Probiotics and prevention of neonatal necrotizing enterocolitis
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Updated: Jun 5, 2026

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Published on: January 27, 2019
Brandy L Frost1, Michael S Caplan
1Department of Pediatrics, NorthShore University Health System/Pritzker School of Medicine, University of Chicago, Evanston, Illinois 60201, USA. bfrost@northshore.org
Insights
Probiotic supplementation may reduce necrotizing enterocolitis (NEC) in preterm infants. Ensuring safe, high-quality probiotic products is crucial before widespread use for NEC prevention.
Area of Science:
- Neonatal Medicine
- Gastroenterology
- Microbiology
Background:
- Necrotizing enterocolitis (NEC) is a significant gastrointestinal emergency in preterm neonates.
- Current therapeutic options for NEC prevention and treatment are limited, highlighting the need for novel strategies.
Purpose of the Study:
- To review clinical trials assessing the efficacy of prophylactic probiotic supplementation in preterm infants for reducing NEC incidence.
- To synthesize current evidence on the role of probiotics in NEC prevention.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials.
- Evaluation of various probiotic formulations, dosages, and administration protocols used in clinical trials.
Main Results:
- Evidence indicates that probiotic supplementation can decrease the incidence of NEC in preterm infants.
- Recent meta-analyses suggest probiotics as a potential preventive therapy for specific preterm infant populations.
Conclusions:
- Probiotics show promise in preventing NEC, a serious condition in preterm neonates.
- Further research is needed to address variations in probiotic products, safety concerns, and quality control before widespread clinical adoption.
Purpose Of Review:
This review will summarize the clinical trials evaluating the role of prophylactic probiotic supplementation in preterm infants in order to reduce the incidence of necrotizing enterocolitis (NEC).
Recent Findings:
Evidence suggests that probiotic supplementation in preterm infants reduces the incidence of NEC. In fact, recent meta-analyses have called for the use of probiotics as preventive therapy in subsets of this population. However, although multiple studies have evaluated the use of probiotics for this indication in preterm infants, these trials have used different formulations of bacteria, at differing doses and using varied protocols for administration; thus many unanswered questions remain. In addition, theoretical safety issues and concerns regarding quality of product still need to be addressed.
Summary:
As NEC remains a serious problem for preterm neonates, proven therapies for prevention and treatment of this dreaded disease are needed. While the evidence does support a future role for probiotics in the prevention of NEC, it is of utmost importance to first ensure that a safe and high-quality product meeting rigorous standards will be provided to these at-risk infants.
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