A research group in Spain found that probiotic supplementation may be able to reduce mortality and prevent necrotising enterocolitis and sepsis in preterm infants with very low birth weight.
Necrotising enterocolitis (NEC) is a common and often fatal disease in very low birth weight (VLBW) infants. Research has shown that breastfeeding and special nutrition protocols may be able to reduce the risk of NEC. Breastfeeding is extremely important, as bacteria from the milk, such as Lactobacillus and Bifidobacterium are the first to colonize the intestines of the infant preventing the proliferation of harmful species and the development of NEC. Antibiotics, that are often administered in VLBW infants, may also alter the microbiome of the infant`s gastrointestinal system. In these cases, probiotics (Lactobacillus rhamnosus GG (LGG), Lactobacillus acidophilus and Bifidobacterium infantis) may restore the gastrointestinal balance and help to reduce the risk of NEC and other complications.
In an article published in the British Journal of Nutrition, researchers assessed if routine probiotic supplementation (RPS) was able to reduce the risk of NEC in preterm neonates. They compared two periods: before (2010-2013) and after (2013-2016) introduction of RPS. They included infants born ≤32 weeks of gestation with a birth weight of ≤1500g who did not have any severe congenital malformations.
There was a significant difference between the use of probiotics between the two periods. Also, mortality was slightly lower between 2013 and 2016. Furthermore, researchers found that the use of probiotics decreased NEC (5.3% vs. 1.4%) and late-onset sepsis significantly. In addition, probiotic supplementation reduced mortality and NEC in infants born before 27 weeks of gestational age. The effect of different bacterium species did not differ significantly.
In conclusion, probiotic supplementation seems to be a safe and effective mean to prevent NEC, sepsis and to reduce mortality in preterm VLBW infants. However, further studies are needed in infants born before 27 weeks of gestation to validate the results in this group as well.
Written By: Dr. Fanni R. Eros