HMOs: Supporting Your Baby's Gut and Immune Health

Summary

HMOs (Human Milk Oligosaccharides) are complex sugars found in breast milk that support the development of a healthy gut microbiota in babies.
They act as prebiotics, specifically nourishing beneficial gut bacteria like Bifidobacteria, which seem to have a role in immune system development.
HMOs provide many benefits, including increasing microbial stability, supporting the immune system, and promoting cognitive development.
Genetic factors can influence the production and types of HMOs, leading some mothers to produce lower amounts or different types of these beneficial sugars, and some mothers do not produce HMOs at all.
For formula-fed babies or those whose mothers do not produce HMOs, some formula products are supplemented with HMOs to promote gut health.

Introduction on HMOs

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Human Milk Oligosaccharides (HMOs) are unique components of breast milk that play a crucial role in your baby's health. At Alba Health, we’re here to help you understand the science of HMOs in an easy and practical way. In this article, we'll explore:

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What HMOs are and their importance for your baby.
How HMOs support your baby's gut microbiome and overall development.
The impact of genetics on HMO production and its importance.
The advantages of HMO-supplemented formulas for formula-fed babies.

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What are HMOs?

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Human Milk Oligosaccharides (HMOs) are among the most significant bioactive substances in human breast milk and are essential for developing a healthy gut microbiota in babies [1].

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Key Facts About HMOs:

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Abundance: HMOs are the third most abundant solid component in breast milk after lactose and lipids [2].
Indigestibility: Babies cannot digest HMOs. Instead, these sugars serve as prebiotics, nourishing beneficial gut bacteria [1],[3].
Diversity: There are over 200 distinct types of HMOs, and their composition varies among women and throughout the lactation period [3],[4].

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Feeding Specific Bacteria:

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Selective Feeding: HMOs are like special food that only certain beneficial bacteria can eat. These include Bifidobacterium and Bacteroides, which have the right enzymes to break down these complex sugars [3].
Species Specificity: Some Bifidobacterium species, such as B. longum subsp. infantis, B. bifidum, and B. breve, are particularly good at digesting HMOs and using them to grow [2].
Supporting Gut Barrier: Akkermansia muciniphila is another beneficial bacteria that uses specific HMOs to strengthen the gut lining and improve overall health. This is especially helpful for babies born by cesarean section [5].

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HMOs and Genetics

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The composition of HMOs in breast milk varies among women due to genetic factors, notably the mother's FUT2 gene status. This genetic trait determines whether a mother is a 'secretor' or 'non-secretor' of specific fucosylated HMOs [4].

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Secretor Mothers: These mothers have a functional FUT2 gene that allows them to produce high levels of fucosylated HMOs, which are particularly beneficial for the growth of Bifidobacteria.
Non-Secretor Mothers: These mothers have a mutation in the FUT2 gene and produce lower levels of fucosylated HMOs, or none at all [6].

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Benefits of HMOs

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HMOs play a crucial role in your baby’s health by:

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Increasing Microbial Stability: HMOs help create a stable community of gut bacteria. They do this by allowing beneficial bacteria to produce substances that other good bacteria can use as food, creating a supportive environment where they all thrive [7].‍
Supporting Immune System: HMOs help reduce inflammation and help strengthen the cells that line the baby's gut. This makes it harder for harmful bacteria to cause infections and helps the baby's immune system function better [7],[8].‍
Preventing Pathogen Colonization: HMOs act as decoys, mimicking the structures on the baby's gut cells where harmful bacteria would normally attach. This can prevent the bad bacteria from sticking to the gut lining and causing infections [7],[9].‍
Promoting Cognitive Development: HMOs positively influence brain development by supporting neural growth and the formation of connections in the brain, which are essential for learning and memory [7].

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HMOs in Infant Formula

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For formula-fed babies or those born to non-secretor mothers, some formulas are supplemented with HMOs to replicate the benefits of breast milk. Here's why this is important:

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Mimicking Breast Milk: HMOs in formulas help develop a healthy gut microbiota and support the immune system, similar to the benefits provided by breast milk [10].
Clinical Evidence: Studies show that HMO-supplemented formulas can improve immune markers in babies, making them more like those of breastfed babies [11],[12].
Immune Support: Formulas with HMOs enhance the immune system by improving the balance of immune cells (such as T lymphocytes, which help fight infections) and reducing unwanted immune cell breakdown [13].

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Alternatives to HMOs:

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FOS and GOS: Fructo-oligosaccharides (FOS) and Galacto-oligosaccharides (GOS) are sugars derived from chicory and dairy products. They mimic natural milk oligosaccharides and support gut health, although they lack the detailed structural complexity and targeted action of HMOs [14].

Providing your baby with these beneficial sugars, whether through breastfeeding or HMO-supplemented formulas, supports their gut health, immune function, and overall development. Always consult with your healthcare practitioner to find the best options for your baby's needs.

