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Lactobacillus rhamnosus GG to Reduce Necrotising Enterocolitis, Sepsis, and Mortality in Very Low Birth Weight

Sachin Shah1, Amita Kaul2, Prerna Pandey3

  • 1Department of Neonatal and Pediatric Intensive Care Services, Surya Mother and Child Super Specialty Hospital, Pune Octroi Naka, Sr. No.8, Near Bhujbal Chowk, Wakad Road, Pune, Maharashtra, 411057, India.

Indian Pediatrics
|January 14, 2026
PubMed

Insights

Oral Lactobacillus rhamnosus GG (LGG) did not significantly reduce neonatal enterocolitis (NEC), sepsis, or mortality in very low birth weight (VLBW) infants. This probiotic intervention showed no benefit in the primary composite outcome for these vulnerable infants.

Area of Science:

  • Neonatalogy
  • Microbiology
  • Clinical Trials

Background:

  • Very low birth weight (VLBW) infants are at high risk for serious complications.
  • Probiotics are explored as a potential intervention to improve outcomes in VLBW infants.
  • Lactobacillus rhamnosus GG (LGG) is a commonly studied probiotic strain.

Purpose of the Study:

  • To evaluate the efficacy of oral Lactobacillus rhamnosus GG (LGG) in preventing neonatal enterocolitis (NEC), sepsis, and mortality.
  • To assess the impact of LGG on feeding milestones and hospital stay duration in VLBW infants.

Main Methods:

  • An open-label randomized controlled trial was conducted with enterally-fed VLBW infants (gestational age ≤ 32 weeks).
  • Infants were randomized to receive either LGG or no probiotic (control).
  • Outcomes including mortality, NEC, and sepsis were compared during hospitalization.

Main Results:

  • The composite outcome of sepsis, NEC, or mortality occurred in 30.4% of the LGG group and 27.2% in the control group (RR 0.85; 95%CI 0.48-1.50).
  • No significant differences were observed in the time to reach full feeds, time to regain birth weight, duration of hospital stay, mechanical ventilation, or antimicrobial therapy.
  • The study included 236 VLBW infants.

Conclusions:

  • The use of Lactobacillus rhamnosus GG as a single probiotic agent did not provide significant benefits for the composite outcome of mortality, sepsis, or NEC in VLBW infants.
  • Further research may be needed to explore other probiotic strains or combinations for this population.
Abstract

Keywords:
Infant feedingInfant mortalityLGGMicrobiotaProbioticVLBW

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