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.