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Published on: January 27, 2019
Probiotics in the fight against necrotizing enterocolitis: a cost-effective yet underutilized strategy in neonatal
Qadr Amir1, Gyaneshwari2, Maliha Khalid3
1Department of Medicine, Fatima Jinnah Medical University, Lahore, Pakistan.
Insights
Probiotics show promise in reducing necrotizing enterocolitis (NEC) in preterm infants by improving gut health. Wider clinical adoption requires addressing uncertainties in optimal use and long-term safety.
Area of Science:
- Neonatal Medicine
- Gastroenterology
- Microbiome Research
Background:
- Necrotizing enterocolitis (NEC) is a major cause of illness and death in premature infants.
- Probiotics, especially multi-strain formulas, may prevent NEC by influencing the gut microbiome, barrier function, and inflammation.
- Meta-analyses support probiotic efficacy in reducing NEC and mortality.
Abstract:
Necrotizing enterocolitis (NEC) remains a leading cause of gastrointestinal morbidity and mortality among preterm and very low birth weight infants. Probiotics, particularly multi-strain formulations including Bifidobacteria, Lactobacillus, and Enterococcus, have shown considerable promise in reducing the incidence and severity of NEC by modulating the neonatal gut microbiome, enhancing mucosal barrier integrity, and reducing systemic inflammation. Recent meta-analyses confirm their efficacy in lowering NEC risk and associated mortality. Nevertheless, routine use in clinical practice remains limited due to heterogeneity in neonatal intensive care unit practices, uncertainty around optimal strains, dosage, and treatment duration, and insufficient long-term safety data. Given their cost-effectiveness and strong evidence base, integrating probiotics into standard neonatal care protocols, while addressing existing research gaps, could significantly improve outcomes for this vulnerable population.
