[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-459303-105":59,"doc-detail-459303-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","biotics-supplementation-of-infant-formula-lessons-for-the-development-and-testing-of-infant-formulas","Biotics supplementation of infant formula - Lessons for the development and testing of infant formulas","","Invited commentary examining biotics supplementation in infant formula and its implications for developing and testing infant formulas. Milk is described as a complex fluid with bioactive components, while breastfeeding is framed as a public health intervention yet hard to sustain for many infants. The text summarizes guidance from the ESPGHAN SIG-GMM, focusing on safety and efficacy, including probiotic-, prebiotic-, synbiotic-, and postbiotic-related evidence and the need for robust, well-designed trials. It concludes with practical lessons about study heterogeneity and gaps for future R&D.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/biotics-supplementation-of-infant-formula-lessons-for-the-development-and-testing-of-infant-formulas/459303/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/biotics-supplementation-of-infant-formula-lessons-for-the-development-and-testing-of-infant-formulas/459303.png","ImageObject",300,407,{"name":92,"@type":93},"Aria","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-07","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":19},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is biotics supplementation considered for infant formulas?","Question",{"text":112,"@type":113},"The commentary explains that adding biotics may influence gastrointestinal microbiota composition, supporting development of a beneficial bifidogenic microbiota and reducing possible pathogens, which could affect health outcomes.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What safety conclusion does the ESPGHAN SIG-GMM reach?",{"text":117,"@type":113},"It concludes that infant formulas supplemented with one or more of the evaluated biotics, when fed to healthy infants, do not raise safety concerns related to growth, tolerance, and adverse effects.",{"name":119,"@type":110,"acceptedAnswer":120},"Why are efficacy recommendations limited for most biotics?",{"text":121,"@type":113},"The text states that for most evaluated biotics, recommendations could not be made “in favor” or “against” supplementation due to variability in study designs, intervention types, and measured outcomes.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},459303,1790755636,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":19,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":129,"read_time":39,"preview_page_count":4},2336464648322,"https://ap-avatar.wpscdn.com/avatar/2200025388227c56fec?_k=1778556882303663488","DOI: 10.1002/jpn3.70234  \nINVITED C OMMENTARY  \nBiotics supplementation of infant formula: Lessons for the development and testing of infant formulas?  \nMary S. Fewtrell   \nPopulation, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK  \nCorrespondence  \nMary S. Fewtrell, Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London WC1N 1EH, UK.  \n[Email:](Email: m.fewtrell@ucl.ac.uk)[ m.fewtrell@ucl.ac.uk](Email: m.fewtrell@ucl.ac.uk)  \nKEYWORDS  \nbioactive components, breast milk substitute, breastfeeding, regulation  \nFunding information None  \nLactation evolved over millions of years to provide nutrition for mammalian infants and to act as a regulatory signal between mother and offspring, allowing the mother to transmit information about her current environment as well as her previous experiences which can shape the infant's growth and development.1 Milk is a complex and highly variable fluid containing nutrients but also numerous bioactive components including hormones, growth factors, biotics, microRNAs (miRNAs), as well as cells and its own microbiome. While the function and mechanism of action of many components is still poorly understood, it is thought that they may explain some of the differences in health and developmental outcomes observed between individuals who receive breast milk versus those who receive breast milk substitutes (infant formulas) .  \nAs well as being the biological norm, breastfeeding isan important public health intervention, with health benefits for mother and infant.2 Exclusive breastfeeding is recommended for the first 6 months of life by the World Health Organization 3 and for at least the first 4 months of life by the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) .4 However, despite many initiatives, compliance with recommendations is poor in most settings—particularly in higher‐income countries—and many healthy infants are breast‐fed for less than 6 months or not at all. In this situation, the only safe  \nalternative is an infant formula.5 These products may bethe sole source of nutrition during a vulnerable period of postnatal life when infants are growing and developing rapidly. Hence, the design and composition of infant formulas must be based on rigorous science with robust safety and efficacy testing. The aim is not to mimic the composition of human milk—which would be impossible—but to reduce the gap in health and developmental outcomes between infants receiving breast milk and those receiving infant formula.  \nOver the last 40 years, infant formulas have been modified in many ways. This includes adaptation of macro‐ and micronutrient content but also the addition of potential bioactive components that are present in human milk but not present (or not in the same quantity or structure) in formulas which are largely derived from cows' milk. The hope has been that adding these components to an infant formula may help reduce the gap in outcomes between breast‐fed versus formula‐fed infants. One group of bioactive components which has received increasing research focus over the past 20 years is the biotics—probiotics, prebiotics, human‐identical milk oligosaccharides, synbiotics, and postbiotics. The rationale for adding biotics to infant formula is that there is evidence suggesting they can influence gastrointestinal microbiota composition,  \nSee related articles, pages 224‐235, 236‐245, 246‐262, 263‐288, 289‐299, 300‐315.  \nThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.  \n© 2025 The Author(s) . Journal of Pediatric Gastroenterology and Nutrition published by Wiley Periodicals LLC on behalf of European Society for Pediatric Gastroenterology, Hepatology, and Nutrition","cbCaicj4iTQUOiWn","https://ap.wps.com/l/cbCaicj4iTQUOiWn","pdf",300434,"English","# Biotics supplementation and the rationale\n## Breastfeeding and the need for formulas\n## Biotics as potential functional components\n# Evidence and guidance from ESPGHAN SIG-GMM\n## Safety conclusions\n## Efficacy limitations and weak recommendations\n# Practical implications and future research","[{\"question\":\"Why is biotics supplementation considered for infant formulas?\",\"answer\":\"The commentary explains that adding biotics may influence gastrointestinal microbiota composition, supporting development of a beneficial bifidogenic microbiota and reducing possible pathogens, which could affect health outcomes.\"},{\"question\":\"What safety conclusion does the ESPGHAN SIG-GMM reach?\",\"answer\":\"It concludes that infant formulas supplemented with one or more of the evaluated biotics, when fed to healthy infants, do not raise safety concerns related to growth, tolerance, and adverse effects.\"},{\"question\":\"Why are efficacy recommendations limited for most biotics?\",\"answer\":\"The text states that for most evaluated biotics, recommendations could not be made “in favor” or “against” supplementation due to variability in study designs, intervention types, and measured outcomes.\"}]","Biotics supplementation of infant formula - Lessons for the development and testing of infant formulas | PDF"]