Trials on probiotics and prebiotics in infant formula, with Prof. Yvan Vandenplas MD PhD

This episode features Prof. Yvan Vandenplas MD PhD from the University Hospital Brussels and Vrije Universiteit Brussel (Belgium), speaking about the science on probiotics and prebiotics in infant formula. Over the past 20 years in this field, awareness of the importance of the gastrointestinal microbiota has grown, and biotics have been employed to try to shape the gut microbiota of infants formula-fed to resemble that of breastfed infants. In particular, human milk oligosaccharides (HMOs) are prebiotics that are shown to change the microbiota composition, although the clinical benefits of these changes are not yet clear. What clinical benefits are achievable for infants who receive formula with added probiotics or prebiotics? Looking closely at the trials, it’s evident that probiotics and prebiotics are associated with a decrease in infections and antibiotic prescriptions, but researchers need to use these as primary endpoints in their trials to increase the strength of the evidence. In a recent European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) recommendations paper, the probiotic recommendations were challenging because for each specific probiotic intervention the group had difficulty finding two clinical trials with a similar design, limiting their ability to make conclusions. Prof. Vandenplas says more trials need to be done independently to strengthen the evidence. Long-term outcomes from probiotic or prebiotic supplementation in infant formula are possible as well, but much larger longitudinal trials are necessary to establish these outcomes. Episode abbreviations and links: ESPGHAN recommendations paper: Recommendations on the health outcomes of infant formula supplemented with biotics by the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition Special Interest Group on Gut Microbiota and Modifications Trial showing positive outcomes of an infant probiotic and prebiotic intervention in a region with high prevalence of infectious disease: A randomized synbiotic trial to prevent sepsis among infants in rural India About Prof. Yvan Vandenplas MD PhD: Yvan Vandenplas did his medical studies at the ”Vrije Universiteit Brussel” (Free University of Brussels) and trained in pediatrics (1981-1986) at the same University. He became Head of the Unit for Pediatric Gastroenterology and Nutrition in 1987 and created the Pediatric Hospital, the KidZ Health Castle, at the University Hospital Brussels (UZ Brussel) of the same university, where he had the Chair of Pediatrics since 1994 up to 2021. He is now Prof. Emeritus and consultant at the same hospital. He is associate editor of Nutrients.