Multi-strain probiotics for extremely preterm infants: a randomized controlled trial

Area of Science:

• Neonatal Medicine
• Microbiome Research
• Gastroenterology

Background:

• The impact of probiotics on the intestinal microbiota and feeding tolerance in extremely low-birth-weight (ELBW) infants is not well understood.
• Establishing optimal feeding practices and gut health is critical for the survival and development of ELBW infants.

Purpose of the Study:

• To investigate the effects of probiotics on intestinal microbiota composition in ELBW infants.
• To assess the impact of probiotics on feeding tolerance and clinical outcomes in ELBW infants.

Main Methods:

• A randomized controlled trial involving ELBW infants assigned to receive probiotics or no intervention.
• Stool sample analysis to evaluate changes in intestinal microbiota.
• Monitoring of feeding progression, incidence of hematochezia, and need for specialized formulas.

Main Results:

• Infants receiving probiotics achieved full enteral feeds significantly sooner (MD -1.8 days).
• Probiotic use was associated with a trend towards lower incidence of hematochezia and reduced need for extensively hydrolyzed or amino acid-based formulas.
• Multi-strain probiotics increased fecal Bifidobacterium and Lactobacillus while reducing Candida abundance.

Conclusions:

• Probiotics can sustain beneficial intestinal bacteria like Bifidobacterium and Lactobacillus in extremely preterm infants.
• Probiotic supplementation may improve feeding tolerance and reduce the time to achieve full enteral feeds in ELBW infants.
• Probiotics show potential in improving tolerance to cow's milk protein supplements in this vulnerable population.