Pro- and Prebiotic Supplementation Induces a Transient Reduction in Hemoglobin Concentration in Infants

Objectives: Regarding safety, we investigated the effect of prenatal probiotic and 6 months of pro- and prebiotic supplementation of infants on their hematologic values at 6 months and 2 years and factors affecting these values. Patients and Methods: In a prospective randomized controlled probiotic intervention trial in infants at high risk for allergy, we obtained blood samples consecutively from 98 infants at 6 months and from 658 children at 2 years to measure hematologic values. We collected fecal samples at 3 and 6 months to measure immunologic development by calprotectin, alpha-1-antitrypsin, tumor necrosis factor-alpha, and immunoglobulin A. Results: At 6 months, infants in the probiotic group had significantly lower hemoglobin (Hb) values than did the placebo group, mean (SD): 119.8 g/L (6.3) versus 123.3 g/L (8.4), P=0.025. Adjustment for factors that might affect Hb values (breast-feeding duration, solid-food introduction, and sex), revealed no need for adjustment. A significant negative correlation emerged between Hb values at 6 months and fecal calprotectin at age 3 months r=-0.301, P=0.009, which was affected neither by breast-feeding, sex, nor study group. At 2 years, hematologic values in both groups became similar. Conclusions: Probiotics cause a gut mucosal inflammation with decreased Hb values during intervention, corrected after halting the supplementation. JPGN 49:626-630, 2009.