As part of the Vitafoods Insights July 2023 webinar on infant and childrens health, Dr. Regina Karim, global senior science manager at H&H Group, a global health and nutrition company, discussed H&H’s research on the health benefits of HMOs.

Karim highlighted the first 1000 days of a child’s life as a critical period for establishing optimal microbiome growth and development, referring to this period as “a window of opportunity for a healthy microbiota”. She noted that human milk oligosaccharides (HMOs), which are naturally occurring milk sugars in human breast milk, play a significant role in establishing a healthy microbiome.

Karim emphasised that HMOs, despite being non-digestible carbohydrates with no direct nutritional value for infants, act as prebiotics, specifically supporting the growth of beneficial bacteria. They are primarily absorbed by B. Infantis, a friendly strain dominant in an infants gut.

Karim also stressed that HMOs play a crucial role in strengthening the gut barrier function, acting as decoy receptors that prevent pathogens from attaching to the gut. Instead, pathogens get trapped by HMOs and are flushed away, providing a crucial immunity protection function.

Translating the benefits of HMOs to formula

Despite the well-established benefits of HMOs in breast milk, practical challenges may hinder breastfeeding such as maternal health, work-related commitments, or infant health conditions. In such scenarios, infant formulas step in to provide essential nutrition to babies. Historically, these formulas lacked the bioactive components present in breast milk, particularly HMOs.

In recent years, HMOs have made a significant impact by becoming key ingredients in infant formulas, making their debut in the European market back in 2018 and steadily gaining popularity since. Regulatory bodies such as the US Food and Drug Administration (FDA) and European Food Safety Authority (EFSA) have given the green light to specific HMOs, including 2′-fucosyllactose (2′-FL) and Lacto‐N‐neotetraose (LNnT), to be incorporated into infant formulas.

Further research is necessary to comprehensively evaluate the advantages and disadvantages of introducing individual HMOs into formulas compared to natural breast milk. Encouragingly, a 2023 review, conducted by the HMO science team from Chr. Hansen and published in Nutrients, analysed 26 clinical studies involving the supplementation of manufactured HMOs. These studies consistently affirmed the safety and tolerability of HMO supplementation. Notably, when exclusively examining infant studies, the researchers reported improvements in gut microbiome and immune markers closely resembling the outcomes observed in breastfed infants.

Balancing affordability in the growing global HMO market

Balancing the evident advantages of HMOs with affordability is a pivotal concern for the industry. The substantial costs associated with incorporating HMOs into infant formula can pose accessibility challenges, particularly in regions experiencing high inflation. Recent Mintel research on the future of baby milk and food, published in October of this year, indicates 64% of UK consumers with children aged four and under are feeling the impact of rising food and drink prices. To address this, it was suggested that formulas emphasising essential nutrients for babies at an affordable price could alleviate parents concerns regarding the rising costs of infant milk formula.

In tandem with these challenges, the global HMO market is experiencing growth. Its value has surged from US $125.9 million in 2020 to a projected $332.6 m by 2028, as reported by Allied Market Research. As this market expands, some companies are exploring opportunities beyond infant nutrition. One such example is the US-based startup Layer Origin Nutrition, which recognised the potential benefits of HMOs for products targeting adults. In 2021, it launched seven HMO-based products, signalling a growing trend towards diversifying the use of HMOs beyond infant nutrition.

The industrys challenge lies in striking a delicate balance: creating products that harness the potential benefits of HMOs while ensuring they remain affordable.