title: Medically Graded Honey Supplementation Formula to Preterm Infants as a Prebiotic: A Randomized Controlled Trial.
abstract: The aim of the study was to assess the effect of medically graded enteral honey supplementation on the intestinal microbiota, immune response, and somatic growth of preterm infants.
  
  
  
  A prospective randomized controlled trial was conducted on preterm infants with gestational age ≤34 weeks and postnatal age >3 days. After reaching 1/2 goal enteral feeds, medically graded bee honey was added to milk at a dose of 5, 10, 15, and 0 g/day for 2 weeks in groups A, B, C, and D, respectively. Anthropometric measurements, CD4 and CD8 cytokines, stool cultures, and stool polymerase chain reaction assays for molecular detection of microbiomes were performed at 0, 7, and 14 days of intervention. Analysis of variance test was used to detect differences among the 4 groups.
  
  
  
  A total of 40 subjects were enrolled; 10 in each arm of the study. Compared with group D, all 3 intervention groups demonstrated significant increase in weight (P < 0.0001). Head circumference increased in groups B and C (P = 0.0056). There were no changes in CD4 or CD8 cytokines (P = 0.24 and P = 0.11, respectively). Enterobacter stool colonization decreased in groups A and B (P = 0.002), whereas Bifidobacterium bifidum colony counts increased in groups A, B, and C (P = 0.002) and lactobacilli colony counts increased in group B (P < 0.0001). Applying real-time polymerase chain reaction, B bifidum and lactobacilli increased in group C (P < 0.0001).
  
  
  
  Supplementation of milk formula with medically graded honey was associated with changes in physical growth and colonic microbiota of preterm infants. Further studies are needed to examine the sustainability of these effects and associated long-term outcomes.
authors.affiliation: *Newborn Services, The George Washington University and Children's National Medical Center, Washington, DC †Division of Neonatology ‡Department of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University §Department of Clinical Pathology. National Research Center, Cairo, Egypt ||Albert Einstein College of Medicine, New York, NY.
authors.forename: Hany
authors.initials: H
authors.lastname: Aly
authors.forename: Reem N
authors.initials: RN
authors.lastname: Said
authors.forename: Iman E
authors.initials: IE
authors.lastname: Wali
authors.forename: Amany
authors.initials: A
authors.lastname: Elwakkad
authors.forename: Yssra
authors.initials: Y
authors.lastname: Soliman
authors.forename: Alaa R
authors.initials: AR
authors.lastname: Awad
authors.forename: Mahmoud A
authors.initials: MA
authors.lastname: Shawky
authors.forename: Mohamed S Abu
authors.initials: MSA
authors.lastname: Alam
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Mohamed
mesh_terms: D004311:Double-Blind Method; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D000069196:Gastrointestinal Microbiome; D006722:Honey; D006801:Humans; D041943:Infant Formula; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D008297:Male; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D056692:Prebiotics / Q000008:administration & dosage*; D011446:Prospective Studies
chemical_list: D056692:Prebiotics