title: Oral probiotics prevent necrotizing enterocolitis in very low birth weight neonates.
abstract: OBJECTIVE
  To test the hypothesis that normalizing the intestinal flora by administration of prophylactic probiotics would provide a natural defense, thereby reducing both the incidence and severity of necrotizing enterocolitis (NEC) in preterm neonates.
  
  
  METHODS
  Neonates < or =1500 g birth weight were randomized to either receive a daily feeding supplementation with a probiotic mixture (Bifidobacteria infantis, Streptococcus thermophilus, and Bifidobacteria bifidus; Solgar, Israel) of 10(9) colony forming units (CFU)/day or to not receive feed supplements. NEC was graded according to Bell's criteria.
  
  
  RESULTS
  For 72 study and 73 control infants, respectively, birth weight (1152 +/- 262 g vs 1111 +/- 278 g), gestational age (30 +/- 3 weeks vs 29 +/- 4 weeks), and time to reach full feeds (14.6 +/- 8.7 days vs 17.5 +/- 13.6 days) were not different. The incidence of NEC was reduced in the study group (4% vs 16.4%; P=.03). NEC was less severe in the probiotic-supplemented infants (Bell's criteria 2.3 +/- 0.5 vs 1.3 +/- 0.5; P=.005). Three of 15 babies who developed NEC died, and all NEC-related deaths occurred in control infants.
  
  
  CONCLUSIONS
  Probiotic supplementation reduced both the incidence and severity of NEC in our premature neonatal population.
authors.affiliation: Department of Neonatology and Laboratories, Shaare Zedek Medical Center, the Faculty of Medicine of the Hebrew University, Jerusalem, Israel.
authors.forename: Alona
authors.initials: A
authors.lastname: Bin-Nun
authors.forename: Ruben
authors.initials: R
authors.lastname: Bromiker
authors.forename: Michael
authors.initials: M
authors.lastname: Wilschanski
authors.forename: Michael
authors.initials: M
authors.lastname: Kaplan
authors.forename: Bernard
authors.initials: B
authors.lastname: Rudensky
authors.forename: Michael
authors.initials: M
authors.lastname: Caplan
authors.forename: Cathy
authors.initials: C
authors.lastname: Hammerman
mesh_terms: D000284:Administration, Oral; D001034:Apgar Score; D001644:Bifidobacterium / Q000276:immunology; D020345:Enterocolitis, Necrotizing / Q000145:classification / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D019936:Probiotics / Q000008:administration & dosage / Q000627:therapeutic use*; D012720:Severity of Illness Index; D048249:Streptococcus thermophilus / Q000276:immunology