Sugars and Infant Formula

Oligosaccharides (sugars) in the milk of farm animals are much less abundant and structurally less complex than sugars in human milk. Therefore, infant formula does not provide newborns with necessary human milk oligosaccharides (HMOs). Bovine milk has been used as the model for infant formula but it is radically different from human milk.

Bovine milk has four times the amount of protein than human milk. Human milk has 100 to 1000 times more oligosaccharides (sugars) and those sugars are dramatically more abundant and complex. Human milk has 2.5 times more (100 vs 40) unique sugars than bovine milk and 80 times more fucosylated sugars (sugars glycosylated with the sugar fucose).

Primate milk (chimpanzees and gorillas) is closer to human milk than bovine milk but interestingly their milk is still radically different from human milk. It is so different that cluster analysis comparison of their oligosaccharides compared to human demonstrate that human milk does not even follow primate phylogeny! Human milk did not evolve from primates. It had an independent emergence potentially driven by distinct pathogen exposures.

As an alternative and in an attempt to mimic the multiple benefits of human milk, formula companies are currently adding other non-HMOs to infant formula. They include galactooligosaccharides (GOS) and fructooligosaccharides (FOS). FOS is often made synthetically. It is important to understand that GOS and FOS do not occur in human milk at all. It is not surprising to note that pectin-derived acidic oligosaccharides have failed to affect infant stool viscosity, frequency, pH or feeding tolerance. Mother’s breast milk is still vastly superior to the latest infant feeding formulations.

Additional studies are being recommended to assess short- and long term benefits or adverse effects of introducing non-human milk in early infant feeding. It remains to be seen whether concentrations of non-human oligosaccharides in infant formula are sufficient to trigger adverse IgE-mediated responses.

Many questions remain and much needs to be explored. Unfortunately, we have added these compounds into infant formula without fully understanding the ramifications. What is clear, is that human breast milk is best suited for infants. If at all possible mothers should breast feed to provide the best immune system support to their babies.

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