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Probiotic Studies in Neonatal Mice Using Gavage
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Routine Lactobacillus rhamnosus GG administration in VLBW infants: a retrospective, 6-year cohort study

Paolo Manzoni1, Gianluca Lista, Elena Gallo

  • 1Neonatology, S. Anna Hospital, Torino, Italy. paolomanzoni@hotmail.com

Early Human Development
|February 8, 2011
PubMed

Insights

Routine use of Lactobacillus rhamnosus GG (LGG) probiotic in very low birth weight (VLBW) infants was safe and well-tolerated. This 6-year study found no adverse effects, demonstrating LGG

Area of Science:

  • Neonatal Medicine
  • Microbiology
  • Pediatric Nutrition

Background:

  • Probiotic use in preterm neonates is popular for preventing necrotizing enterocolitis (NEC), fungal colonization, and improving feeding tolerance.
  • Concerns exist regarding the safety and tolerability of long-term probiotic administration in non-immunocompetent hosts.
  • This study reports on the routine use of Lactobacillus rhamnosus GG (LGG) in very low birth weight (VLBW) infants over six years.

Purpose of the Study:

  • To evaluate the safety and tolerability of routine Lactobacillus rhamnosus GG (LGG) supplementation in very low birth weight (VLBW) infants.
  • To assess the microbiological safety and clinical outcomes associated with LGG administration.
  • To analyze feeding tolerance and infection rates in VLBW infants receiving LGG.

Main Methods:

  • Retrospective study of VLBW infants admitted to two Italian Neonatal Intensive Care Units (NICUs) from 2003-2008.
  • Standard LGG administration: 3 x 10⁹ CFU/day orally for 4-6 weeks, starting on day 4 of life.
  • Data collected included safety, tolerability, infections, feeding tolerance, and microbiological cultures.

Main Results:

  • Complete data from 743 VLBW infants were analyzed; mean birth weight 1056g, mean gestational age 29.5 weeks.
  • A total of 17,108 LGG doses were administered with no adverse effects or intolerances attributed to LGG.
  • No LGG or other Lactobacilli were detected in over 5350 clinical and surveillance cultures; no LGG-attributable sepsis occurred. Fourteen NEC cases (1.9%) were reported.

Conclusions:

  • Routine Lactobacillus rhamnosus GG (LGG) supplementation in a large cohort of VLBW infants is microbiologically safe.
  • Clinical outcomes indicate that LGG is well-tolerated in this vulnerable population.
  • The findings support the use of LGG as a safe probiotic intervention for VLBW infants.
Abstract

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