Does Baby Formula Need Prebiotics?

Prebiotic supplements in baby formula may reduce eczema risk but other benefits unclear

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Prevention of allergies in children is a murky science. Some parents may add prebiotic supplements to baby formula in the hopes that the prebiotics could reduce allergy risk.

A recent study looked at whether there is evidence to support the use of prebiotics to reduce allergies.

The researchers found that adding prebiotics to formula does appear to reduce the risk of babies developing eczema. Eczema refers to conditions causing irritation or inflammation on the skin.

However, the evidence is still weak to know how much prebiotics in formulas can help babies in reducing asthma or other allergies.

"Ask your pediatrician about baby feeding issues."

The study, led by David A. Osborn, the director of the Neonatal Intensive Care Unit at the Central Clinical School at the University of Sydney in Australia, reviewed the evidence available for whether prebiotics in formula could help prevent allergies in children.

The researchers searched medical databases, conference presentations  and registries of clinical trials for studies related to the use of prebiotic supplements in formula.

They narrowed their search to the studies that included randomized trials comparing a formula with a prebiotic to one without for the purpose of preventing an allergy.

A total of four studies, including 1,428 babies, met the researchers' criteria, though all four had the potential for their results to be skewed because of the number of participants who had dropped out of the study.

The researchers analyzed the results from these four studies, looking at the allergies the children developed from 4 months old to 2 years old.

Two of the studies, including 226 babies, did not find any decrease in asthma between the formulas with or without prebiotics.

However, looking at the data for 1,218 babies across four studies, the researchers did find a lower rate of eczema among babies who had formula with prebiotic supplements compared to those with non-prebiotic formula.

The babies who were fed prebiotic formula were about 32 percent less likely to develop eczema than those who received standard formula.

The researchers calculated that 25 babies would need to eat prebiotic-supplemented formula for one baby to avoid developing eczema.

A couple of the individual studies found a lower rate of asthma and eczema for babies who were already at high risk for allergies and who ate formula with a mixture of galactooligosaccharide (GOS) and fructooligosaccharide (FOS). Babies who were not considered at risk for allergies appeared to have a lower risk of eczema with formula containing GOS/FOS and acidic oligosaccharide.

Overall, however, the evidence was too weak to know for sure whether prebiotics in formula can help prevent allergies. The researchers said there is some evidence that prebiotics can reduce eczema, but the evidence is not strong for reducing asthma.

The study was published March 27 in The Cochrane Library. The research was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health and the Australian Satellite of the Cochrane Neonatal Review Group, Australia. One of the authors has been invited to speak at industry-funded meetings, but no other conflicts of interest were noted.

Reviewed by: 
Review Date: 
March 28, 2013
Last Updated:
March 31, 2013