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Key Takeaways on HMOs

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Critical Role: HMOs are essential for developing a healthy gut microbiota and supporting immune function and cognitive development in infants.
Genetic Influence: The genetic makeup of mothers affects HMO production, influencing the infant's gut microbiota.
Benefits: HMOs enhance microbial stability, support the immune system, and promote cognitive development.
‍HMO-Supplemented Formulas: These formulas help replicate the benefits of breast milk for formula-fed babies, supporting their gut health and immune function.

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Written by: Alba Health Team

Scientifically reviewed by: Nikola Daskova, PhD

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Do you want to discover your child's gut health? Alba's pioneering test helps you discover you child's gut health and guides you on how to improve it, with the help of a certified Nutrition & Health Coach.

References

[1] M. Dinleyici, J. Barbieur, E. C. Dinleyici, and Y. Vandenplas, “Functional effects of human milk oligosaccharides (HMOs),” Gut Microbes, vol. 15, no. 1, 2023, doi: 10.1080/19490976.2023.2186115.

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[2] C. Walsh, J. A. Lane, D. Van Sinderen, and R. M. Hickey, “Human milk oligosaccharides: Shaping the infant gut microbiota and supporting health,” J. Funct. Foods, vol. 72, no. January, 2020, doi: https://doi.org/10.1016/j.jff.2020.104074.

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[3] A. Marcobal and J. L. Sonnenburg, “Human milk oligosaccharide consumption by intestinal microbiota,” Clin. Microbiol. Infect., vol. 18, no. SUPPL. 4, pp. 12–15, 2012, doi: 10.1111/j.1469-0691.2012.03863.x.

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[4] K. Korpela and W. M. de Vos, “Infant gut microbiota restoration: state of the art,” Gut Microbes, vol. 14, no. 1, pp. 1–14, 2022, doi: 10.1080/19490976.2022.2118811.

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[5] K. Korpela et al., “Fucosylated oligosaccharides in mother’s milk alleviate the effects of caesarean birth on infant gut microbiota,” Sci. Rep., vol. 8, no. 1, pp. 1–7, 2018, doi: 10.1038/s41598-018-32037-6.

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[6] C. Kunz et al., “Influence of Gestational Age, Secretor, and Lewis Blood Group Status on the Oligosaccharide Content of Human Milk,” J. Pediatr. Gastroenterol. Nutr., vol. 64, no. 5, pp. 789–798, 2017, doi: 10.1097/MPG.0000000000001402.

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[7] D. R. Hill, J. M. Chow, and R. H. Buck, “Multifunctional benefits of prevalent hmos: Implications for infant health,” Nutrients, vol. 13, no. 10, 2021, doi: 10.3390/nu13103364.

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[8] J. Tan, C. McKenzie, M. Potamitis, A. N. Thorburn, C. R. Mackay, and L. Macia, The Role of Short-Chain Fatty Acids in Health and Disease, 1st ed., vol. 121. Elsevier Inc., 2014. doi: 10.1016/B978-0-12-800100-4.00003-9.

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[9] Ardythe L Morrow et al., “Protection against diarrhea in breast-fed infants,” J. Pediatr., vol. 145, no. 3, pp. 297–303, 2004.

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[10] Y. Fan, A. L. McMath, and S. M. Donovan, “Review on the Impact of Milk Oligosaccharides on the Brain and Neurocognitive Development in Early Life,” Nutrients, vol. 15, no. 17, pp. 1–37, 2023, doi: 10.3390/nu15173743.

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[11] L. Schack-Nielsen and K. F. Michaelsen, “Advances in our understanding of the biology of human milk and its effects on the offspring,” J. Nutr., vol. 137, no. 2, pp. 503S-510S, 2007, doi: 10.1093/jn/137.2.503s.

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[12] G. Puccio et al., “Effects of infant formula with human milk oligosaccharides on growth and morbidity: A randomized multicenter trial,” J. Pediatr. Gastroenterol. Nutr., vol. 64, no. 4, pp. 624–631, 2017, doi: 10.1097/MPG.0000000000001520.

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[13] K. C. Goehring, B. J. Marriage, J. S. Oliver, J. A. Wilder, E. G. Barrett, and R. H. Buck, “Similar to those who are breastfed, infants fed a formula containing 2’-fucosyllactose have lower inflammatory cytokines in a randomized controlled trial,” J. Nutr., vol. 146, no. 12, pp. 2559–2566, 2016, doi: 10.3945/jn.116.236919.

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[14] D. A. Sela and D. A. Mills, “Nursing our microbiota: Molecular linkages between bifidobacteria and milk oligosaccharides,” Trends Microbiol., vol. 18, no. 7, pp. 298–307, 2010, doi: 10.1016/j.tim.2010.03.008.

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HMOs: Supporting Your Baby's Gut and Immune Health

Introduction on HMOs

What are HMOs?

Key Facts About HMOs:

Feeding Specific Bacteria:

HMOs and Genetics

Benefits of HMOs

HMOs in Infant Formula

Alternatives to HMOs:

Key Takeaways on HMOs

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