Oral Probiotics Reduce the Incidence and Severity of Necrotizing Enterocolitis in Very Low Birth Weight Infants

Lin, Hung Chih; Su, Bai-Horng; Chen, An Chyi; Lin, Tsung Wen; Tsai, Chang Hai; Yeh, T. F.; Oh, William

doi:10.1542/peds.2004-1463

Cited by 576 publications

(453 citation statements)

References 38 publications

Supporting

Mentioning

409

Contrasting

Unclassified

Order By: Relevance

“…It seems unlikely that differences in dosage are the cause as the log units of probiotic germs were highest in our study. Moreover, the dosage did not directly correlate with the effect (here: 4 × 10 9 vs. Lin et al (15): 2 × 10 9 /kg and Hoyos (16): 0.25 × 10 9 ). Also, the smaller effect in our study may be accounted for by practice differences between different units.…”

Section: Discussionmentioning

confidence: 58%

See 1 more Smart Citation

Probiotics (Lactobacillus acidophilus and Bifidobacterium bifidum) prevent NEC in VLBW infants fed breast milk but not formula

et al. 2014

View full text Add to dashboard Cite

Background: Specific probiotics prevent necrotizing enterocolitis (NEC). A mixture of lactobacilli and bifidobacteria (Infloran) was highly effective in Asian very-low-birth-weight (VLBW) infants. We analyzed the effect of Infloran on NEC, NEC severity, and the influence of enteral feedings (breast milk vs. formula) on NEC prevention in a cohort of European VLBW infants. Methods: Infloran was implemented for routine use at our department. VLBW infants receiving probiotics were prospectively followed (2010)(2011)(2012) and compared with historic controls (2008)(2009). Data on NEC, neonatal morbidity, feeding tolerance, and descriptive parameters on NEC cases were analyzed. results: Infloran had no statistically significant impact on NEC (controls: 24/233 (10.3%); probiotics: 16/230 (7%); P = 0.2). However, NEC was significantly reduced in infants of the probiotics group who were fed any breast milk (20/179 (11.2%) vs. 10/183 (5.5%); P = 0.027), whereas it was ineffective in infants exclusively fed formula (4/54 (7.4%) vs. 6/44 (13.6%); P = 0.345). Occurrence of severe NEC (IIIb), time until full feeds, and gastric residuals were similar. conclusion: Infloran was of lower efficacy in a European VLBW cohort and showed a reduction of NEC only in infants fed breast milk. Future studies should investigate the influence of feeding formula or breast milk on the effect of probiotics.n ecrotizing enterocolitis (NEC) is an important cause of mortality and morbidity in premature infants (1). Although its pathogenesis is incompletely understood, a relation to an immature intestinal barrier, aberrant bacterial colonization, and enteral feedings is well established (2). Due to the seriousness of the disease, preventive strategies like the use of human milk and standardized feeding protocols (3-5) are of highest interest.Probiotics are microorganisms that confer a health benefit after ingestion (6). They are generally regarded as safe, and only single cases of sepsis were described in patients with major comorbidities (7). In preterm infants, probiotics may act beneficially by improving the intestinal barrier (8) and promoting a healthy gut microflora (9). Furthermore, they exert antiinflammatory effects on the gut epithelium (10) and improve local and systemic immune responses (11) that may strengthen a preterm infant's still immature immune defense. In the recent past, a preventive effect against NEC was assumed (12), and a variety of probiotic preparations were studied in randomized trials. Meta-analyses of these trials reported on a reduction of NEC in very-low-birth-weight (VLBW) infants by 65% (13,14), and the use of probiotics in clinical routine was recommended. Based on these suggestions, we decided to introduce probiotics for NEC prophylaxis as standard of care at our department. The probiotic preparation Infloran (Laboratorio Farmaceutico, Mede, Italia) consists of a mixture of Lactobacillus acidophilus and Bifidobacterium infantis and was chosen as its use was suggested by European experts (14) and it was available ...

show abstract

Section: Discussionmentioning

confidence: 58%

“…Some studies suggest that probiotics also reduce the severity of NEC. Using Infloran (Laboratorio Farmaceutico), Lin et al (15) showed that 6/10 NEC cases in the control group, but only 0/2 in the study group, were Bell stage 3. Bin-Nun et al (18) also reported a significant reduction in NEC severity using ABCDophilus (Solgar).…”

Section: Discussionmentioning

confidence: 99%

Probiotics (Lactobacillus acidophilus and Bifidobacterium bifidum) prevent NEC in VLBW infants fed breast milk but not formula

et al. 2014

View full text Add to dashboard Cite

show abstract

“…In 1999, Hoyos and colleagues reported the outcome of a cohort study, in which, probiotic administration was associated with a reduction in the incidence of necrotizing enterocolitis [53]. Between 2003 and 2006, several randomised studies reported a reduction in the incidence of NEC among preterm babies recruited to probiotic trials (and receiving the probiotic intervention) though not all these studies were designed to evaluate NEC as a primary outcome [54][55][56][57][58][59]. The first meta-analysis combining these results was published in 2007 and concluded that probiotics might reduce the risk of NEC in preterm babies born less 33 weeks gestation [60].…”

