Prebiotic oligosaccharides in premature infants

Mark A. Underwood, Karen M. Kalanetra, Nicholas A. Bokulich, Majid Mirmiran, Daniela Barile, Daniel J. Tancredi, J. Bruce German, Carlito B. Lebrilla, David A. Mills

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


OBJECTIVE:: The aim of the study was to determine the impact of increasing doses of 2 prebiotic oligosaccharides and of an "all-human diet" on the intestinal microbiota of premature infants. METHODS:: Twelve premature infants receiving formula feedings were randomly assigned to receive either galacto-oligosaccharide (F+GOS) or a pooled concentrated donor human milk product containing human milk oligosaccharides (F+HMO) in increasing doses during a 5-week period. A second group of 15 premature infants received their motherÊs own milk fortified with either a concentrated donor human milk product (H+H) or a bovine powdered fortifier (H+B). Serial stool specimens from each infant were analyzed by terminal restriction fragment length polymorphism and quantitative polymerase chain reaction for bacterial composition. RESULTS:: All of the infants studied had relatively low levels of bifidobacteria and no measurable Lactobacilli. Infants from the F+GOS and F+HMO groups demonstrated an increase in relative numbers of Clostridia with increasing doses. Compared with the H+B group, the infants in the F+HMO and the H+H groups showed an unexpected trend toward an increase in γ-Proteobacteria over time/dose. Principal coordinate analyses and Shannon diversity scores were not significantly different among the 4 groups. Infants in the H+H group received more antibiotics during the study period than those in the other groups. Two of the infants receiving GOS developed feeding intolerance. CONCLUSIONS:: None of the prebiotic interventions resulted in significant increases in bifidobacteria compared with baseline specimens or the H+B group; however, many of the infants did not receive the highest doses of GOS and HMO, and antibiotic use in the H+H group was high.

Original languageEnglish (US)
Pages (from-to)352-360
Number of pages9
JournalJournal of Pediatric Gastroenterology and Nutrition
Issue number3
StatePublished - Mar 2014


  • All-human diet
  • Galacto-oligosaccharide
  • Human milk oligosaccharide
  • Late-onset sepsis
  • Necrotizing enterocolitis

ASJC Scopus subject areas

  • Gastroenterology
  • Pediatrics, Perinatology, and Child Health


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