The role of human milk oligosaccharides in preventing necrotising enterocolitis and human immunodeficiency virus transmission

Abstract

The heavy burden of maternal human immunodeficiency virus (HIV) infection has resulted in a high prevalence of premature births, with an associated increase in the incidence of necrotising enterocolitis (NEC). NEC is a life-threatening inflammatory disease of the gastrointestinal tract that predominantly occurs in preterm infants. Human milk oligosaccharides (HMOs) are carbohydrate compounds which have been shown to have health-promoting effects through their bifidogenic and antiadhesive properties. There is a reduced incidence of NEC in infants who receive human milk, compared to those receiving infant formula. It is suggested that the oligosaccharides found within human milk may act as specific substrates in assisting the growth of selected beneficial bacteria, called probiotics. Probiotics are live microbial food ingredients which have been shown to have health-promoting effects. Lactobacillus rhamnosus GG and Bifidobacterium infantis have been used as probiotics to reduce the incidence of NEC. Furthermore, HMOs have been associated with protection against postnatal HIV transmission. HMOs may hold key responsibility for the prevention of NEC, and possibly the transmission of HIV, to infants in resource-limited settings and in a developing country, such as South Africa, where HIV plays a major role in the outcomes of preterm neonates.