title: The effects of lactulose supplementation to enteral feedings in premature infants: a pilot study.
abstract: OBJECTIVE
  To assess the safety and prebiotic effects of lactulose in preterm infants.
  
  
  METHODS
  This was a prospective, double-blinded, placebo-controlled, single-center study in 23- to 34-weeks premature infants. The study group received 1% lactulose, and control infants received 1% dextrose in all feeds (human milk or formula).
  
  
  RESULTS
  Twenty-eight infants participated (15 lactulose, 13 placebo). Small doses of lactulose appeared to be safe and did not cause diarrhea. Premature infants on lactulose had more Lactobacilli-positive stool cultures that appeared earlier with larger number of colonies. The lactulose group tended to have less intolerance to enteral feedings, to reach full oral feeds earlier, and to be discharged home earlier. They also tended to have fewer episodes of late-onset sepsis, lower Bell stage necrotizing enterocolitis, and their nutritional laboratory indices were better, especially calcium and total protein.
  
  
  CONCLUSIONS
  This pilot study supports the safety of supplementing preterm infants' feeds with low doses of lactulose. It also demonstrated trends that may suggest positive prebiotic effects.
authors.affiliation: Department of Neonatology, Bnai Zion Medical Center, Technion, Israel Institute of Technology, 47 Golomb Street, POB 4940, Haifa 31048, Israel. arik.riskin@b-zion.org.il
authors.forename: Arieh
authors.initials: A
authors.lastname: Riskin
authors.forename: Ori
authors.initials: O
authors.lastname: Hochwald
authors.forename: David
authors.initials: D
authors.lastname: Bader
authors.forename: Isaac
authors.initials: I
authors.lastname: Srugo
authors.forename: Gabi
authors.initials: G
authors.lastname: Naftali
authors.forename: Amir
authors.initials: A
authors.lastname: Kugelman
authors.forename: Ella
authors.initials: E
authors.lastname: Cohen
authors.forename: Frida
authors.initials: F
authors.lastname: Mor
authors.forename: Bela
authors.initials: B
authors.lastname: Kaufman
authors.forename: Ron
authors.initials: R
authors.lastname: Shaoul
mesh_terms: D015169:Colony Count, Microbial; D004311:Double-Blind Method; D004750:Enteral Nutrition; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007778:Lactobacillus / Q000254:growth & development; D007792:Lactulose / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D010865:Pilot Projects; D056692:Prebiotics / Q000009:adverse effects; D011446:Prospective Studies; D012449:Safety
chemical_list: D005765:Gastrointestinal Agents; D056692:Prebiotics; D007792:Lactulose