title: Prevention of Necrotizing Enterocolitis Through Manipulation of the Intestinal Microbiota of the Premature Infant.
abstract: In spite of four decades of research, necrotizing enterocolitis (NEC) remains the most common gastrointestinal complication in premature infants with high mortality and long-term morbidity. The composition of the intestinal microbiota of the premature infant differs dramatically from that of the healthy term infant and appears to be an important risk factor for NEC.
  
  
  
  We review the evidence of an association between intestinal dysbiosis and NEC and summarize published English language clinical trials and cohort studies involving attempts to manipulate the intestinal microbiota in premature infants.
  
  
  
  Promising NEC prevention strategies that alter the intestinal microbiota include probiotics, prebiotics, synbiotics, lacteroferrin, and human milk feeding.
  
  
  
  Shaping the intestinal microbiota of the premature infant through human milk feeding and dietary supplements decreases the risk of NEC. Further studies to identify the ideal microbial composition and the most effective combination of supplements are indicated.
authors.affiliation: Department of Pediatrics, HRH Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University, Nakornayok, Thailand; Department of Pediatrics, University of California Davis, Sacramento, California.
authors.forename: Kannikar
authors.initials: K
authors.lastname: Vongbhavit
authors.affiliation: Department of Pediatrics, University of California Davis, Sacramento, California. Electronic address: munderwood@ucdavis.edu.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Underwood
mesh_terms: D064806:Dysbiosis; D020345:Enterocolitis, Necrotizing / Q000517:prevention & control*; D000069196:Gastrointestinal Microbiome / Q000276:immunology / Q000502:physiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000276:immunology / Q000502:physiology
keywords: lactoferrin; necrotizing enterocolitis; prebiotic; premature infant probiotic; s: human milk; synbiotic