Oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants.
OBJECTIVE
We evaluated the efficacy of probiotics in reducing the incidence and severity of necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants.


METHODS
A prospective, masked, randomized control trial was conducted to evaluate the beneficial effects of probiotics in reducing the incidence and severity of NEC among VLBW (<1500 g) infants. VLBW infants who started to fed enterally and survived beyond the seventh day after birth were eligible for the trial. They were randomized into 2 groups after parental informed consents were obtained. The infants in the study group were fed with Infloran (Lactobacillus acidophilus and Bifidobacterium infantis) with breast milk twice daily until discharged. Infants in the control group were fed with breast milk alone. The clinicians caring for the infants were blinded to the group assignment. The primary outcome was death or NEC (>or= stage 2).


RESULTS
Three hundred sixty-seven infants were enrolled: 180 in the study group and 187 in the control group. The demographic and clinical variables were similar in both groups. The incidence of death or NEC (>or= stage 2) was significantly lower in the study group (9 of 180 vs 24 of 187). The incidence of NEC (>or= stage 2) was also significantly lower in the study when compared with the control group (2 of 180 vs 10 of 187). There were 6 cases of severe NEC (Bell stage 3) in the control group and none in the study group. None of the positive blood culture grew Lactobacillus or Bifidobacterium species.


CONCLUSIONS
Infloran as probiotics fed enterally with breast milk reduces the incidence and severity of NEC in VLBW infants.
Lin
Hung-Chih
HC
Department of Pediatrics, China Medical University Hospital, China Medical University, 2 Yuh Der Rd, Taichung 404, Taiwan. d0373@www.cmuh.org.tw
Su
Bai-Horng
BH
Chen
An-Chyi
AC
Lin
Tsung-Wen
TW
Tsai
Chang-Hai
CH
Yeh
Tsu-Fuh
TF
Oh
William
W
D001644:Bifidobacterium; D019587:Dietary Supplements; D020345:Enterocolitis, Necrotizing / Q000145:classification / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000401:mortality / Q000517:prevention & control*; D019102:Infant, Very Low Birth Weight; D007779:Lactobacillus acidophilus; D016015:Logistic Models; D008297:Male; D008895:Milk, Human; D019936:Probiotics / Q000627:therapeutic use*; D011446:Prospective Studies; D018805:Sepsis / Q000453:epidemiology; D012720:Severity of Illness Index; D016037:Single-Blind Method