Human Milk Oligosaccharide Associated with Infant Nutritional Status and Macroscopic Stool Examination among Stunted Infants in Malang Indonesia

Abstract

This study aims to investigate the concentration of 2’-FL HMO and its relationship with infant health status, then examine their correlation to macroscopic stool examination. A case-control study was conducted among 103 mother-infant pairs in 3 primary health care in Malang City, Indonesia. HPLC analyzed HMO quantification and fecal assessment by gross macroscopic stool examination. The findings showed that 49 infants had stunted nutrition status, and 54 had not stunted nutritional status. Among the group of stunted infants came from mothers with secretor-positive status (40.81%), while all infants with not stunted nutritional status came from mothers with secretor-positive status (100%). However, the status of secretor mothers to nutritional status was not significantly related (p>0.05). Levels of 2’-FL HMO in breast milk in stunted infants had a lower average than in non-stunted infants (1.21 mg/L vs. 1.40 mg/L). After analysis with the Mann-Whitney Test, 2’-FL HMO levels had a significant relationship with the baby's nutritional status, the yellow color in infant stool, and mucus in large amounts of stool (p>0.05). 2’-FL HMO has a significant role in the nutritional status of infants. Further analysis is needed to validate the macroscopic assessment of stool to detect inflammation and indigestion in stunted infants.