2016; abstract N-O-030]
Prebiotic consisted of short-chain galactooligosaccharides and long-chain fructooligosaccharides (scGOS/lcFOS, 0.8 g/100 mL) whereas synbiotic comprised scGOS/lcFOS (0.8 g/100 mL) and probiotic strain B. breve M-16V (7.5×108 CFU/100 mL).
Another 30 infants delivered by vaginal birth receiving breast milk were included as the reference group. Stool samples for all groups were collected at different intervals up to 6 weeks post-intervention (week 22) for biochemical analysis.
Infants receiving synbiotic supplementation had a significantly greater total gene count of bifidobacteria as early as the third or fifth day of life compared with infants fed with control formula (p<0.0001), and this trend persisted until week 12 (p=0.032).
There was no significant difference between the prebiotic group and the control group throughout the period.
At week 22, 38.7 percent of infants in the synbiotic group still showed signs of B. breve M-16V in their stool, indicating that the probiotic bifidobacterium strain persisted up to 6 weeks post-intervention.
“Synbiotic not only closes the gap but consistently achieves the reference level of bifidobacteria from the first days of life,” Chua said.
Infants in synbiotic group also showed a lower pH and a higher acetate levels in their stool samples compared with control group during early days of life (p<0.0001 for both), indicating that synbiotic supports healthy gut development in infants delivered through C-section.
The lower stool pH in synbiotic group remained significant until 1 month of age (p=0.001) compared with the control group.
Additionally, fewer infants in the synbiotic group (n=3) had adverse events of eczema compared with the control (n=10) and prebiotic group (n=9), even after adjusting for family allergy history (p<0.05), suggesting that synbiotic may protect against eczema early in life.
“Synbiotic may offer a potential nutritional strategy for the C-section delivered infants [in] a population at risk for developing noncommunicable diseases (chronic diseases) later in life,” Chua said.
The researchers are currently conducting a 3-year follow-up of the infants, which might be extended to 7 years in the future, to study if the bifidogenic effects observed in the early life actually translate to favourable clinical outcomes in the long term, Chua added.