Efficacy of Bifidobacterium breve and Lactobacillus casei oral supplementation on necrotizing enterocolitis in very-low-birth-weight preterm infants: a double-blind, randomized, controlled trial

Abstract

Background: Probiotics are used for the prevention of necrotizing enterocolitis (NEC) because of their positive effects on intestinal motor function, modulation of inflammatory response, and mucosal barrier function.

Probiotic Effects on Late-onset Sepsis in Very Preterm Infants: A Randomized Controlled Trial

“…Our finding of a lack of effect of the probiotic combination on definite lateonset sepsis is consistent with most, 14,[19][20][21][22][23][24][25][26][27][28][29] but not all, 13,28,[30][31][32] RCTs, as well as published systematic reviews and meta-analyses. [8][9][10] Interestingly, our study suggests a differential benefit of this probiotic combination on late-onset sepsis and possibly NEC of Bell stage 2 or more in infants born at 28 to 31 6 weeks' gestation.…”

Probiotic Supplementation and Its Effect on Weight and Feed tolerance in Preterm Low Birth Weight Newborns: A Clinical Trial

“…This finding was comparable with most other studies. 22,23 A relevant meta-analysis also concluded such improvement in gastrointestinal tolerance. 24 Probiotic improves gastrointestinal motility in both upper and lower gut which probably accounted for improvement in feed tolerance in probiotic supplemented group.…”

“…Most other studies also demonstrated similar results. 23,25,28 However one study from Japan reported improved weight gain and feed tolerance when Bifidobacterium breve was given to preterm infants. 29 Weight gain in the sick newborns are affected by many coexistent morbidities as well as provision for total parental supplementation and/ or breast milk fortifier which possibly affected the weight pattern in both groups in that study.…”

Composition of the early intestinal microbiota

“…85,130 There has been considerable interest in the use of probiotics to prevent NEC by normalizing the intestinal microbiota of preterm infants, i.e., trying to change its composition to resemble that of healthy, full term infants. 131,132 Notably, trials using animal models of NEC have shown the benefits of introducing probiotic supplemented diets. 133,134 In one instance the animals, which were fed 10 9 organisms/animal/day, had significantly reduced cases of NEC with just 7/24 in the treatment group suffering from NEC, compared with 19/27 in the control group.…”