Rismaina Putri, Sri Andarini, Hikmawan Wahyu Sulistomo, Diadjeng Setya Wardani
Human milk oligosaccharides (HMOs) are key bioactive components of breast milk that support infant growth and gut microbiome development. This study evaluated the effects of HMO-enriched infant formula compared with non-HMO formula on clinical outcomes in healthy infants. This systematic review followed PRISMA guidelines and was registered with PROSPERO (CRD420251148484). Multiple databases were searched. Anthropometric outcomes showed no significant differences between groups. However, HMO supplementation over 6 and 12 months reduced the risk of lower respiratory tract infections (RR 0.61; 95% CI: 0.38–0.97 at 6 months; RR 0.59; 95% CI: 0.43–0.82 at 12 months) and was associated with decreased antibiotic use (RR 0.74; 95% CI: 0.64–0.86). Common HMOs included 2′-FL, LNnT, LNFP I, and LDFT. Early initiation (<3 months) was associated with increased Bifidobacterium abundance. HMO supplementation may improve early-life outcomes and supports its potential role in infant formula fortification. © 2026 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
Doctoral Program of Medical Science, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia; Department of Midwifery, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia; Family Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia; Department of Pharmacology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
