Abstract
BackgroundFew studies have evaluated nutritive effects of prebiotics on infant behavior state, physiology, or metabolic status.MethodsIn this double-blind randomized study, infants (n = 161) received cow’s milk-based infant formula (Control) or similar formula with an added prebiotic blend (polydextrose and galactooligosaccharides [PDX/GOS]) from 14–35 to 112 days of age. Infant wake behavior (crying/fussing, awake/content) and 24-h sleep–wake actograms were analyzed (Baseline, Days 70 and 112). Salivary cortisol was immunoassayed (Days 70 and 112). In a subset, exploratory stool 16S ribosomal RNA-sequencing was analyzed (Baseline, Day 112).ResultsOne hundred and thirty-one infants completed the study. Average duration of crying/fussing episodes was similar at Baseline, significantly shorter for PDX/GOS vs. Control at Day 70, and the trajectory continued at Day 112. Latency to first and second nap was significantly longer for PDX/GOS vs. Control at Day 112. Cortisol awakening response was demonstrated at Days 70 and 112. Significant stool microbiome beta-diversity and individual taxa abundance differences were observed in the PDX/GOS group.ConclusionsResults indicate faster consolidation of daytime waking state in infants receiving prebiotics and support home-based actigraphy to assess early sleep–wake patterns. A prebiotic effect on wake organization is consistent with influence on the gut–brain axis and warrants further investigation.ImpactFew studies have evaluated nutritive effects of prebiotics on infant behavior state, cortisol awakening response, sleep–wake entrainment, and gut microbiome.Faster consolidation of daytime waking state was demonstrated in infants receiving a prebiotic blend in infant formula through ~4 months of age.Shorter episodes of crying were demonstrated at ~2 months of age (time point corresponding to age/developmental range associated with peak crying) in infants receiving formula with added prebiotics.Results support home-based actigraphy as a suitable method to assess early sleep–wake patterns.Prebiotic effect on wake organization is consistent with influence on the gut–brain axis and warrants further investigation.
Highlights
Infant state regulation, reflecting responsivity to everyday environmental stimuli, matures and consolidates with age
Prebiotics are dietary components that have been defined as: “a substrate that is selectively utilized by host microorganisms conferring a health benefit.”[12]. In healthy term infants, we have previously demonstrated a prebiotic blend of polydextrose (PDX) and galactooligosaccharides (GOS) (4 g/L, 1:1 ratio) in infant formula was well tolerated, supported normal growth, promoted softer stools closer to that of breastfed infants, and had a bifidogenic effect closer to breast milk when compared to infants fed a formula without the added prebiotic blend.[13,14,15,16,17]
Shorter episodes of crying were demonstrated by Day 70—a time point corresponding to the same age and developmental range typically associated with peak crying at ~2 months of age
Summary
Infant state regulation, reflecting responsivity to everyday environmental stimuli, matures and consolidates with age. Infant sleep–wake patterns undergo progressive nocturnal sleep consolidation and maturation of wake rhythm during the first 6 months of age. METHODS: In this double-blind randomized study, infants (n = 161) received cow’s milk-based infant formula (Control) or similar formula with an added prebiotic blend (polydextrose and galactooligosaccharides [PDX/GOS]) from 14–35 to 112 days of age. Infant wake behavior (crying/fussing, awake/content) and 24-h sleep–wake actograms were analyzed (Baseline, Days 70 and 112). Average duration of crying/fussing episodes was similar at Baseline, significantly shorter for PDX/GOS vs Control at Day 70, and the trajectory continued at Day 112. CONCLUSIONS: Results indicate faster consolidation of daytime waking state in infants receiving prebiotics and support homebased actigraphy to assess early sleep–wake patterns. A prebiotic effect on wake organization is consistent with influence on the gut–brain axis and warrants further investigation
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