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Probiotics given to pregnant and lactating mothers reduced atopic eczema during the first two years of their child’s life

Luise Kalbe, PhD., Brigitte Reusens, PhD., and Professor Claude Remacle, Cellular Biology Laboratory, University de Louvain, Belgium

Excerpted from Functional Foods, Ageing and Degenrative Disease, C Remacle and B Reusens, editor, ISBN 1 85573 725 6

[EXTRACT:]

Nutrition is truly functional during pregnancy and lactation, because it exerts prenatal and early postnatal influences on the developing baby: maternal nutrition affects the intra-uterine development of the baby and determines the quality of the breast milk needed to support adequate growth and gut-flora composition.

The more commonly used approach to functional foods involves designed foods in which ingredients have been added or removed. Only the former category will be considered here. Different types of designed foods are classified as functional foods: pre-biotics and probiotics, vitamins and minerals, bioactive molecules, and fatty acids

Probiotics added to food products must meet several criteria such as a beneficial effect on health, survival during transit through the gastrointestinal tract, adhesion (permanent or temporarily) to the intestinal epithelial cell lining, production of antimicrobial substances toward pathogens or stabilisation of the intestinal microflora. Over-the-counter supplements, however, may not fulfill these criteria and may not even survive in the gastrointestinal tract.

With particular relevance for the subject on hand are several trials with either pregnant women, lactating mothers and their babies, or with children, that have demonstrated several beneficial effects of probiotics. These include the maturation and health of the intestinal tract and the immune system, the reduction of lactose intolerance and allergy prevalence, the reduction of the risk of microorganism-induced diarrhea, or the enhancement of nutrient bioavailability.

Not only are probiotics therefore promising functional foods for pregnant women and infants, but they can be considered for prophylactic as well as therapeutic uses. Prophylactic use of probiotics for women during the last trimester of pregnancy and through childbirth, for instance, permanently colonised the gastrointestinal tracts of their infants. It is not yet known whether the immune-boosting properties of these probiotics require periodic pulse dosage or continuous administration.

Probiotics given to pregnant and lactating mothers increased the immuno-protective potential of breast milk and reduced the incidence of atopic eczema during the first two years of life in their children.

Another study showed that in addition to allergy occurrence, the number of infections and the need for antibiotics due to preventive probiotic treatment after birth were reduced even ten years later.

Preventive feeding of fermented milk also increased the absorption of iron due to the liberation of lactic acid and other organic acids during fermentation. The authors even suggested that consumption of fermented milk during meals might also have a positive effect on the absorption of iron from other foods. Based on such findings and the fact that even temporary colonisation of a baby’s intestines with probiotic bacteria prevents colonisation with less beneficial bacteria, probiotic supplementation of milk formula has been proposed.

Probiotic foods are non-digestible food ingredients that beneficially affect the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria in the colon.

Prebiotic oligosaccharides from different origins have been used as ingredients in functional foods. They may be inulin; lactulose; fructo-, galacto-, isomalto- or xylo-oligosaccharides.

According to their chemical nature they support higher populations of individual bacteria species in the gut flora. The largest increase in lactobacilli was seen with xylo-oligosaccharides and lactulose. Although fructo-oligosaccharides promoted a large increase in lactobacilli, they also supported higher populations of streptococci than did galacto-oligosaccharides. The latter supported higher populations of bifidobacteria and higher levels of lactate than fructo-oligosaccharides. Latulose and xylo- and galacto-oligosaccharides thus stimulate the growth of bacteria found in the colon of breast-fed infants, on the other hand, have a more diverse and adult microflora and tend to suffer more from microbial infections than breast-fed infants.

This means that lactulose, xylo- and glacto-oligosaccharides are the prebiotic oligosaccharides of choice for functional foods aimed at infants. Supplementing milk formula with these oligosaccharides should therefore circumvent the problem of aberrant colon colonisation in formula-fed infants. However, prebiotics functional foods will be effective only where there is a real need, since responses to prebiotics depend on the numbers of bacteria colonising the colon. Individuals with low bifidobacterial counts displayed much higher responses to prebiotics than individuals with higher bacterial counts.

Prebiotics positively affect the absorption of various minerals as well as mineral contents in bones. The risk of osteoporosis is higher in formula-fed children than in breast-fed children born at term, even though milk formula has a higher calcium content than breast milk. Prebiotic supplementation of milk formula might thus help reduce the risk of osteoporosis in formula-fed children born at term.

This finding does not apply, however, to children born pre-term, where the source of milk does not seem to influence bone mass later on. Nevertheless, it might be worthwhile later on to follow these term and pre-term children into adult age to check for possible long-term protection against osteoporosis due to early prebiotic supplementation.