人乳低聚糖结肠代谢与婴儿排便模式

Colonic metabolism of human milk oligosaccharides and infant defecation patterns

摘要

母乳喂养婴儿常见的高频率稀便并非病理状态,而是人乳低聚糖(HMO)代谢利用的特有排便模式。HMO作为“天然益生元”可选择性促进双歧杆菌属,尤其是长双歧杆菌婴儿亚种的增殖。该菌代谢利用HMO产生乳酸、乙酸等有机酸,降低肠腔pH,调节水电解质平衡,可能是大便稀软且排便频繁的原因之一。其次,如果HMO不被完全代谢利用,可使肠腔渗透负荷增加携带水分通过粪便呈稀便被排出。临床上,在评估时应摒弃单一频率改变,应结合婴儿精神状态、生长曲线及大便性状进行综合分层判断,慎用“生理性腹泻”的诊断,减少过度诊断与干预,促进母乳喂养的持续与落实。

Abstract

The high-frequency loose stools commonly observed in breastfed infants are not a pathological condition, but rather a specific defecation pattern resulting from the metabolic utilization of human milk oligosaccharides (HMO).As a natural prebiotic, HMO selectively promotes the proliferation of Bifidobacterium, particularly the B.longum subsp.infantis.These bacteria metabolize HMO to produce organic acids such as lactic acid and acetic acid, lowering the intestinal lumen pH and regulating water and electrolyte balance, which may be one of the reasons for the soft consistency and frequent defecation.Secondly, if HMOs are not completely metabolized, they can increase the osmotic load in the intestinal lumen, drawing in water that is then excreted as loose stools.Clinically, assessment should not rely on stool frequency alone.Instead, a stratified evaluation integrating the infant′s general condition, growth trajectory, and stool characteristics is recommended.The diagnosis of physiological diarrhea should be used cautiously to reduce overdiagnosis and unnecessary interventions and to support the continuation and implementation of breastfeeding.

关键词

人乳低聚糖 / 结肠代谢 / 排便模式 / 婴儿

Key words

human milk oligosaccharides / colonic metabolism / bowel movement patterns / infants

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