Section: Probiotics For the Prevention Of Necmentioning

confidence: 99%

Probiotics and necrotizing enterocolitis

2015

View full text Add to dashboard Cite

“…33,34 Generally, prematurity, enteral feeding, ischaemia and bacterial colonisation are the most common risk factors for the development of NEC. [35][36][37][38] The pathogenesis of NEC in neonates born to HIV-infected mothers has not been clearly elucidated. Some described contributing factors include maternal antiretroviral treatment, maternal sepsis and immunological abnormalities.…”

Section: Necrotising Enterocolitismentioning

confidence: 99%

The role of human milk oligosaccharides in preventing necrotising enterocolitis and human immunodeficiency virus transmission

Niekerk

Blaauw

Kirsten

2014

South African Journal of Clinical Nutrition

View full text Add to dashboard Cite

The role of human milk oligosaccharides in preventing necrotising enterocolitis and human immunodeficiency virus transmission IntroductionResearch, started over a century ago, on human milk oligosaccharides (HMOs) has focused predominantly on their prebiotic effects. Today it is known that the bifidogenic effects of HMOs are one of the many beneficial effects now being discovered. 1 In addition to providing a substrate for the growth of beneficial bacteria, HMOs also directly inhibit pathogens from adhering to the intestinal epithelia through their antiadhesive properties. 1 Recent data suggest that firstly, a relationship exists between the HMOs and the incidence of necrotising enterocolitis (NEC), 2,3 and secondly, they may have an influence on human immunodeficiency virus (HIV) transmission. 4 This article aims to describe the prebiotic and antiadhesive effects of HMOs, and how they could possibly prevent the development of NEC in the presence of HIV infection. Human milk oligosaccharidesHMOs 5,6 are complex carbohydrates that are highly abundant in breast milk, but not in infant formula. 7 Oligosaccharides are carbohydrates made up of 3-9 monosaccharide units. 5,6 The oligosaccharide concentration of human milk varies with gestational age, lactation duration, and from one mother to another. 6,8 HMOs reach the highest concentration in colostrum (20-25 g/l), and then decrease after roughly two weeks to approximately 5-20 g/l in mature breast milk. 1,6,[8][9][10][11] HMOs consists of five different monosaccharide units:• Glucose.• Galactose.• The sialic acid component, known as N-acetylglucosamine.• Fucose.• N-acteylneuaminic acid. 1,12 With a few exceptions, all HMOs contain lactose at their reducing end. They may be elongated (an enzymatic attachment) by the addition of β1-3-or β1-6-linked lacto-N-biose or N-acetyllacetosamine. The latter can be further extended by one or two disaccharides. Chain branching may occur at the β1-6 linkage. Branched lactose molecules may form both linear (para-HMOs) and branched structures (iso-HMOs). Furthermore, oligosaccharide chains can be fucosylated (also known as neutral oligosaccharides) in the α1-2, α1-3 or α1-4 linkage, or sialylated (also known as acidic oligosaccharides) in the α2-3 or α2-6 linkage. The ABH secretor (Se) status and Lewis (Le) blood group determines the HMO composition of a mother's breast milk. 1 The presence or absence of blood group substances (A, B and H) in the saliva and other body secretions is controlled by a gene on chromosome 19, the fucosyltransferase AbstractThe heavy burden of maternal human immunodeficiency virus (HIV) infection has resulted in a high prevalence of premature births, with an associated increase in the incidence of necrotising enterocolitis (NEC). NEC is a life-threatening inflammatory disease of the gastrointestinal tract that predominantly occurs in preterm infants. Human milk oligosaccharides (HMOs) are carbohydrate compounds which have been shown to have health-promoting effects through their bifidogenic and antiadhesiv...

show abstract

Oral Probiotics Reduce the Incidence and Severity of Necrotizing Enterocolitis in Very Low Birth Weight Infants

Abstract: Infloran as probiotics fed enterally with breast milk reduces the incidence and severity of NEC in VLBW infants.

Cited by 576 publications

References 38 publications

Probiotics (Lactobacillus acidophilus and Bifidobacterium bifidum) prevent NEC in VLBW infants fed breast milk but not formula

Probiotics (Lactobacillus acidophilus and Bifidobacterium bifidum) prevent NEC in VLBW infants fed breast milk but not formula

Probiotics and necrotizing enterocolitis

The role of human milk oligosaccharides in preventing necrotising enterocolitis and human immunodeficiency virus transmission

Contact Info

Product

Resources

About