Human Milk Oligosaccharide Profiles and Associations with Maternal Nutritional Factors: A Scoping Review

Biddulph, Caren; Holmes, Mark; Kuballa, Anna; Davies, Peter S. W.; Koorts, Pieter; Carter, Roger; Maher, Judith

doi:10.3390/nu13030965

Cited by 30 publications

(28 citation statements)

References 48 publications

(281 reference statements)

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“…The total HMO concentration and the ratio of the HMOs in the formula remained constant during the intervention period, whereas in breast milk the concentration of several HMOs decreases within the first few months after delivery [ 40 ], while a few HMOs, such as 3-FL, become more abundant [ 29 , 40 ]. The absolute concentration of different HMOs is primarily influenced by the mother’s Secretor status but also by her BMI and diet as well as several other factors described above [ 40 , 61 ]. The overall concentration of HMOs declines from 20–25 g/L in the colostrum to 10–15 g/L in mature milk ([ 33 , 34 ] and references therein).…”

Section: Discussionmentioning

confidence: 99%

Clinical Evaluation of 16-Week Supplementation with 5HMO-Mix in Healthy-Term Human Infants to Determine Tolerability, Safety, and Effect on Growth

Parschat¹,

Melsæther

Jäpelt

et al. 2021

Nutrients

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Human milk oligosaccharides (HMOs) are complex sugars that occur naturally in human breast milk and provide many beneficial functions. Most formula products lack HMOs or contain only the most abundant HMO, 2′-fucosyllactose; however, benefits of HMOs come from multiple sugars. We therefore developed a mixture of five HMOs (5HMO-Mix) mimicking the natural concentrations of the top five HMOs (5.75 g/L total, comprising 52% 2′-fucosyllactose, 13% 3-fucosyllactose, 26% lacto-N-tetraose, 4% 3′-sialyllactose, and 5% 6′-sialyllactose) representing the groups of neutral, neutral-fucosylated, and sialylated HMOs. We conducted the first multicenter, randomized, controlled, parallel-group clinical study assessing the safety, tolerability, and effect on growth of formula containing the 5HMO-Mix in healthy infants. We enrolled 341 subjects aged ≤14 days; 225 were randomized into groups fed either with infant formula containing 5HMO-Mix (5HMO-Mix) or infant formula without HMOs (IF) for 4 months, with the others exclusively breastfed. There were no differences in weight, length, or head circumference gain between the two formula groups. The 5HMO-Mix was well tolerated, with 5HMO-Mix and breastfed infants producing softer stools at a higher stool frequency than the control formula group. Adverse events were equivalent in all groups. We conclude that the 5HMO-Mix at 5.75 g/L in infant formula is safe and well tolerated by healthy term infants during the first months of life.

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Section: Discussionmentioning

confidence: 99%

Clinical Evaluation of 16-Week Supplementation with 5HMO-Mix in Healthy-Term Human Infants to Determine Tolerability, Safety, and Effect on Growth

Parschat¹,

Melsæther

Jäpelt

et al. 2021

Nutrients

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“…The information on how maternal diet may influence HMO composition has been recently reviewed [ 67 ]. Although positive associations between diet, nutrition status and HMO profile has been found, robust data remains scarce.…”

Section: Factors Influencing Hmo Profile and Concentrationmentioning

confidence: 99%

Changes in HMO Concentrations throughout Lactation: Influencing Factors, Health Effects and Opportunities

et al. 2021

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Human milk oligosaccharides (HMOs) are important functional biomolecules in human breast milk. Understanding the factors influencing differences in HMO composition and changes in their concentration over lactation can help to design feeding strategies that are well-adapted to infant’s needs. This review summarises the total and individual concentration of HMOs from data published from 1999 to 2019. Studies show that the HMO concentrations are highest in colostrum (average 9–22 g/L), followed by slightly lower concentrations in transitional milk (average 8–19 g/L), with a gradual decline in mature milk as lactation progresses, from 6–15 g/L in breast milk collected within one month of birth, to 4–6 g/L after 6 months. Significant differences in HMO composition have been described between countries. Different HMOs were shown to be predominant over the course of lactation, e.g., 3-fucosyllactose increased over lactation, whereas 2′-fucosyllactose decreased. Recent clinical studies on infant formula supplemented with 2′-fucosyllactose in combination with other oligosaccharides showed its limited beneficial effect on infant health.

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“…The impact of BMI on the glycobiome has been postulated by different authors. According to the recent review by Biddulph and colleagues [ 136 ], an influence of body composition and maternal dietary intake on HMO biosynthesis can be cautiously inferred. Apparently, indeed, mothers with higher pre-pregnancy BMI display different HMO patterns (richer in 3′-SL, 6′-GL and lower in LNT) compared to mothers with regular pre-pregnancy BMI [ 40 , 137 ].…”

Section: Human Milk Oligosaccharides Interindividual Variability: Is It Always About the Genes?mentioning

confidence: 99%

Human Milk Oligosaccharides: A Comprehensive Review towards Metabolomics

et al. 2021

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Human milk oligosaccharides (HMOs) are the third most represented component in breast milk. They serve not only as prebiotics but they exert a protective role against some significant neonatal pathologies such as necrotizing enterocolitis. Furthermore, they can program the immune system and consequently reduce allergies and autoimmune diseases’ incidence. HMOs also play a crucial role in brain development and in the gut barrier’s maturation. Moreover, the maternal genetic factors influencing different HMO patterns and their modulation by the interaction and the competition between active enzymes have been widely investigated in the literature, but there are few studies concerning the role of other factors such as maternal health, nutrition, and environmental influence. In this context, metabolomics, one of the newest “omics” sciences that provides a snapshot of the metabolites present in bio-fluids, such as breast milk, could be useful to investigate the HMO content in human milk. The authors performed a review, from 2012 to the beginning of 2021, concerning the application of metabolomics to investigate the HMOs, by using Pubmed, Researchgate and Scopus as source databases. Through this technology, it is possible to know in real-time whether a mother produces a specific oligosaccharide, keeping into consideration that there are other modifiable and unmodifiable factors that influence HMO production from a qualitative and a quantitative point of view. Although further studies are needed to provide clinical substantiation, in the future, thanks to metabolomics, this could be possible by using a dipstick and adding the eventual missing oligosaccharide to the breast milk or formula in order to give the best and the most personalized nutritional regimen for each newborn, adjusting to different necessities.

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Human Milk Oligosaccharide Profiles and Associations with Maternal Nutritional Factors: A Scoping Review

Cited by 30 publications

References 48 publications

Clinical Evaluation of 16-Week Supplementation with 5HMO-Mix in Healthy-Term Human Infants to Determine Tolerability, Safety, and Effect on Growth

Clinical Evaluation of 16-Week Supplementation with 5HMO-Mix in Healthy-Term Human Infants to Determine Tolerability, Safety, and Effect on Growth

Changes in HMO Concentrations throughout Lactation: Influencing Factors, Health Effects and Opportunities

Human Milk Oligosaccharides: A Comprehensive Review towards Metabolomics

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