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HMO – Human Milk Oligosaccharides Explained

HMO (Human Milk Oligosaccharides) are natural sugar chains found in breast milk that support the immune system and gut health of infants.

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Things worth knowing about "HMO"

HMO (Human Milk Oligosaccharides) are natural sugar chains found in breast milk that support the immune system and gut health of infants.

What Are HMO?

HMO stands for Human Milk Oligosaccharides – a group of complex carbohydrate structures that occur naturally in human breast milk. With more than 200 distinct structures identified, HMO represent the third most abundant solid component of breast milk after lactose and fats. Although present in significant quantities, infants cannot directly digest HMO. Instead, these molecules perform essential biological functions in the infant gut and immune system.

Biological Functions

HMO fulfil multiple roles in the infant organism:

Prebiotic effect: HMO serve as a food source for beneficial gut bacteria, particularly Bifidobacterium longum subsp. infantis, thereby promoting a healthy gut microbiome in the infant.
Protection against pathogens: HMO act as so-called decoy receptors – they mimic structures on the intestinal lining and bind harmful bacteria and viruses before these pathogens can attach to gut cells.
Immune system support: HMO directly modulate the infant immune response by influencing immune cells and regulating inflammatory processes.
Brain development support: Certain HMO such as sialyllactose provide sialic acid, which is important for neural cell development and cognitive function.

Structure and Composition

HMO are oligosaccharides, meaning short chains of simple sugar units (monosaccharides). The most common building blocks include:

Glucose
Galactose
N-acetylglucosamine
Fucose
Sialic acid (N-acetylneuraminic acid)

The exact composition of HMO in breast milk varies between mothers and depends on the stage of lactation as well as genetic factors such as the mother's blood group.

HMO in Infant Formula

Since breastfed infants are considered to have health advantages, there is substantial research into incorporating HMO into commercially produced infant formula. The most commonly used synthetically produced HMO include:

2'-Fucosyllactose (2'-FL): The most abundant HMO in breast milk. Already added to numerous infant formula products.
Lacto-N-neotetraose (LNnT): Another well-researched HMO used in infant formula.
3-Fucosyllactose (3-FL), 6'-Sialyllactose (6'-SL), Lacto-N-tetraose (LNT) and others.

The European Food Safety Authority (EFSA) has approved several HMO as safe ingredients for use in infant formula.

Health Benefits According to Current Evidence

Clinical and observational studies suggest several health benefits associated with HMO:

Reduced risk of gastrointestinal infections
Lower risk of necrotising enterocolitis (NEC) in preterm infants
Positive influence on the intestinal microbiome composition
Potential support for cognitive development
Reduction of allergy risk through immune modulation

Research into HMO is ongoing, and not all observed effects have yet been fully confirmed by large-scale randomised controlled trials.

HMO for Adults

HMO are increasingly being studied in adults as well. Early research suggests that HMO may positively influence the gut microbiome in adults, reduce inflammation, and support intestinal barrier function. HMO-containing dietary supplements are becoming more widely available, although the evidence base for adult use remains limited at this stage.

References

Bode, L. (2012). Human milk oligosaccharides: Every baby needs a sugar mama. Glycobiology, 22(9), 1147–1162. https://doi.org/10.1093/glycob/cws074
European Food Safety Authority (EFSA). (2019). Safety of 2'-fucosyllactose as a novel food ingredient. EFSA Journal, 17(6), e05717.
Puccio, G. et al. (2017). Effects of Infant Formula with Human Milk Oligosaccharides on Growth and Morbidity. Journal of Pediatric Gastroenterology and Nutrition, 64(4), 624–631.

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