Prebiotics in infants for prevention of allergic disease and food hypersensitivity

There is insufficient evidence to recommend the addition of prebiotics to infant feeds for prevention of allergic disease or food reactions. Reactions to foods and allergies (including asthma, eczema and hay fever) are common and may be increasing in developed countries. Many infants become sensitised to foods, including infant formula, through their gastrointestinal tract, a process that may be affected by the composition of the intestinal bacteria. Attempts to promote the growth of normal gastrointestinal bacteria and prevent sensitisation to foods have included the addition of prebiotics to infant formula. Prebiotics are nondigestible food components that help by selectively stimulating the growth or activity of 'healthy' bacteria in the colon. In formula fed infants at high risk of allergy, this review found one small trial that reported a mixture of prebiotic oligosaccharides added to infant formula reduced the incidence of eczema in infants up to six months of age. A second trial in low risk infants reported no difference in eczema. No consistent adverse effects were found on infant growth. Further studies are needed to confirm these results, and to determine if the effects persist beyond infancy or affect other manifestations of allergic disease.