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Updated: Aug 4, 2025
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Published on: January 27, 2019
The preterm gut microbiota and administration routes of different probiotics: a randomized controlled trial
Ella-Noora Rahkola1,2, Samuli Rautava3,4, Henni Hiltunen3,5
1Department of Clinical Sciences, Faculty of Medicine, University of Turku, Turku, Finland. enrahk@utu.fi.
Insights
Early probiotic intervention with Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb-12 directly administered to preterm infants effectively modulated their gut microbiota. This approach shows promise for establishing a healthy gut microbiome in vulnerable neonates.
Area of Science:
- Microbiology
- Neonatal Research
- Gastroenterology
Background:
- Preterm infants often have abnormal gut microbiota, increasing susceptibility to infections and inflammation.
- Probiotic therapy is a potential strategy to develop age-appropriate gut microbiota in preterm neonates.
Purpose of the Study:
- To investigate the efficacy of direct oral administration versus maternal administration of probiotics in modulating the gut microbiota of preterm neonates.
- To compare the effects of Lactobacillus rhamnosus GG (LGG) alone and in combination with Bifidobacterium lactis Bb-12 (Bb12).
Main Methods:
- 68 preterm neonates were randomized into five groups receiving LGG, LGG + Bb12, or placebo, either directly or via the lactating mother.
- Fecal microbiota was analyzed using 16S rRNA gene sequencing at 7 days of age.
Main Results:
- Direct administration of LGG + Bb12 resulted in a gut microbiota significantly different from other groups (p=0.0012).
- This difference was attributed to increased relative abundance of Bifidobacterium animalis and the order Lactobacillales.
- Maternal administration of probiotics was less effective than direct administration.
Conclusions:
- Early, direct, and brief probiotic intervention with LGG + Bb12 is sufficient to modulate the gut microbiota in preterm neonates.
- This intervention increases bifidobacteria proportion, crucial for a healthy gut microbiome.
- Further research is needed, but direct probiotic administration shows potential for managing preterm infant gut health.
Background:
Preterm children with their aberrant gut microbiota and susceptibility to infections and inflammation constitute a considerable target group for probiotic therapy to generate the age-appropriate healthy microbiota.
Methods:
68 preterm neonates were randomized into five intervention groups: Beginning from the median age of 3 days, 13 children received Lactobacillus rhamnosus GG (LGG) directly orally, and 17 via the lactating mother. 14 children received LGG with Bifidobacterium lactis Bb-12 (Bb12) orally, and 10 via the lactating mother. 14 children received placebo. The children's faecal microbiota was assessed at the age of 7 days by 16S rRNA gene sequencing.
Results:
The gut microbiota compositions of the children directly receiving the probiotic combination (LGG + Bb12) were significantly different from those of the children receiving the other intervention modes or placebo (p = 0.0012; PERMANOVA), the distinction being due to an increase in the relative abundance of Bifidobacterium animalis (P < 0.00010; ANCOM-BC), and the order Lactobacillales (P = 0.020; ANCOM-BC).
Conclusion:
The connection between aberrant primary gut microbiota and a heightened risk of infectious and non-communicable diseases invites effective microbiota modulation. We show that the direct, early, and brief probiotic intervention of LGG + Bb12 109 CFU each, is sufficient to modulate the gut microbiota of the preterm neonate.
Impact:
Preterm children have a higher risk of several health problems partly due to their aberrant gut microbiota. More research is needed to find a safe probiotic intervention to modify the gut microbiota of preterm children. The maternal administration route via breast milk might be safer for the newborn. In our study, the early and direct administration of the probiotic combination Lactobacillus rhamnosus GG with Bifidobacterium lactis Bb-12 increased the proportion of bifidobacteria in the preterm children's gut at the age of 7 days, but the maternal administration route was not as effective.
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