Despite these documents and numerous existing RCTs, the efficacy and/or safety of many modifications of infant feeding remain(s) questionable [14]. This is mainly due to the methodological limitations of many of the trials. One such example could
be infant formulas supplemented with probiotics and/or prebiotics. In the position
paper recently published by the ESPGHAN Committee on Nutrition [15], it was
noted that interpreting studies on the effects of probiotic supplementation of infant
formula on growth is difficult due to the limited number of studies that analyzed the
effects of a given probiotic strain. The studies were often too small with insufficient
power to identify relevant effects on growth, and the follow- up periods in the trials
were short. Although, in general, it was concluded that a few probiotic strains used
to supplement infant formula support normal growth in healthy term infants, this
conclusion needs to be considered with caution. The same caution applies to other
outcomes.