Starter formula enriched in prebiotics and probiotics ensures normal growth of infants and promotes gut health: a randomized clinical trial

Pediatr Res. 2017 Apr;81(4):622-631. doi: 10.1038/pr.2016.270. Epub 2016 Dec 21.


Background: Prebiotics and probiotics exert beneficial effects by modulating gut microbiota and immune system. This study evaluates efficacy and safety of an infant formula containing bovine milk-derived oligosaccharides and Bifidobacterium animalis ssp lactis (B. lactis) (CNCM I-3446) on incidence of diarrhea and febrile infections during the first year of life (primary outcome).

Methods: Full-term infants receiving Test or Control (without bovine milk-derived oligosaccharide and B. lactis) formulae were enrolled in a multicenter, randomized, controlled, and double-blind trial with a reference breastfeeding group. .

Results: 413 infants were assigned between Test (n = 206) and Control (n = 207) formula. There was no significant difference for diarrhea and febrile infections incidence between groups at 6 (odds ratio (95% confidence interval) = 0.56 (0.26-1.15), P = 0.096) and 12 mo (odds ratio = 0.66 (0.38-1.14), P = 0.119). Test formula was well tolerated, anthropometrics parameters were not significantly different between groups and aligned with WHO growth standards up to 12 mo. Data from test group showed that gut microbiota pattern, fecal IgA and stool pH were brought to be closer to those of breastfed infants.

Conclusion: An infant formula enriched with bovine milk-derived oligosaccharide and B. lactis supports normal infant growth, is well tolerated and improves intestinal health markers. No differences in diarrhea and febrile infection incidence were found in the population studied.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Animals
  • Bifidobacterium animalis
  • Breast Feeding
  • Cattle
  • Diarrhea / microbiology
  • Double-Blind Method
  • Fever
  • Gastrointestinal Microbiome
  • Humans
  • Hydrogen-Ion Concentration
  • Immune System
  • Infant Formula / chemistry*
  • Infant, Newborn
  • Intestines / physiology*
  • Kaplan-Meier Estimate
  • Milk / chemistry
  • Milk, Human / chemistry
  • Odds Ratio
  • Oligosaccharides / chemistry
  • Prebiotics*
  • Probiotics / therapeutic use*
  • Treatment Outcome


  • Oligosaccharides
  • Prebiotics