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Empfehlungen zu Prä- und Probiotika in Säuglingsanfangsnahrungen

Recommendations on pre- and probiotics in infant formula

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Zusammenfassung

Seit einiger Zeit werden Säuglingsnahrungen mit Prä- und Probiotika angereichert. Präbiotika sind unverdauliche Nahrungsbestandteile, welche selektiv Wachstum und Aktivität bestimmter Mikroorganismen vorwiegend im Dickdarm fördern und dadurch gesundheitsfördernde Effekte erzielen sollen. Probiotika sind lebende Mikroorganismen, die bei Zufuhr in angemessener Menge ebenfalls die Gesundheit fördern sollen. Bei gesunden Säuglingen ist ein klinisch relevanter Vorteil von mit Prä- oder Probiotika angereicherten Säuglingsanfangsnahrungen gegenüber nicht angereicherten Säuglingsanfangsnahrungen bisher nicht zweifelsfrei belegt. Ist Muttermilch nicht oder nicht ausreichend verfügbar, sollen herzkranke Säuglinge, Säuglinge mit geschwächtem Immunsystem sowie alle immunsupprimierten Säuglinge und Kinder aufgrund der derzeit in diesen Risikosituationen nicht eindeutig belegten Sicherheit nicht mit einer probiotisch angereicherten Säuglingsnahrung ernährt werden. Ist Muttermilch nicht oder nicht ausreichend verfügbar, sollen Frühgeborene mit einer Frühgeborenennahrung ernährt werden, die keine Probiotika enthält. Die Ernährungskommissionen sprechen sich für die Durchführung wissenschaftlich hochwertiger, kontrollierter randomisierter Studien an großen Probandenkollektiven zur Sicherheit und Wirkung von Prä- und Probiotika in Säuglingsanfangs- und Frühgeborenennahrungen aus, die, so weit möglich, auch potenzielle Langzeiteffekte untersuchen sollten.

Abstract

For some time infant formulas have been enriched with pre- and probiotics. Prebiotics are nondigestible food components that beneficially affect host health by selectively stimulating the growth or activity of a number of bacteria in the gut. Probiotics are live microorganisms capable of benefitting human health when supplied in effective doses. In healthy infants, a clinically relevant advantage of infant formulas enriched with pre- and probiotics, as compared to non-supplemented formulas, has not yet been unequivocally demonstrated. In cases where mother’s milk is unavailable or insufficient, infants with heart disease, a compromised immune system or on immunosuppressive treatment should currently not be given infant formulas with probiotics due to remaining questions on safety in these risk situations. Preterm infants who cannot receive fortified human milk should receive a preterm formula without probiotics. The Committees on Nutrition support carrying out further controlled randomised trials of high scientific standards with adequate sample sizes to further evaluate the safety and efficacy of infant formulas and preterm formulas with pre- and probiotics, which should address longer term effects as far as possible.

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Ernährungskommission der Deutschen Gesellschaft für Kinder- und Jugendmedizin (DGKJ)

Ernährungskommission der Österreichischen Gesellschaft für Kinder- und Jugendheilkunde (ÖGKJ)

Ernährungskommission der Schweizerischen Gesellschaft für Pädiatrie (SGP)

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Ernährungskommission der Deutschen Gesellschaft für Kinder- und Jugendmedizin (DGKJ)., Ernährungskommission der Österreichischen Gesellschaft für Kinder- und Jugendheilkunde (ÖGKJ). & Ernährungskommission der Schweizerischen Gesellschaft für Pädiatrie (SGP). Empfehlungen zu Prä- und Probiotika in Säuglingsanfangsnahrungen. Monatsschr Kinderheilkd 157, 267–270 (2009). https://doi.org/10.1007/s00112-008-1942-1

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