What you need know about Human Milk Oligosaccharide (HMO)

Human milk oligosaccharide. It’s quite a mouthful. I know.

But it's worth the trouble of trying to pronounce it. Trust me. 

Human milk oligosaccharides (HMOs) are present in great quantities in human breast milk; the third largest element after lipids and lactose. While numerous studies have determined that breast milk is a great benefit to babies, just what these HMOs—a group of carbohydrates or complex sugars—accomplish remained a mystery for quite a while.

But numerous studies over the past several decades determined that while they do nothing for a baby’s nutrition, they do play another incredibly important role in infant health: as non-digestible carbohydrates, making their way to the colon and acting as a sort of prebiotic, where they feed the good bacteria, such as bifidobacteria, helping the body to ward off a variety of infections and inflammations.

And, it turns out, what is good for babies, is also good for adults. Let’s stop here for a second: What is the difference between a prebiotic and probiotic? 

Probiotic: the good bacteria that live in our bodies and are also found in some foods, such as yogurt.

Prebiotic: indigestible food that feed the probiotics in the gut.

Background on HMOS

If you’re interested in sleek scientific findings that fit together like a hand and a glove, this is for you. The discovery of these non-digestible sugars (HMOs), which make up 10 percent of the dry weight of human milk, went through a metamorphosis of sorts over the decades as one studies built upon each other like scaffolding, in one fascinating discovery after another.

In the early 1900s, leading researchers noticed that babies not fed breast milk suffered a higher mortality rate than their breast-fed counterparts. Those studying this sad concept noticed that bacteria in the stools differed between breast-fed versus non-breast-fed babies.

Later, scientists linked this difference to human milk, or the lack of, and named this elusive component that fed the good bacteria (part of that gut microbiota living in the intestines), the bifidus factor.

Simultaneously, but in separate research, scientists looked into breast milk components and discovered a non-lactose carbohydrate that they named gynolactose. It took another 20 years to discover they were the same entity, and that there were well over a hundred of these (now called HMOs) that fed the good bacteria.

(It’s interesting to note that not all mothers have HMOs in their breastmilk. This component is also largely absent in farm-animal milk, as well.)

As the research continued, scientists determined the HMOs, particularly the one dubbed 2’-FL, could aid babies in the battle against infectious diseases, in addition to helping them fight viruses of the gut, respiratory tract, and urinary tract. Scientists also determined 2'-FL could aid in the immune system over the long term.

Moreover, further studies established that an abnormal gut microbiota contributed to diabetes pathology. Low levels of bifidobacteria have been reported in diabetics, in addition to obese individuals, as well as those taking antibiotics and people dealing with bowel issues.

With the vast amount of information emerging from studies, the importance of HMOs was hard to ignore. Just within the last five years, methods for utilizing HMOs began to surface, both as an ingredient in baby formula and as a supplement for adults.

Studies indicated that HMOs, 2’-FL and LNnT, were safe for healthy adults and could create stability within the gut microbiota. Today, the benefits to adults are equal to those for infants - aiding in the fight against irritable bowel syndrome, allergies, and the aging brain, according to data cited in a 2019 Bloomberg report.

Fermented HMOs

Millions are being invested in the HMO market with large players like Dow DuPont, Abbott, and Nestle SA seeing an exponential rise in both the popularity of HMO baby formula (first introduced by Abbott in 2016) and adult supplements. The HMOs created through fermentation are able to duplicate the positive effects of the HMOs in human breast milk, aiding both formula-fed babies and adults.

There are multiple benefits for adults, from head to gut. HMO prebiotic powder has a dual effect, both encouraging the growth of good bacteria while warding off the bad bacteria. In addition, as mentioned before, it can aid in fighting infections and inflammations, while also providing a component that helps with brain cognition

Studies have indicated that interventions, such as HMO supplements, are a viable option for those needing to replenish some of that good bacteria. Research continues regarding the production of some of the other valuable HMOs found in human breast milk. Again, there are 100+ different types of HMOs and only a handful have been substantially researched. 

This video demonstrates the difference between HMOs and GOS/FOS: 

[[READ: the team of registered dietitians at Go Wellness review PureHMO®]]

References

Pediatr Gastroenterol Hepatol Nutr. 2019 Jul; 22(4): 330–340. Published online 2019 Jun 25. doi: 10.5223/pghn.2019.22.4.330

Lianghui Cheng, Renate Akkerman, Chunli Kong, Marthe T. C. Walvoort & Paul de Vos (2020) More than sugar in the milk: human milk oligosaccharides as essential bioactive molecules in breast milk and current insight in beneficial effects, Critical Reviews in Food Science and Nutrition, DOI: 10.1080/10408398.2020.1754756

Vandenplas, Y.; Berger, B.; Carnielli, V.P.; Ksiazyk, J.; Lagström, H.; Sanchez Luna, M.; Migacheva, N.; Mosselmans, J.-M.; Picaud, J.-C.; Possner, M.; Singhal, A.; Wabitsch, M. Human Milk Oligosaccharides: 2′-Fucosyllactose (2′-FL) and Lacto-N-Neotetraose (LNnT) in Infant Formula. Nutrients 2018, 10, 1161.