It has been suggested that the first 3 years of life are a critical period for dietary interventions aimed at gut microbiota modulation for improving child growth and development—the so-called “window of opportunity for microbial modulation”. Contrary to current belief, recent research has found that the gut microbiome of young children (study; study) and adolescents (study) is different from that of adults. Although the composition and diversity of gut microbiota may change during childhood and adolescence in response to physiological and environmental cues, studies assessing the impact of nutritional interventions with specific mixtures of prebiotics and/or probiotics on healthy toddlers’ gut microbiota are scarce.

A new randomized, double-blind and controlled multicenter clinical study, led by Dr Pantipa Chatchatee from the King Chulalongkorn Memorial Hospital in Bangkok (Thailand), has found that a synbiotic formula supplemented with short-chain galacto-oligosaccharides/long-chain fructo-oligosaccharides and Bifidobacterium breve M-16V may modulate healthy toddlers’ gut microbiota by increasing levels of Bifidobacterium.

In order to study the impact of nutrition on the development of the fecal microbiota in healthy children, the researchers randomized 129 healthy Thai children aged between 1 and 3 years to receive either the synbiotic formula (n=65) or the control product (n=64) over a period of 12 weeks. Subjects were balanced across the study groups with respect to baseline characteristics.

The formula for these young children consisted of 0.95 g/100 mL of scGOS/lcFOS (ratio 9:1) and 1.8×107 colony-forming units/g of B. breve M-16V, administered three times a day, with 210 mL at each serving. Meanwhile, the control group received the same formula without supplementation. Stool samples were used to determine stool characteristics as a measure of safety and tolerance, the composition and metabolic activity of the fecal microbiota (measured as a panel of the fecal pH and several organic acids including acetic, propionic, n-butyric, iso-butyric, n-valeric and iso-valeric acids and lactate), and the level of secretory immunoglobulin A.

Previous research that has investigated the therapeutic effect of this synbiotic mixture in infants has demonstrated its role in reducing the severity of immunoglobulin E-associated atopic dermatitis and preventing delayed colonization by Bifidobacterium in infants delivered by C-section.

Stool microbiota at baseline was comparable between both groups, with Bifidobacterium as the predominant bacterial member. The consumption of the synbiotic formula containing scGOS/lcFOS and B. breve M-16V led to an increased proportion of Bifidobacterium at week 12 compared to baseline, together with a significant difference (7.48%) in change from baseline at week 12 between the intervention and control groups. Within the active group, the proportion of Lactobacillus and Enterococcus genera also increased significantly from baseline to week 12.

The consumption of the synbiotic mixture was also accompanied by a more acidic intestinal milieu and led to softer stool consistency at week 6 and week 12 compared to the control group. Lactate and short-chain fatty acids were not affected after 12 weeks of synbiotic formula intake. As for the impact of the synbiotic mixture on mucosal immunity, the level of secretory IgA increased in the active group compared to the control group, although this change did not reach statistical significance.

Some adverse events and a few serious adverse events were detected in both groups, with no difference in incidence and type between the active and control group; they were not considered to be related to the study product.

In conclusion, the results of this study show that a synbiotic formula supplemented with scGOS/lcFOS and B. breve M-16V may have a positive influence on the development of the fecal microbiota in healthy toddlers by increasing levels of Bifidobacterium, decreasing intestinal pH and driving softer stools. Further studies are needed to better explore exposure to the consumption of synbiotics early in life and the outcomes for health.



Kosuwon P, Lao-Araya M, Uthaisangsook S, et al. A synbiotic mixture of scGOS/lcFOS and Bifidobacterium breve M-16V increases faecal Bifidobacterium in healthy young children. Benef Microbes. 2018; 1-12. doi: 10.3920/BM2017.0110.