The effects of lactulose supplementation to enteral feedings in premature infants: a pilot study.
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.
Riskin
Arieh
A
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
Hochwald
Ori
O
Bader
David
D
Srugo
Isaac
I
Naftali
Gabi
G
Kugelman
Amir
A
Cohen
Ella
E
Mor
Frida
F
Kaufman
Bela
B
Shaoul
Ron
R
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
D005765:Gastrointestinal Agents; D056692:Prebiotics; D007792:Lactulose