That ‘breast is best’ has long been known by infant feed professionals. The challenge for baby formula manufacturers is therefore to make products that can come as close as they can in replicating the unique diversity and complexity of human milk and reassure those women who cannot or choose not to breastfeed that their babies can enjoy healthy growth and development.
Part and parcel of this challenge is to use science as a key driver of innovation and product development. And Danone, among others, is concentrating its efforts on advancing its understanding of breast milk composition and functionality to develop its breast milk substitutes.
Working at the cutting-edge of infant nutritional health is Dr Rocío Martín, Senior Director Global Medical Affairs and Health Innovation for Danone’s Specialized Nutrition arm, known for its Aptamil formula brand.
The wonder of human milk
Human milk is “impossible to mimic exactly”, she admitted. “It's the first personalised nutrition that you can have… Breast milk is a very complex fluid and it provides the best nutrition for infants but is also tailored for their needs. For instance, if a baby has a cold, the mother's milk will actually adapt to provide the baby what it needs at that moment."
Increasingly, however, science is gaining a better understaning of human milk's macronutrients, composition of fats, lipids and carbohydrates, which companies like Danone are looking to mimic.
Breastfeeding is also an important factor in establishing an infant’s immune system and is associated with reduced risk of childhood obesity, allergies and asthma and NCDs. While these links have been known “for many years”, knowledge on how breast milk and breastfeeding can help establish a healthy gut microbiota early in life is quickly emerging, Martín explained.
A baby’s gastrointestinal tract undergoes rapid growth during the first 1000 days of life. Ensuring healthy development of the gut is therefore vital as gut function is closely linked to overall health and wellbeing, as well as the development of the immune system.
Much of the wonder of human milk is down to its high concentration of oligosaccharides: complex carbohydrates that are only found in human milk. The latest science is telling Danone that these oligosaccharides also help a baby’s gut health and therefore its positive development.
C-sections and gut health
Knowledge too is growing about the effects of caesarean birth on the gut health of the baby.
The number of babies born via C section has risen to 1 in 3 in Europe, Martín told us. “This disrupts the microbiota colonisation because the babies do not receive the bacteria from the mother at birth and then it has a different composition in the gut.”
These bacteria babies normally receive at birth are beneficial by helping create an environment in the gut with a lower pH that will not allow pathogens to grow.
“It will be the first bacteria that get into the gut of the baby and start creating that ecosystem and community in your gut,” Martín explained. “If a baby is born by C-section it doesn't get exposed to that, so the first bacteria that they get in their gut are different.”
This difference, or gap, in a baby’s gut’s bacteria community does eventually resolve, or close, typically in three to four months. Sometimes it takes even up to a year. However, this disruption in exposure to bacteria has unfortunately also been associated with an increased risk of childhood obesity, allergies and asthma and NCDs. “It occurs in a moment when the baby is still developing and the immune system is still learning how to react to bacteria and to different substances,” elaborated Martín. “So it’s critical for the development of the child. That's why a lack of bacterial can have an impact on the health of the baby.”
The good news for parents of those babies born by C-section, however, is that biotics can provide an opportunity to modulate the baby’s gut after birth. The ‘bacteria gap’ in C-section born babies, for example, can be restored, revealed Martín, with a specific combination of a probiotic and a prebiotic, called a synbiotic, which provides bacteria and food for the bacteria. “When you provide this in a formula you see within a few days that this gap is closed,” Martín explained. “The infant born by C-section also will have more amounts of oligosaccharides and bifidobacterium very rapidly which creates the right environment for them to have a normal microbiota composition which is linked to better health outcomes.”
The growing link between gut health and infant health
Danone has recently unveiled new data showing for the first time that its synbiotic was successfully able to restore the gap in bacteria in Chinese babies born by C-section.
The evidence was presented at the recently-held 8th Probiotics, Prebiotics, Postbiotics in Pediatrics Congress, where Nutricia discussed the importance of infant gut health.
Another key takeaway from the symposium concerned mastitis, an inflammation of breast tissue that Danone estimates stops one in four mothers globally from breastfeeding. Danone has shown that mothers who consume a specific probiotic in the last trimester have 60% less chance of getting mastitis.
Danone will continue, via its Aptamil brand, to develop products with different biotics tailored to the different needs of babies and mothers. The challenge now, said Martín, is communicating the benefits of these products to healthcare professionals.
“We still need to continue explaining the difference between the different biotics: pre-pro-post and synbiotics and what it means for the health of infants. The main questions we always get are: ‘how can I know what to recommend?’; ‘where do I find the information?’ and ‘which one is best for each condition? So there’s still work to do on that message.”