Probiotics to improve the gut microbiome in premature infants: are we there yet?

Area of Science:

• Neonatal microbiome research
• Pediatric gastroenterology
• Immunology

Background:

• Preterm infants exhibit altered gut microbiome development compared to term infants.
• Microbiome dysbiosis is linked to clinical conditions such as necrotizing enterocolitis (NEC) and late-onset sepsis (LOS).
• Probiotic supplementation is a potential strategy to modulate the preterm infant gut microbiome.

Approach:

• This review synthesizes current literature on probiotic effects in preterm infants.
• It explores proposed mechanisms of probiotic action on the gut microbiome, metabolome, and immune system.
• Clinical considerations for optimal probiotic use are discussed.

Key Points:

• Probiotics demonstrate efficacy in preventing NEC and LOS in preterm infants.
• Emerging evidence supports probiotic benefits for preterm gut microbiome composition, metabolic activity, and immune modulation.
• Understanding these effects is crucial for establishing best practices.

Conclusions:

• Probiotic supplementation is a promising prophylactic intervention for preterm infants.
• Further research is needed to elucidate optimal probiotic strains, dosages, and administration timing.
• Evidence-based guidelines are essential for integrating probiotics into neonatal care protocols.