By: Talking Nutrition Editors
HMOs are important components of human milk that play a multifunctional role in early life, from the establishment of the gut microbiome to supporting neurodevelopment and immunity. In a rapidly evolving landscape marked by emerging science, recent regulatory approvals and new ingredients, staying on top of the HMO market can be challenging.
To bridge this gap, we recently hosted a global webinar in collaboration with Nutrition Insight, where Sharon M. Donovan, PhD, (Professor and Director of Personalized Nutrition Initiative at University of Illinois at Urbana-Champaign) and James Young (Vice President, Early Life Nutrition at dsm-firmenich) shared invaluable insights into the world of HMOs.
Before delving into the latest scientific developments, Donovan emphasized that HMOs are uniquely human in terms of their abundance, diversity, complexity and high fucosylation compared to bovine milk content.1,2,3 Every mother synthesizes a unique set of HMOs, of which there are over 200 structures available. Factors such as environmental impact, feeding practices and blood group contribute to variations in HMO content and concentration.4 For instance, mothers who express the FUT2 gene, known as secretors, present with higher HMO concentrations compared to mothers who express the FUT3 gene, known as non-secretors.4
HMOs are resistant to digestive enzymes and remain as intact structures within the intestine, where they serve as prebiotics for specific strains of beneficial gut microbiota. Small amounts of HMOs and their microbial metabolites can also enter the bloodstream, where they may have systemic effects. So far, the multifunction biological activities of HMOs (in formula or breastmilk) from in vitro, preclinical and clinical studies reveal that they can support infant:5,6,7
Donovan highlighted emerging science that is accelerating innovation in HMOs for early life nutrition. For instance, a recent review of more than 30 studies testing eight different HMO structures found that supplementation was safe and tolerated in infants.8 The results revealed that there were no differences in growth, tolerance, adverse events, sleep or behavior outcomes between babies receiving breast milk or formula supplemented with HMOs.8
Moreover, the review showed that infants receiving HMOs in formula displayed a shift in outcomes towards those observed in breastfed infants, including stool characteristics, gut microbiome composition and intestinal immune markers.8 Beyond infants, gut health and immune system benefits were also observed in other populations, including children and adults, following HMO supplementation.8
Donovan next shone a light on one of the largest HMO randomized controlled clinical trials to date, which assessed the benefits of five HMOs – 2'fucosyllactose (2’FL), Difucosyllactose (DFL), Lacto-N-Tetraose (LNT), 3´Sialyllactose Sodium Salt (3SL) and 6´Sialyllactose Sodium Salt (6SL) – at two different doses in almost 700 healthy term infants.9 The 15-month trial revealed that infants receiving HMOs in formula displayed a similar fecal microbiota composition to that of breastfed infants.9 Specifically, supplementation increased the abundance of Bifidobacterium, a beneficial gut bacteria, and reduced the abundance of Clostridium difficile, a toxigenic bacteria that can increase the risk of diarrheal illness.9 This HMO-induced shift in microbiota is associated with better health outcomes, such as reduced parent-reported bronchitis and lower respiratory tract illnesses.10,11
In addition, the study found that HMO supplementation could modulate the intestinal immune response, leading to increased levels of fecal secretory immunoglobin A (sIgA) and reduced levels of α-1-Antitrypsin, which could be a result of the shift in the gut microbiota.9 As such, supplementing infant formula with a blend of five HMOs is a promising and efficacious approach to support the gut microbiome, gut barrier and immune maturation during early life development of formula-fed infants.
James Young (Vice President, Early Life Nutrition at dsm-firmenich) touched on how our unique expertise and capabilities in the HMO space can assist customers in bringing new product developments to life. Over the past five years, the fortification of infant formula with HMOs has increased five-fold.12 However, in 2023, this still equated to only 20% of total infant formula including these crucial ingredients.12 This presents a significant opportunity to expand access to the health benefits of HMOs to more infants worldwide, with the potential to revolutionize early life nutrition.
Young continued by highlighting how dsm-firmenich is spearheading innovation in this space with our science-backed ingredients, customized solutions and expert services. Our GlyCare™ HMOs have the largest global reach, offering a rich portfolio of eight HMOs – with more under development – covering all three structural HMO classes. Plus, we’re leading in regulatory market access worldwide with over 100 explicit HMO approvals and commercialization in 165 countries.
During the webinar, Young also touched on how we are committed to advancing HMO knowledge around the world with our dedicated team of HMO scientists and a unique donation program for healthcare professionals, researchers and academics.
The HMO Donation Program includes over 25 HMO structures, blends or premixes that are available for donation to researchers. So far, we have supported over 100 projects globally, resulting in over 50 publications – including a recent review investigating the concentrations of HMOs throughout lactation, which was selected for Editor’s Choice by Nutrients Journal. Not only do we support researchers with the most widely clinically tested HMOs on the market, but we also offer a suite of tools designed to assist customers in new product development, including a team of formulation experts, application specialists and advocacy support.
Learn more about how dsm-firmenich is transforming early life nutrition with purpose-led, science-backed HMOs.
16 April 2024
5 min read
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1 Jantscher-Krenn & Bode, Minerva Pediatr. 64: 83-99 (2012).
2 Albrecht et al, Br J Nutr. 111: 1313-1328 (2014).
3 Xi Chen, Adv Carbohydr Chem Biochem. 72:113-190 (2015).
4 Azad MB, et al. J Nutr. 148:1733-1742 (2018).
5 Bode L. Glycobiology; 22: 1147–1162 (2012).
6 Sprenger N et al. J Hum Nutr Diet; 35:280-299 (2022).
7 Thum C et al. Nutrients; 13; 2272 (2021).
8 Schönknecht et al. Clinical studies on the supplementation of manufactured human milk oligosaccharides: A systematic review. Nutrients; 15: 3622 (2023).
9 Bosheva M, Tokodi I, Krasnow A,Pedersen HK, Lukjancenko O, Eklund AC, Grathwohl D, Sprenger N, Berger B, Cercamondi CI and 5 HMO Study Investigator Consortium. Infant formula with a specific blend of five human milk oligosaccharides drives the gut microbiota development and improves gut maturation markers: A randomized controlled trial. Front. Nutr. 9:920362 (2022).
10 Puccio G, Alliet P, Cajozzo C, Janssens E, Corsello G, Sprenger N, Wernimont S, Egli D, Gosoniu L, Steenhout P. Effects of infant formula with human milk oligosaccharides on growth and morbidity: A randomized multicenter trial. J Pediatr Gastroenterol Nutr. 64(4):624-631 (2017).
11 Dogra SK, Martin FP, Donnicola D, Julita M, Berger B, Sprenger N. Human milk oligosaccharide-stimulated Bifidobacterium species contribute to prevent later respiratory tract infections. Microorganisms. 9(9): 1939 (2021).
12 Mintel GNPD, 2024
