From the Desk of Dr Stutts

HMOs: Unique Prebiotics

Since coming to Abbott, I’ve been thoroughly impressed by our company’s innovative nature. A drive to stay on the cutting edge of scientific developments is truly central to our values and goals. An excellent example of our commitment to innovation is Abbott’s contribution to the study of human milk oligosaccharides (HMOs). For over 25 years, Abbott has explored the important role HMOs play in human breast milk, as well as the benefits of including them in infant formula.

HMOs in Breast Milk

To understand the importance of HMOs, it’s necessary to understand the composition of human breast milk. Breast milk is made up of many bioactive components, such as hormones, enzymes, and nucleotides. HMOs are major prebiotics found in breast milk. In fact, they are the third most abundant solid component found in breast milk, after lactose and fats. While there are over 150 HMOs found in breast milk, on average, the top 15 most abundant HMOs in mature milk make up over 75% of total HMO concentrations.¹ Within the 3 categories of HMOs (fucosylated, sialylated, and acetylated), 5 of the most abundant HMOs are LNT, 2'-FL, 3-FL, 3'-SL, and 6'-SL.^1,2 Each of these HMOs has a unique structure and serves a different function. 

The Possible Role of HMOs in Infant Development

Preclinical research shows that HMOs support digestive health, immune support, and brain development.

• First, HMOs can support digestive health by encouraging the growth of beneficial bacteria in the gut.^3-11
• HMOs specifically interact with immune cells and facilitate a balance of pro/anti-inflammatory cytokines. HMOs assist in maintaining immune homeostasis.^12,13
• Preclinical research suggests that HMOs play a beneficial role in the brain through communication via circulation and the vagus nerve. Studies suggest fucose metabolites, sialic acid, and microbiota-derived metabolites are absorbed into the bloodstream where they can travel to the brain to support cognitive development. Preclinical research shows 2'-FL and microbiota-derived metabolites may activate the vagus nerve and thus stimulate the developing brain.^14-29
• Finally, breastfeeding associative studies have shown that human milk concentrations of 2'-FL and 6'-SL HMOs were associated with measures of improved cognitive function in infants through 24 months of age.^30-32

HMOs—Unique Prebiotics

Advancements in HMO commercial production have enabled HMOs to be added to infant formulas. Breast milk will always remain the ideal first choice. When recommending an infant formula, it’s important to recognize that not all infant formulas contain HMOs. Consider a formula that supports infants’ immunity, brain development, and digestive health.

References: 1. Soyyilmaz, et al. Nutrients. 2021;13(8):2737. 2. Hill DR, et al. Nutrients. 2021;13(10):3364. 3. Gotoh A, et al. Sci Rep. 2018; 8(1):1-14. 4. Lawson MA, et al. ISME J. 2020;14(2):635-648. 5. Marcobal A, et al. J Agric Food Chem. 2010;58(9):5334-5340. 6. Underwood MA, et al. Pediatr Res. 2015;77(1-2):229-235. 7. Yu ZT, et al. Glycobiology. 2013;23(11):1281-1292. 8. Bunesova V, et al. BMC Microbiol. 2016;16(1):248. 9. Özcan E, et al. Front Nutr. 2018;5:46. 10. James K, et al. Sci Rep. 2016;6:38560. 11. Thongaram T, et al. J Dairy Sci. 2017;100(10):7825-7833. 12. Walsh C, et al. J Funct Foods. 2020;72:104074. 13. Kulinich A, et al. Carbohydr Res. 2016;432:62-70. 14. Goehring KC, et al. PLoS One. 2014;9(7):e101692. 15. Ruhaak LR, et al. Anal Bioanal Chem. 2014;406(24):5775-5784. 16. Al-Khafaji AH, et al. J Funct Foods. 2020;74:104176. 17. Castanys-Muñoz E, et al. Adv Nutr. 2016;7(2):323-330. 18. Bienenstock J, et al. PLoS One. 2013;8(10):e76236. 19. Krug M, et al. Brain Res. 1994;643(1-2):130-135. 20. Wang B, et al. Am J Clin Nutr. 2007;85(2):561-599. 21. Wang B. Annu Rev Nutr. 2009;29:177-222. 22. Wang B. Adv Nutr. 2012;3(3):465S-72S. 23. Tarr AJ, et al. Brain Behav Immun. 2015;50:166-177. 24. Jacobi SK, et al. J Nutr. 2016;146(2):200-208. 25. Mudd AT, et al. Nutrients. 2017;9(12):1297. 26. Lis-Kuberka J, et al. Nutrients. 2019;11(2):306. 27. Oliveros E, et al. J Nutr Biochem. 2016;31:20-27. 28. Vazquez E, et al. PLoS One. 2016;11(11):e0166070. 29. Perdigon G, et al. Curr Issues Intest Microbiol. 2001;2:27-42. 30. Jorgensen JM, et al. Am J Clin Nutr. 2021;113(1):209-220. 31. Berger PK, et al. PLoS One. 2020;15(2):e0228323. 32. Oliveros E, et al. J Nutr Food Sci. 2021;4:024.