title: Probiotics, feeding tolerance, and growth: a comparison between HIV-exposed and unexposed very low birth weight infants.
abstract: OBJECTIVE
  The aim of this study was to compare the effect of administration of probiotics on feeding tolerance and growth outcomes of HIV-exposed (but uninfected) versus HIV non-exposed preterm infants. The null hypothesis of this study states that there will be no difference in the feeding tolerance and growth outcomes for both probiotic-exposed and unexposed premature very low birth weight infants.
  
  
  METHODS
  A randomized, double-blind, placebo-controlled trial was conducted during the period from July 2011 to August 2012. HIV-exposed and non-exposed premature (<34 wk gestation) infants with a birth weight of ≥500 g and ≤1250 g were randomized to receive either a probiotic mixture or placebo. The multispecies probiotic mixture consisted of 1 × 10(9) CFU, Lactobacillus rhamnosus GG and Bifidobacterium infantis per day and was administered for 28 d. Anthropometrical parameters, daily intakes, and feeding tolerance were monitored.
  
  
  RESULTS
  Seventy-four HIV-exposed and 110 unexposed infants were enrolled and randomized (mean birth weight 987 g ± 160 g, range, 560-1244 g; mean gestational age 28.7 wk). In all 4227 probiotic doses were administered (mean 22.9/infant). There was no difference in the average daily weight gain for treatment groups or HIV exposure. The HIV-exposed group achieved significantly higher z scores for length and head circumference at day 28 than the unexposed group (P < 0.01 and P = 0.03, respectively). There were no differences in the incidence of any signs of feeding intolerance and abdominal distension between the groups.
  
  
  CONCLUSIONS
  Probiotic supplementation did not affect growth outcomes or the incidence of any signs of feeding intolerance in HIV exposure.
authors.affiliation: Division Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa. Electronic address: Evettev@sun.ac.za.
authors.forename: Evette
authors.initials: E
authors.lastname: Van Niekerk
authors.affiliation: Department of Pediatrics and Child Health, Division of Neonatology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
authors.forename: Gert F
authors.initials: GF
authors.lastname: Kirsten
authors.affiliation: Department of Statistics and Actuarial Science, Stellenbosch University, Tygerberg, South Africa.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Nel
authors.affiliation: Division Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
authors.forename: Reneé
authors.initials: R
authors.lastname: Blaauw
mesh_terms: D001644:Bifidobacterium; D001724:Birth Weight; D002657:Child Development; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D015658:HIV Infections; D006801:Humans; D007223:Infant; D007234:Infant, Premature / Q000254:growth & development; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D052201:Lacticaseibacillus rhamnosus; D008297:Male; D019936:Probiotics / Q000008:administration & dosage*; D016896:Treatment Outcome; D015430:Weight Gain
keywords: Anthropometrical parameters; Feeding intolerance; Feeding volume; HIV; Premature infant