Emma and Noah were born in the same hos­pi­tal on the same day. Every­thing has started well and their par­ents are de­lighted that they are in such good health. To main­tain this ideal be­gin­ning, the new­born child has to de­velop a strong im­mune sys­tem and healthy mi­cro­biota as soon as pos­si­ble. This is the only way to pro­tect Emma and Noah’s lit­tle sys­tems from all kinds of for­eign bod­ies and pathogens. It’s an un­usual ex­pe­ri­ence for both ba­bies as they have not had any con­tact with path­o­genic bac­te­ria or viruses in the womb. The pla­centa only sup­plies them with the first bac­te­r­ial strains (1) that they need to build up and de­velop the mi­cro­biota and the im­mune sys­tem.

The rapid de­vel­op­ment of healthy mi­cro­biota – es­sen­tial to life

How do Emma and Noah ac­quire the ideal amount of be­nign bac­te­r­ial strains and a healthy mi­cro­biota as quickly as pos­si­ble? Re­search has shown (2) that the com­po­si­tion of bac­te­ria pop­u­la­tions and so mi­cro­biota is re­lated, among other things, to our diet and to en­vi­ron­men­tal con­di­tions.

Emma was able to ac­quire new bac­te­r­ial strains with pos­i­tive prop­er­ties rel­a­tively quickly. The lit­tle girl wasted lit­tle time in leav­ing the womb via the birth ­canal and so picked up around 900 “free” bac­te­ria types (3). They were passed from mother to daugh­ter in the birth canal, pro­tect­ing the new­born child be­fore she even came into con­tact with ex­ter­nal germs.

Noah had a harder time of it. In­stead of squeez­ing through the birth canal, he was born by Cae­sarean sec­tion. So his first bac­te­ria came from skin con­tact with the var­i­ous peo­ple com­ing and going on the ­maternity ward rather than straight from his mother.

The body and bac­te­ria form a sen­si­tive eco-sys­tem to­gether. The human sys­tem pro­vides both space to live and nu­tri­tion.

Com­pared to the vagi­nal flora, the skin flora is much more ex­posed to the ex­ter­nal en­vi­ron­ment. It might there­fore con­tain bac­te­ria that is not con­ducive to the de­vel­op­ment of healthy mi­cro­biota and to a well-func­tion­ing im­mune sys­tem. Noah will take many more months to de­velop the same mi­cro­biota com­pared to chil­dren de­liv­ered nat­u­rally (3, 4). He will reach the age of seven be­fore it is no longer de­tectable whether he was born nat­u­rally or by Cae­sarean sec­tion.

The right com­bi­na­tion of good bac­te­ria is what makes the dif­fer­ence

The first ma­ter­nal bac­te­ria mix is nor­mally all the new­born needs to de­velop a healthy mi­cro­biota. It will sub­se­quently in­clude around 400 dif­fer­ent species of bac­te­ria (5). How­ever breast milk also sup­plies in­fants with bac­te­ria and nu­tri­ents that en­cour­age the growth of bac­te­r­ial strains in a more spe­cific, in­tes­tine- friendly way. This is just one of the many rea­sons why breast feed­ing is gen­er­ally the health­i­est way to feed an in­fant.

The lac­to­bacilli and bi­fi­dobac­te­ria that pro­duce lac­tic acid make up half the bac­te­ria pre­sent in the colon. They pro­vide the acidic en­vi­ron­ment that is es­sen­tial for our health. Lac­tic acid forms a nat­ural bar­rier that is vir­tu­ally im­preg­nable for most pathogens such as Sal­mo­nella or pu­tre­fac­tive or co­l­iform bac­te­ria. And if they do get past this bar­rier they are then faced with a huge array of be­nign bac­te­ria that have pop­u­lated our in­testi­nal wall. The wall is so densely pop­u­lated, in fact, that the path­o­genic in­vaders have lit­tle room to spread.

