Synbiotics failed to significantly increase growth in boys and girls .
Use of synbiotics increased stool frequency , had no impact on stool consistency , colic , spitting up / regurgitation , crying , restlessness or vomiting .
Probiotics in formula also failed to have any significant effect on growth , stool frequency or consistency .
Probiotics did not lower the incidence of diarrhoea , colic , spitting up / regurgitation , crying , restlessness or vomiting .
Prebiotics in formula did increase weight gain but had no impact on length or head circumference gain .
Prebiotics increased stool frequency but had no impact on stool consistency , the incidence of colic , spitting up / regurgitation , crying , restlessness or vomiting .
There was no impact of prebiotics on the volume of formula tolerated , infections and gastrointestinal microflora .
Authors ’ conclusions There is not enough evidence to state that supplementation of term infant formula with synbiotics , probiotics or prebiotics does result in improved growth or clinical outcomes in term infants .
There is no data available to establish if synbiotics are superior to probiotics or prebiotics
Background Synbiotics , probiotics or prebiotics are being added to infant formula to promote growth and development in infants .
Previous review s ( 2007 to 2011 ) on term infants given probiotics or prebiotics focused on prevention of allergic disease and food hypersensitivity .
This review focused on growth and clinical outcomes in term infants fed only infant formula containing synbiotics , probiotics or prebiotics .
Urinary D-Lactate Excretion in Infants Receiving Lactobacillus johnsonii with Formula
Background / Aims : Supplementation with certain probiotics can improve gut microbial flora and immune function but should not have adverse effects . This study aim ed to assess the risk of D-lactate accumulation and subsequent metabolic acidosis in infants fed on formula containing Lactobacillus johnsonii ( La1 ® ) .  Methods : In the framework of a double-blind , r and omized controlled trial enrolling 71 infants aged 4–5 months , morning urine sample s were collected before and 4 weeks after being fed formulas with or without La1  ( 1 × 108/g powder ) or being breastfed . Urinary D- and L-lactate concentrations were assayed by enzymatic , fluorimetric methods and excretion was normalized per mol creatinine . Results : At baseline , no significant differences in urinary D-/L-lactate excretion among the formula-fed and breastfed groups were found . After 4 weeks , D-lactate excretion did not differ between the two formula groups , but was higher in both formula groups than in breastfed infants . In all infants receiving La1  , urinary D-lactate concentrations remained within the concentration ranges of age-matched healthy infants which had been determined in an earlier study using the same analytical method . Urinary L-lactate also did not vary over time or among groups . Conclusions : Supplementation of La1 to formula did not affect urinary lactate excretion and there is no evidence of an increased risk of lactic acidosis
Synbiotics failed to significantly increase growth in boys and girls .
Use of synbiotics increased stool frequency , had no impact on stool consistency , colic , spitting up / regurgitation , crying , restlessness or vomiting .
Probiotics in formula also failed to have any significant effect on growth , stool frequency or consistency .
Probiotics did not lower the incidence of diarrhoea , colic , spitting up / regurgitation , crying , restlessness or vomiting .
Prebiotics in formula did increase weight gain but had no impact on length or head circumference gain .
Prebiotics increased stool frequency but had no impact on stool consistency , the incidence of colic , spitting up / regurgitation , crying , restlessness or vomiting .
There was no impact of prebiotics on the volume of formula tolerated , infections and gastrointestinal microflora .
Authors ’ conclusions There is not enough evidence to state that supplementation of term infant formula with synbiotics , probiotics or prebiotics does result in improved growth or clinical outcomes in term infants .
There is no data available to establish if synbiotics are superior to probiotics or prebiotics
Background Synbiotics , probiotics or prebiotics are being added to infant formula to promote growth and development in infants .
Previous review s ( 2007 to 2011 ) on term infants given probiotics or prebiotics focused on prevention of allergic disease and food hypersensitivity .
This review focused on growth and clinical outcomes in term infants fed only infant formula containing synbiotics , probiotics or prebiotics .