Since coming to Abbott, I’ve been thoroughly impressed by our company’s innovative nature. A drive to stay on the cutting edge of scientific developments is truly central to our values and goals. An excellent example of our commitment to innovation is Abbott’s contribution to the study of human milk oligosaccharides (HMOs). For over 25 years, Abbott has explored the essential role HMOs play in human breast milk, as well as the benefits of including them in infant formula.

HMOs in Breast Milk

To understand the importance of HMOs, it’s necessary to understand the composition of human breast milk. Breast milk is made up of many bioactive components, such as hormones, enzymes, and nucleotides. HMOs are the only major prebiotics found in breast milk. In fact, they are the third most abundant solid component found in breast milk, after lactose and fats.1 While there are over 150 HMOs found in breast milk, on average, the top 15 most abundant HMOs in mature milk make up about 80% of total HMO concentrations.1 Within the 3 categories of HMOs (fucosylated, sialylated, and acetylated), 5 of the most abundant HMOs are LNT, 2'-FL, 3-FL, 3'-SL, and 6'-SL.1,2 Each of these HMOs has a unique structure and serves a different function.

The Possible Role of HMOs in Infant Development

Preclinical research shows that HMOs support digestive health, the immune system, and brain development.

• First, HMOs can support digestive health by encouraging the growth of beneficial bacteria in the gut.^2-8
• HMOs can also support the developing immune system by binding to immune cells to support a more balanced immune response. Certain HMOs act as receptor decoys to block specific pathogens from attaching to the epithelial cell walls. The pathogens attach to the HMO decoys instead, which helps block adhesion.^2,9-13
• Finally, as shown in an observational study, HMOs may support brain development through communication via 2 pathways—circulation and the vagus nerve. In the first pathway, fucose, sialic acid, and microbiota-derived metabolites are absorbed into the bloodstream, where they can travel to the brain to support cognitive development. In the second pathway, 2'-FL and microbiota-derived metabolites may activate the vagus nerve, which stimulates the developing brain.^2,14-26
  • And, in a clinical study, human milk concentrations of 2'-FL and 6'-SL HMO were associated with measures of improved cognitive function in infants through 24 months of age.²⁷

HMOs—Unlike Any Other Prebiotic

Part of what makes HMOs so significant is their application to infant formula. Human breast milk will always be the ideal, first choice. But when choosing to incorporate infant formula into feeding plans, it’s optimal to have access to one that is as close to breast milk in nutritional composition as possible. It’s also worth noting that not all oligosaccharides are the same. For example, FOS and GOS do not function in the same way as HMOs and are not structurally identical to the oligosaccharides in human milk. The data is clear—HMOs play complementary roles to power the gut, brain, and immune system in ways that are unlike any other prebiotic.

References: 1. Soyyilmaz, et al. Nutrients. 2021;13(8):2737. 2. Hill DR, et al. Nutrients. 2021;13(10):3364. 3. Rudloff S, et al. Acta Paediatr. 1996;85(5):598-603. 4. Rudloff S, et al. Adv Nutr. 2012;3(3):398S-405S. 5. Ruhaak LR, et al. Anal Bioanal Chem. 2014;406(24):5775-5784. 6. Goehring KC, et al. PLoS One. 2014;9(7):e101692. 7. Goehring KC, et al. J Nutr. 2016;146(12):2559-2566. 8. Reverri EJ, et al. Nutrients. 2018;10(10):E1346. 9. Marriage BJ, et al. J Pediatr Gastroenterol Nutr. 2015;61(6):649-658. 10. Bode L. Nestle Nutr Inst Workshop Ser. 2020;94:115-123. 11. Walsh C, et al. J Funct Foods. 2020;72:104074. 12. Kunz C, et al. Annu Rev Nutr. 2000;20(1):699-722. 13. Newburg DS, et al. Annu Rev Nutr. 2005;25:37-58. 14. Oliveros E, et al. Nutrients. 2018;10(10):1519. 15. Jacobi SK, et al. J Nutr. 2016;146(2):200-208. 16. Lis-Kuberka J, et al. Nutrients. 2019;11(2):306. 17. Mudd AT, et al. Nutrients. 2017;9(12):1297. 18. Tarr AJ, et al. Brain Behav Immun. 2015;50:166-177. 19. Vázquez E, et al. PLoS One. 2016;11(11):e0166070. 20. Vázquez E, et al. J Nutr Biochem. 2015;26(5):455-465. 21. Wang B, et al. Am J Clin Nutr. 2007;85(2):561-569. 22. Wang B. Annu Rev Nutr. 2009;29:177-222. 23. Wang B. Adv Nutr. 2012;3(3):465S-472S. 24. Krug M, et al. Brain Res. 1994;643(1-2):130-135. 25. Matthies H, et al. Brain Res. 1994;725(2):276-280. 26. Al-Khafaji AH, et al. J Funct Foods. 2020;74. 27. Berger PK, et al. PLoS One. 2020;15(2):e0228323.