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  • Systematic Review
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Safety and efficacy of adding postbiotics in infant formula: a systematic review and meta-analysis

Pediatric Research volume 95, pages 43–51 (2024)Cite this article

Abstract

Postbiotics, as emerging products, were added to infant formula, but their safety and efficacy are unclear. To clarify this issue, we wrote this meta-analysis. We searched PubMed, Embase, Web of Science and ProQuest from its establishment to February 2023. The review was registered on PROSPERO database (CRD42022352405). The effects of infant formula with and without postbiotics were compared, and the incidence of serious adverse events (SAEs), digestive symptoms, concentration of stool secretory immunoglobulin A (SIgA), and growth and development indexes were analyzed. Nine randomized controlled trials with 2065 participants were included. The addition of postbiotics to infant formula was found to increase the concentration of stool SIgA (P < 0.05) with very low certainty of evidence, without significantly impacting the incidence of SAEs, infantile colic, flatulence, diarrhea, vomiting, abdominal pain and gastrointestinal disorders, the daily weight gain, the total gain in body length and the daily head circumference gain (all P > 0.05). Adding postbiotics to the formula is safe for infants, which would not increase the incidence of SAEs, infantile colic, flatulence, diarrhea, vomiting, abdominal pain, and gastrointestinal disorders, and could increase the concentration of stool SIgA.

Impact

  • Our study provides evidence that the addition of postbiotics to infant formula is safe but not effective.

  • This is the first systematic review and meta-analysis of postbiotics.

  • This study provides strong evidence for the safety of postbiotics and lays a foundation for related clinical trials.

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Fig. 1: Flowchart of study selection.
Fig. 2: The forest plot shows primary outcomes.
Fig. 3: The forest plot shows primary outcomes.
Fig. 4: The forest plot shows secondary outcomes.

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Data availability

All data generated or analyzed during this study are included in this published article.

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Author information

Authors and Affiliations

  1. School of Nursing, Weifang Medical University, Weifang, China

    Xifeng Liang, Yu Li, Zhijiao Zhao & Ru Ding

  2. School of Nursing, Jining Medical University, Jining, China

    Xifeng Liang, Yu Li & Cheng Chi

  3. School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia

    Jing Sun

  4. Institute for Integrated and Intelligent Systems, Griffith University, Brisbane, QLD, Australia

    Jing Sun

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  1. Xifeng Liang
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  2. Yu Li
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Contributions

J.S. and C.C. designed the study and reviewed the manuscript. X.L. drafted the manuscript. X.L. and C.C. screened the literature. X.L., Y.L., Z.Z. and R.D. extracted and analyzed the data. J.S. and C.C. revised the manuscript.

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Correspondence to Jing Sun or Cheng Chi.

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Liang, X., Li, Y., Zhao, Z. et al. Safety and efficacy of adding postbiotics in infant formula: a systematic review and meta-analysis. Pediatr Res 95, 43–51 (2024). https://doi.org/10.1038/s41390-023-02813-w

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