Term infants fed formula supplemented with selected blends of prebiotics grow normally and have soft stools similar to those reported for breast-fed infants

Objectives: The present study was designed to evaluate the effect of 2 different combinations of prebiotic ingredients, polydextrose (PDX), galactooligosaccharides (GOS), and lactulose (LOS), at 2 different intake levels on the overall growth and tolerance in healthy term infants up to 120 days of age. Patients and Methods: Healthy, formula-fed, term infants (n=226) were randomly assigned to 1 of 3 study formula groups: control group (n=76), PG4 group (control formula supplemented with 4 g/L of a prebiotic blend, n=74), or PGL8 group (control formula supplemented with 8 g/L of a prebiotic blend, n=76). Anthropornetric measurements were taken at 14, 30, 60, 90, and 120 days of age, and 24-hour dietary recall and 24-hour tolerance recall were recorded at 30, 60, 90, and 120 days of age. Adverse events were recorded throughout the study. Results: There were no statistically significant differences among the 3 formula groups for weight growth rate or length growth rate at any time point. Significant differences in stool consistency were detected among the 3 formula groups at 30, 60, and 90 days of age (P < 0.001, P=0.025, P=0.004, respectively), with the supplemented formula groups having looser stools than the control group. The PGL8 group had significantly higher stool frequency compared with the control and PG4 groups at 30 days of age (P=0.021 and P=0.017, respectively), but all of the groups were similar at 60, 90, and 120 days of age. A statistical difference was detected among the formula groups in 3 categories of adverse events: diarrhea (control vs PG4, 4% vs 18 %, P=0.008), eczema (PG4 vs control, 18% vs 7%, P=0.046; PG4 vs PGL8, 18% vs 4%, P=0.008), and irritability (control vs PGL8, 4% vs 16%, P=0.027). Conclusions: Infants fed formula supplemented with a prebiotic mixture achieved normal growth and stool characteristics more similar to those of breast-fed infants in comparison with infants fed an unsupplemented formula. A pediatrician needs to consider the risk of possible intolerance against the benefits of prebiotics.