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Nutritional outcomes with implementation of probiotics in preterm infants

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Abstract

Objective:

To assess nutritional outcomes in preterm infants after the implementation of probiotics.

Study Design:

Retrospective chart review of infants with birth weight⩽1250 grams and/or⩽28 weeks of gestational age admitted to the KCH-Neonatal Intensive Care Unit was done. Data were collected over two periods, period 1 (before probiotics) and period 2 (after probiotics) and included demographic data, daily weight gain, feeding strategies (type, amount, caloric content and frequency of feeds) and comorbidities affecting feedings (Patent ductus arteriosus, Sepsis). Primary outcomes—extra uterine growth restriction (EUGR) status and incidence of necrotizing enterocolitis (NEC) as well as secondary outcomes—time to reach full feeds, feeding intolerance episodes and weight gain were compared between the two groups.

Results:

A total of 113 infants (period 1) were compared with 108 infants (period 2). The odds of EUGR was significantly lower with probiotics (odds ratio: 0.3, 95% confidence interval 0.138 to 0.611). Time to reach full feeds was significantly reduced and weight gain was significantly better in period 2. Significant reduction was also noted in number of total parental nutrition days, central line days, nil per os days and number of feeding intolerance episodes in period 2. There was no significant difference in the incidence of NEC.

Conclusion:

Probiotics improve feeding tolerance leading to better overall growth and decreases the incidence of EUGR in preterm infants.

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References

  1. Barker DJ . The fetal and infant origins of adult disease. BMJ 1990; 301 (6761): 1111.

    Article  CAS  Google Scholar 

  2. Stoll BJ, Hansen NI, Bell EF, Shankaran S, Laptook AR, Walsh MC et al. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics 2010; 126 (3): 443–456.

    Article  Google Scholar 

  3. Neu J, Walker WA . Necrotizing enterocolitis. N Engl J Med 2011; 364 (3): 255–264.

    Article  CAS  Google Scholar 

  4. Alfaleh K, Anabrees J, Bassler D . Probiotics reduce the risk of necrotizing enterocolitis in preterm infants: a meta-analysis. Neonatology 2010; 97 (2): 93–99.

    Article  Google Scholar 

  5. Deshpande G, Rao S, Patole S, Bulsara M . Updated meta-analysis of probiotics for preventing necrotizing enterocolitis in preterm neonates. Pediatrics 2010; 125 (5): 921–930.

    Article  Google Scholar 

  6. Wang Q, Dong J, Zhu Y . Probiotic supplement reduces risk of necrotizing enterocolitis and mortality in preterm very low-birth-weight infants: an updated meta-analysis of 20 randomized, controlled trials. J Pediatr Surg 2012; 47 (1): 241–248.

    Article  Google Scholar 

  7. Caplan MS, Jilling T . Neonatal necrotizing enterocolitis: possible role of probiotic supplementation. J Pediatr Gastroenterol Nutr 2000; 30 (Suppl 2): S18–S22.

    Article  Google Scholar 

  8. Martin CR, Walker WA . Probiotics: role in pathophysiology and prevention in necrotizing enterocolitis. Semin Perinatol 2008; 32 (2): 127–137.

    Article  Google Scholar 

  9. Fuller R . Probiotics in man and animals. J Appl Bacteriol 1989; 66 (5): 365–378.

    Article  CAS  Google Scholar 

  10. Neu J, Caicedo R . Probiotics: protecting the intestinal ecosystem? J Pediatr 2005; 147 (2): 143–146.

    Article  Google Scholar 

  11. Weng M, Walker WA, Sanderson IR . Butyrate regulates the expression of pathogen-triggered IL- 8 in intestinal epithelia. Pediatr Res 2007; 62 (5): 542–546.

    Article  CAS  Google Scholar 

  12. Fujii T, Ohtsuka Y, Lee T, Kudo T, Shoji H, Sato H et al. Bifidobacterium breve enhances transforming growth factor beta1 signaling by regulating Smad7 expression in preterm infants. J Pediatr Gastroenterol Nutr 2006; 43 (1): 83–88.

    Article  Google Scholar 

  13. Takeda K, Suzuki T, Shimada SI, Shida K, Nanno M, Okumura K . Interleukin-12 is involved in the enhancement of human natural killer cell activity by Lactobacillus casei Shirota. Clin Exp Immunol 2006; 146 (1): 109–115.

    Article  CAS  Google Scholar 

  14. Costalos C, Skouteri V, Gounaris A, Sevastiadou S, Triandafilidou A, Ekonomidou C et al. Enteral feeding of premature infants with Saccharomyces boulardii. Early Hum Dev 2003; 74 (2): 89–96.

    Article  CAS  Google Scholar 

  15. Millar MR, Bacon C, Smith SL, Walker V, Hall MA . Enteral feeding of premature infants with Lactobacillus GG. Arch Dis Child 1993; 69 (5 Spec No): 483–487.

    Article  CAS  Google Scholar 

  16. Reuman PD, Duckworth DH, Smith KL, Kagan R, Bucciarelli RL, Ayoub EM . Lack of effect of Lactobacillus on gastrointestinal bacterial colonization in premature infants. Pediatr Infect Dis 1986; 5 (6): 663–668.

    Article  CAS  Google Scholar 

  17. Sari FN, Dizdar EA, Oguz S, Erdeve O, Uras N, Dilmen U . Oral probiotics: Lactobacillus sporogenes for prevention of necrotizing enterocolitis in very low-birth weight infants: a randomized, controlled trial. Eur J Clin Nutr 2011; 65 (4): 434–439.

    Article  CAS  Google Scholar 

  18. Al-Hosni M, Duenas M, Hawk M, Stewart LA, Borghese RA, Cahoon M et al. Probiotics- supplemented feeding in extremely low-birth-weight infants. J Perinatol 2012; 32 (4): 253–259.

    Article  CAS  Google Scholar 

  19. Wahlig TM, Gatto CW, Boros SJ, Mammel MC, Mills MM, Georgieff MK . Metabolic response of preterm infants to variable degrees of respiratory illness. J Pediatr 1994; 124 (2): 283–288.

    Article  CAS  Google Scholar 

  20. Wahlig TM, Georgieff MK . The effects of illness on neonatal metabolism and nutritional management. Clin Perinatol 1995; 22 (1): 77–96.

    Article  CAS  Google Scholar 

  21. Morley R, Lucas A . Influence of early diet on outcome in preterm infants. Acta Paediatr Suppl 1994; 405: 123–126.

    Article  CAS  Google Scholar 

  22. Barrett E, Kerr C, Murphy K, O'Sullivan O, Ryan CA, Dempsey EM et al. The individual-specific and diverse nature of the preterm infant microbiota. Arch Dis Child Fetal Neonatal Ed 2013; 98 (4): F334–F340.

    Article  Google Scholar 

  23. Shi HN, Walker A . Bacterial colonization and the development of intestinal defences. Can J Gastroenterol 2004; 18 (8): 493–500.

    Article  Google Scholar 

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Correspondence to S Dang.

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The authors declare no conflict of interest.

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Sumit Dang is the author of first draft

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Dang, S., Shook, L., Garlitz, K. et al. Nutritional outcomes with implementation of probiotics in preterm infants. J Perinatol 35, 447–450 (2015). https://doi.org/10.1038/jp.2014.234

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  • DOI: https://doi.org/10.1038/jp.2014.234

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