GOS – an im­por­tant pre­bi­otic for a healthy mi­cro­biota

The de­vel­op­ment or pop­u­la­tion of the colon with “good” in­testi­nal bac­te­ria is rel­a­tively com­plex. The body and bac­te­ria form a sen­si­tive eco-sys­tem to­gether. The human sys­tem pro­vides both space to live and nu­tri­tion. The nu­tri­tion of in­testi­nal bac­te­ria con­sists of fibre and spe­cific car­bo­hy­drates in par­tic­u­lar. How­ever the lac­to­bacilli and bi­fi­dobac­te­ria so im­por­tant for de­vel­op­ing mi­cro­biota are ex­tremely choosey. They will only take nour­ish­ment from car­bo­hy­drates. As a waste prod­uct of their di­ges­tion they ex­crete short-chain fatty acids, gases and strong lac­tic acids. The lac­tic acids ar­rest the growth of un­wanted bac­te­ria, which is an ex­tremely de­sir­able side ef­fect. For in­stance, galac­tooligosac­cha­rides, also known under the tech­ni­cal term GOS, be­long to the car­bo­hy­drate fam­ily. GOS are in­di­gestible oligosac­cha­rides and are also pre­bi­otics. They occur nat­u­rally in breast milk and are also pre­sent in ex­tremely small quan­ti­ties in cow’s milk. This is an ad­di­tional prob­lem for Noah, the Cae­sarean sec­tion baby, who re­jected breast milk after four weeks and has taken in­fant for­mula since then.

In­fant for­mula en­riched with GOS

How­ever, Noah’s par­ents have no great cause for con­cern pro­vided that they give their lit­tle one in­fant and fol­low on for­mula en­riched with GOS, such as the milk pro­duced by HOCHDORF. We have been aware of the im­por­tance of GOS in de­vel­op­ing and main­tain­ing healthy mi­cro­biota for some time. Breast milk con­tains over 130 dif­fer­ent oligosac­cha­rides, but most be­long, like the GOS, to the pre­bi­otics group. Our in­fant for­mula con­tains eas­ily di­gestible galac­tooligosac­cha­rides, which are said to cause very lit­tle gas in ba­bies.

One study, for in­stance, showed min­i­mal ­difference be­tween for­mula and breast-fed chil­dren with re­gard to bi­fi­dobac­te­ria, lac­to­bacilli and other ­parameters (6). There are stud­ies that clearly show that GOS-­enriched in­fant and fol­low on for­mula ­actually stim­u­late both bi­fi­dobac­te­ria and lac­to­bacilli (6, 7, 8) and so also en­sure a bal­anced mi­cro­biota (7, 8, 9, 10, 11).

So it will be in­ter­est­ing to see how Emma and Noah progress in the com­ing months. Find out more in the next edi­tion of HOCHDORF In­side.

Further information

• Short article "Good and bad bacteria"
• Overview "Interesting facts about our bacteria zoo"
• Overview "The difference between prebiotics and probiotics"
• Article "Carbohydrates – It's all the mix"
• Article "Prebiotics in follow-on foods, part 2"

Sources
1) Jimenez E et al. Isolation of commensal bacteria from umbilical cord blood of healthy neonates born by caesarean section. Curr Microbiol 2005; 51:270–274.
2) Enterotypes of the human gut microbiome, published in Nature. 2011 May 12; 473(7346): 174–180.
3) Bik EM. Composition and function of the human-associated microbiota. Nutrition Reviews® Vol. 67 (Suppl. 2): 164–171.
4) Palmer C, Bik EM et al. (2007) Development of the human infant intestinal microbiota. PLoS Biol 5(7): e177; doi:10.1371/ journal.pbio. 0050177.
5) www.spektrum.de/lexikon/biologie/darmflora/ 16824 Copyright 1999 Spektrum Akademischer Verlag, Heidelberg.
6) Ito M et al. Effect of administration of GOS on the human faecal microflora, stool weight and abdominal sensation Microb. Ecol. Health Dis. 1990.
7) Ben XM et al. Supplementation of milk formula with GOS improves intestinal micro-flora and fermantation in term infants. Chin. Med. J. 2004.
8) Napoli JE et al. Bifidogenic effects of feeding infant formula containing GOS in healthy formula-fed infants. Asia Pac. J. Clin. Nutri. 2003.
9) Sierra C et al. Prebiotic effect during the first year of life in healthy infants fed formula containing GOS as the only prebiotic: a multicentre, randomised, double-blind and placebo-controlled trial. Eur J Nutr (2015) 54:89–99.
10) Bongers A. et al. Prebiotics and the bioavailability of minerals and trade elements. Food Reviews international 2003.
11) Schoterman HC. GOS properties and health aspects. Advanced Dietary Fibre Technology/L.Blackwell Science 2001.