Technical review by the ESPGHAN Special Interest Group on Gut Microbiota and Modifications on the health outcomes of infant formula supplemented with prebiotics

Prebiotics are defined as substrates that are selectively utilized by host microorganisms, conferring health benefits. This technical review focusing on prebiotic-supplemented infant formulas is one of the five manuscripts developed by the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition Special Interest Group on Gut Microbiota and Modifications (SIG-GMM). The SIG-GMM conducted a technical review to evaluate the clinical outcomes of prebiotic-supplemented infant formulas in healthy infants (0-12 months) that were published before 2024. The review focused on the following clinical outcomes: anthropometric measurements, stool frequency and consistency, gastrointestinal symptoms, allergy prevention, infection prevention, and safety/tolerability. Following the review, all 20 SIG members anonymously voted on each statement, scoring them from 0 to 9. A score ≥6 indicated agreement with a statement. A statement was rejected if ≥75% of the members voted <6. Fifty-one publications were included, focusing on prebiotics such as short-chain galacto-oligosaccharides, long-chain fructo-oligosaccharides, acidic oligosaccharides, and polydextrose/galacto-oligosaccharides. This technical review demonstrates that prebiotic-supplemented formulas are well tolerated, with no significant differences in anthropometric parameters compared to those fed non-supplemented formula. Prebiotic supplementation decreased stool consistency and increased stool frequency depending on the dosage and type. This technical review provides information on prebiotic-supplemented infant formulas in healthy infants. Overall, no significant clinical health benefits were observed in terms of infections and antibiotic use, colic, and allergy.