HMOs could be the answer to narrow the gap between breastfed and formula fed infants in terms of microbiome composition, immune function and cognition because of their benefits. Two randomized clinical trials have investigated adding HMO to formula, showing formula with the HMOs (2´-FL or 2´-FL+LNnT) were well tolerated and safe.
In the first, infants were fed control formula (CF) or formula containing 0.2 or 1.0 g/L 2´-FL for the first 4 months of life and were compared to a breast-fed (BF) reference. All formulae also contained galactooligosaccharides (GOS). Infants fed the 2´-FL formulae did not differ from BF, but had lower plasma pro-inflammatory cytokine concentrations than CF-fed infants.
In the second study, infants received a CF or a formula with 1.0 g/L 2´-FL and 0.5 g/L LNnT for 6 months, after which all were fed the CF until 12 months of age. Secondary outcomes showed that consuming HMO-supplemented formula reduced parent-reported morbidity (particularly bronchitis) and antipyretics and antibiotics use. In addition, the HMO formula shifted the microbiome composition to be more similar to that of BF and increased Bifidobacterium abundance.
Taken together, supplementing formula with 2´-FL or 2´-FL+LNnT affected infant immunity, reduced infection and medication use, and increased bifidobacteria abundance, thus narrowing the gap between breast- and formula-fed infants.