Human Milk Oligosaccharides and Necrotizing Enterocolitis

In this presentation, Lars Bode explains that HMOs are complex sugars that make up 5-15g per litre of human milk, which is a larger component than protein.  There are hardly any HMOs in bovine milk, and none in infant formula.  Each mother produces a personalised complex HMO composition in her milk, partly determined by genetics.  Some oligosaccharides are added to infant formula, called GOS/FOS, but it is important to note that these are structurally and functionally different to HMOs. 

Lars Bode details the potential direct and indirect benefits of HMOs, as they are absorbed by the infant intact and are found in the systemic circulation.  Pre-term infants have a high mortality rate due to necrotising enterocolitis – more than 25% of pre-term infants die after developing NEC, with a six to 10-fold higher risk in formula-fed infants vs. those that are breastfed. 

The presentation covers preclinical animal trials and human cohort studies in the US which analyse specific HMOs to identify exactly which HMOs are most effective in preventing NEC.  One specific HMO – DSLNT – was most effective in prevention of NEC across two cohort studies, thereby providing strong support to close the gap between the preclinical animal trials and human intervention studies.