Gut health has become very popular, so it’s not surprising to see formula companies changing recipes to try and improve the gut microbiome. One way companies are achieving this is using prebiotics and probiotics in their formula.
The gut microbiome is a relatively new area of study and we don’t have an “ideal” gut bacteria profile yet. Companies are comparing the gut bacteria of breastfed babies to those of formula fed babies, with breastfed being the standard. By adding in prebiotics and probiotics commonly found in breastmilk, the goal is to create a similar microbiome in formula fed infants.
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Prebiotics
Prebiotics are fibers that our body can’t digest, but the bacteria in our gut can. They act as food for our gut bacteria. The prebiotics in breastmilk are called human milk oligosaccharides, commonly referred to as HMOs. In formula, you will find most commonly galacto-oligosaccharides (GOS) and fructo-oligosaccharides (FOS).
In addition to helping the gut bacteria, HMOs also play a role in immune development and function (1). Breastmilk is made up of a variety of HMOs, with each parent’s breastmilk being different and each parent’s breastmilk changing throughout their feeding journey.
At this stage in formula creation, we aren’t able to completely mimic the HMOs in breastmilk, but adding them does seem to change formula fed babies’ gut bacteria closer to that of breastfed babies’ (2).
Probiotics
Probiotics are live bacteria that we consume in hopes to populate our gut with “good” bacteria. Breastmilk has a lot of bacteria which is used to populate the gut (3). In addition to gut health, probiotics in breastmilk may help with eczema, may help with immune response, and may even help with colic (4, 5, 6).
The most common probiotics added to formula are bifidobacteria and lactobacillus. Due to the fact that they must be sterile, probiotics are not available in ready to feed formulas.
Prebiotics and Probiotics in US Formula
| Formula | Prebiotics | Probiotics |
|---|---|---|
| A2 Platinum | GOS | None |
| Aptamil First Infant | GOS, 2’FL HMO, FOS | None |
| Aptamil Care | GOS, FOS | bifidobacterium breve |
| Bellamy’s Organic Infant Formula | GOS | None |
| Bubs Organic Grass Fed Formula | GOS | bifidobacterium longum BB536 |
| Bubs Supreme A2 Infant Formula | GOS, FOS | bifidobacterium longum BB536 |
| Bubs Goat Milk Infant Formula | GOS | None |
| Care A2+ | GOS, FOS | None |
| Enfamil AR | GOS | None |
| Enfamil Enspire | GOS | None |
| Enfamil Gentlease | None | None |
| Enfamil Neuropro | 2’FL-HMO, GOS | None |
| Enfamil Neuropro Sensitive | None | None |
| Enfamil Nutramigen | None | lactobacillus rhamnosus |
| Enfamil Prosobee | None | None |
| Enfamil Reguline | GOS | None |
| Gerber Good Start Extensive HA | None | bifidobacterium lactis |
| Gerber Good Start Gentle | 2’FL-HMO | bifidobacterium lactis |
| Gerber Good Start GentlePro | 2’FL-HMO | bifidobacterium lactis |
| Gerber Good Start Gentle Soy | None | None |
| Gerber Good Start SoothePro | 2’FL-HMO | lactobacillus reuteri |
| Kendamil Classic First Infant Milk | GOS, FOS, 3’GL HMO | None |
| Kendamil Organic First Infant Milk | GOS, 3′-GL HMO | None |
| Kendamil Goat First Infant Milk | GOS, 3′-GL HMO | None |
| Nestle Nan Pro | 2’FL-HMO | lactobacillus reuteri |
| Nestle NAN EXPERTpro SENSIPRO | 2’FL HMO, LNT | lactobacillus reuteri |
| Nestle Nan SupremePro | 2’FL-HMO, LNT | bifidobacterium lactis |
| Similac 360 Total Care Sensitive | 2′-FL HMO, LNT, 3-FL, 6′-SL, 3′-SL | None |
| Similac 360 Total Care Standard | 2′-FL HMO, LNT, 3-FL, 6′-SL, 3′-SL | None |
| Similac Advance/Pro-Advance | 2’FL HMO, FOS | None |
| Similac Alimentum | None | None |
| Similac Pro Total Comfort | 2’FL HMO, FOS | None |
| Similac Sensitive | 2’FL HMO, FOS | None |
| Similac Soy Isomil | FOS | None |
| Similac for Spit Up | GOS | None |
Takeaway
This is a relatively new area of research, but it does look promising. There are probiotic supplements available if the formula you are using does not have probiotics in it (always speak to your doctor before starting any supplement). Prebiotics and probiotics are only a couple of factors when choosing an infant formula. There are many other things to keep in mind. If you’re looking for more information on formula feeding, check out my book Formula Feeding Guide (affiliate link).
Krystyn Parks is a Registered Dietitian and Lactation Consultant who specializes in feeding children. She has a Master’s Degree in Nutritional Science from California State University Long Beach. She is an International Board Certified Lactation Consultant and has been registered with the Commission on Dietetic Registration since 2013.