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Probiotic Supplementation for Preterm Neonates--What Lies Ahead?

Sanjay Patole1

  • 1Department of Neonatal Paediatrics, KEM Hospital for Women, and Centre for Neonatal Research and Education, University of Western Australia, Perth, WA, Australia.

Nestle Nutrition Institute Workshop Series
|June 27, 2015
PubMed

Insights

Probiotic supplements effectively lower the risk of necrotizing enterocolitis (NEC) in premature infants without causing harm. This practice change is recommended due to the significant benefits of probiotics for vulnerable newborns.

Area of Science:

  • Neonatalogy
  • Gastroenterology
  • Microbiome research

Background:

  • Necrotizing enterocolitis (NEC) poses a significant health risk to preterm very-low-birthweight neonates.
  • Optimizing enteral nutrition is critical for extremely preterm infants, especially those with intrauterine growth restriction.
  • Feed intolerance is a common complication in this vulnerable population, increasing NEC risk.

Purpose of the Study:

  • To evaluate the efficacy and safety of probiotic supplementation in preventing NEC in preterm neonates.
  • To assess the impact of probiotics on feed tolerance in extremely preterm infants.
  • To review current evidence and future directions for probiotic use in neonatal care.

Main Methods:

  • Systematic reviews of randomized controlled trials (RCTs) were analyzed.
  • Data on NEC incidence, adverse effects, and feed tolerance were synthesized.
  • Evidence regarding the accessibility of proven probiotic products was considered.

Main Results:

  • Probiotic supplementation significantly reduces the risk of NEC in preterm very-low-birthweight neonates.
  • No significant adverse effects were associated with probiotic use.
  • Probiotics facilitate feed tolerance, a crucial factor in optimizing nutrition for high-risk neonates.
  • Risk reduction is observed even at low baseline NEC incidence rates (around 5%).

Conclusions:

  • Probiotic supplementation is a justified practice change for preventing NEC in preterm neonates.
  • The benefits extend to improving feed tolerance, crucial for nutritional support in high-risk infants.
  • Barriers to accessing safe and effective probiotic products are minimal, supporting wider adoption.
  • Further research should address knowledge gaps and the long-term impact of routine probiotic use.

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