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Published on: January 27, 2019
Effects of Lactobacillus reuteri DSM 17938 in preterm infants: a double-blinded randomized controlled study
Xuewei Cui1, Yongyan Shi1, Siyang Gao1
1Department of Neonatology, Shengjing Hospital, China Medical University, Shenyang, China.
Insights
Lactobacillus reuteri DSM 17938 supplementation improved feeding tolerance and growth in preterm infants. This probiotic intervention also increased defecation frequency and reduced hospital stay without adverse effects.
Area of Science:
- Neonatal Medicine
- Microbiology
- Pediatric Nutrition
Background:
- Preterm infants possess immature gastrointestinal systems and underdeveloped immune responses.
- Evaluating the impact of Lactobacillus reuteri DSM 17938 on feeding tolerance, growth, and infection prevention in preterm infants is crucial.
Purpose of the Study:
- To assess the efficacy of Lactobacillus reuteri DSM 17938 in enhancing early feeding tolerance and promoting growth in preterm infants.
- To investigate the potential of Lactobacillus reuteri DSM 17938 in preventing infections and reducing adverse outcomes in this vulnerable population.
Main Methods:
- A randomized controlled trial involving 114 formula-fed preterm infants (gestational age 30–37 weeks, birth weight 1500–2000g).
- The intervention group received 1 × 10^8 colony-forming units of L. reuteri DSM 17938 daily, while the control group did not.
- Key outcomes measured included feeding tolerance, growth parameters, infection rates (sepsis, localized infection, NEC), and adverse events.
Main Results:
- Infants receiving L. reuteri DSM 17938 showed significantly reduced reflux episodes and a shorter time to full enteral feeding.
- Improved growth was observed, with higher average daily weight gain, head circumference increase, and body length increase in the intervention group.
- While infection rates and NEC did not differ significantly, the L. reuteri group had more frequent daily defecations and a shorter hospital stay. No adverse effects were reported.
Conclusions:
- Lactobacillus reuteri DSM 17938 supplementation appears beneficial for improving early feeding tolerance and promoting growth in preterm infants.
- The probiotic may also increase defecation frequency and shorten hospital stays, offering a potentially useful tool for neonatal care.
- Further research could explore its role in infection prevention, although this study found no significant differences in major infection outcomes.
Background:
Preterm infants have immature gastrointestinal tracts and poor immunity. In this study, the effects of Lactobacillus reuteri DSM 17938 first on early feeding tolerance, growth, and second on infection prevention in preterm infants were evaluated.
Methods:
One hundred fourteen formula-fed preterm infants with a gestational age between 30 weeks and 37 weeks, and a birth weight between 1500 and 2000 g were enrolled; 57 in the intervention and 57 in the control group:the intervention group was given a dose of 1 × 108 colony-forming units (5 drops) of L. reuteri DSM 17938 once daily, beginning with the first feeding until discharge. The control group did not receive probiotics. Early feeding tolerance (as time to full enterla feeding and number of reflux), growth, incidences of sepsis, localized infection, NEC, and adverse effects were recorded for both groups.
Results:
The number of Daily reflux episodes (times/d) was lower (2.18 ± 0.83 vs. 3.77 ± 0.66, P < 0.01) and time to full enteral feedings (120 mL/kg/d) (9.95 ± 2.46 d vs. 13.80 ± 3.47 d, P < 0.05) was shorter in the intervention group. Average daily weight gain (14.55 ± 3.07 g/d vs. 10.12 ± 2.80 g/d), head circumference increas e(0.0760 ± 0.0157 cm/d vs. 0.0681 ± 0.0108 cm/d), and body length increase (0.1878 ± 0.0151 cm/d vs. 0.1756 ± 0.0166 cm/d) of the intervention group were higher (P < 0.01). There were no significant differences in the incidences of sepsis (4.44% vs. 8.33%), localized infection (6.67% vs. 8.33%), or NEC (2.22% vs. 10.42%) between the 2 groups (P > 0.05). The number of daily defecations (times/d) in the intervention group was higher (3.08 ± 0.33 vs. 2.29 ± 0.20, P < 0.01) and the length of hospital stay was shorter than that in the control group (20.60 ± 5.36 d vs. 23.75 ± 8.57 d, P < 0.05). No adverse effects were noted among the infants receiving L. reuteri.
Conclusion:
L. reuteri may be an useful tool in improving early feeding tolerance in preterm infants, promoting growth, increasing the frequency of defecation, and shortening the length of hospital stay.
Trial Registration:
ChiCTR, ChiCTR1900025590. Registered 1 February 2019- Retrospectively registered, http://www.chictr.org.cn/listbycreater.aspx.
