Four hundred thirty-four very-low-birth-weight infants (< 1500 g) who were being breast-fed or receiving mixed feedings (breast milk and formula) were randomly assigned to receive 109 colony-forming units each of Bifidobacterium bifidum and Lactobacillus acidophilus added to their feedings twice a day for 6 weeks or to receive the same feedings without the probiotics. The incidence of death or necrotizing enterocolitis stage 2 or greater was significantly lower in the active-treatment group than in the control group (1.8% vs. 9.2%; p = 0.002). The incidence of necrotizing enterocolitis stage 2 or greater was also significantly lower in the active-treatment group than in the control group (1.8% vs. 6.5%; p = 0.02). No adverse effects, such as sepsis, flatulence, or diarrhea, were seen.
Comment: Necrotizing enterocolitis is a serious gastrointestinal disease seen mainly in premature, very-low-birth-weight infants. It is characterized by necrosis of part of the intestine, which can lead to life-threatening complications. While the cause is unknown, it appears to be related to intestinal ischemia and to the presence of abnormal intestinal flora. The results of the present study indicate that the addition of probiotics to the feedings of very-low-birth-weight infants can reduce the incidence of necrotizing enterocolitis and decrease the death rate in these infants.
Lin HC, et al. Oral probiotics prevent necrotizing enterocolitis in very low birth weight preterm infants: a multicenter, randomized, controlled trial. Pediatrics. 2008;122:693-700.