Effect of a Multi-Strain Probiotic on Growth and Time to Reach Full Feeds in Preterm Neonates

Sowden, Marwyn; Niekerk, Evette van; Bulabula, Andre N H; Twisk, Jos W. R.; Weissenbruch, Mirjam M. van

doi:10.3390/nu14214658

Cited by 3 publications

(1 citation statement)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most frequently used probiotic product in UK neonatal units at the time the survey was conducted was a combination of Lactobacillus acidophilus , Bifidobacterium bifidum Bb-06 and B. infantis Bi-26 (Labinic™). While this probiotic has not been extensively evaluated in large RCTs, 16 it has been reported to show efficacy against NEC, LOS and unadjusted mortality in some studies. 3 Furthermore, it does not meet current ESPGHAN guidelines.…”

Section: Discussionmentioning

confidence: 99%

How frequent is routine use of probiotics in UK neonatal units?

Patel

Evans

Berrington

et al. 2023

bmjpo

View full text Add to dashboard Cite

ObjectiveThere is a lack of UK guidance regarding routine use of probiotics in preterm infants to prevent necrotising enterocolitis, late-onset sepsis and death. As practices can vary, we aimed to determine the current usage of probiotics within neonatal units in the UK.Design and settingUsing NeoTRIPS, a trainee-led neonatal research network, an online survey was disseminated to neonatal units of all service levels within England, Scotland, Northern Ireland and Wales in 2022. Trainees were requested to complete one survey per unit regarding routine probiotic administration.Results161 of 188 (86%) neonatal units responded to the survey. 70 of 161 (44%) respondents routinely give probiotics to preterm infants. 45 of 70 (64%) use the probiotic productLactobacillus acidophilusNCFM/Bifidobacterium bifidumBb-06/B. infantisBi-26 (Labinic™). 57 of 70 (81%) start probiotics in infants ≤32 weeks’ gestation. 33 of 70 (47%) had microbiology departments that were aware of the use of probiotics and 64 of 70 (91%) had a guideline available. Commencing enteral feeds was a prerequisite to starting probiotics in 62 of 70 (89%) units. The majority would stop probiotics if enteral feeds were withheld (59 of 70; 84%) or if the infant was being treated for necrotising enterocolitis (69 of 70; 99%). 24 of 91 (26%) units that did not use probiotics at the time of the survey were planning to introduce them within the next 12 months.ConclusionsMore than 40% of all UK neonatal units that responded are now routinely administering probiotics, with variability in the product used. With increased probiotic usage in recent years, there is a need to establish whether this translates to improved clinical outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

How frequent is routine use of probiotics in UK neonatal units?

Patel

Evans

Berrington

et al. 2023

bmjpo

View full text Add to dashboard Cite

show abstract

Bifidobacterium infantis as a probiotic in preterm infants: a systematic review and meta-analysis

2023

View full text Add to dashboard Cite

Background Bifidobacterium infantis has special abilities to utilise human milk oligosaccharides. Hence we hypothesised that probiotic supplements containing B. infantis may confer greater benefits to preterm infants than probiotic supplements without B. infantis. Methods A systematic review with meta-analysis was conducted according to standard guidelines. We selected RCTs evaluating probiotics compared to placebo or no treatment in preterm and/or low birth weight infants. Probiotic effects on Necrotizing Enterocolitis (NEC), Late Onset Sepsis (LOS) and Mortality were analysed separately for RCTs in which the supplemented probiotic product contained B. infantis and those that did not contain B. infantis. Results 67 RCTs were included (n = 14,606), of which 16 used probiotics containing B. infantis (Subgroup A) and 51 RCTs did not (Subgroup B) Meta-analysis of all RCTs indicated that probiotics reduced the risk of NEC, LOS, and mortality. The subgroup meta-analysis demonstrated greater reduction in the incidence of NEC in subgroup A than subgroup B [(relative risk in subgroup A: 0.38; 95% CI, 0.27–0.55) versus (0.67; 95% CI, 0.55–0.81) in subgroup B; p value for subgroup difference: 0.01]. Conclusions These results provide indirect evidence that probiotic supplements that include B. infantis may be more beneficial for preterm infants. Well-designed RCTs are necessary to confirm these findings. Impact Evidence is emerging that beneficial effects of probiotics are species and strain specific. This systematic review analyses if B. infantis supplementation provides an advantage to preterm infants. This is the first systematic review evaluating the effects of probiotics containing B. infantis in preterm infants. The results of this systematic review provides indirect evidence that probiotics that include B. infantis may be more beneficial for preterm infants. These results will help in guiding future research and clinical practice for using B. infantis as a probiotic in preterm infants.

show abstract