The Effects of Probiotics on Feeding Tolerance, Bowel Habits, and Gastrointestinal Motility in Preterm Newborns

Clinical Study Highlight

The effects of probiotics on feeding tolerance, bowel habits, and gastrointestinal motility in preterm newborns.

J Pediatr. 2008 Jun;152(6):801-6.

Indrio F, Riezzo G, Raimondi F, Bisceglia M, Cavallo L, Francavilla R.

The role of probiotics in improving outcomes for very low birth weight infants is an area receiving more attention. These infants are at risk for developing necrotizing enterocolitis (NEC), one of the major morbidities associated with premature birth. Morbidity and mortality associated with NEC appears to involve both death of part of the intestine due failed blood supply as well as bacterial invasion across the gut mucosa. A metaanalysis of probiotics and NEC has been published (Alfaleh K, Bassler D. 2008. Probiotics for prevention of necrotizing enterocolitis in preterm infants. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD005496) and the authors conclude, “Enteral supplementation of probiotics reduced the risk of severe NEC and mortality in preterm infants”. In the paper highlighted here, Indrio et al (2008) provides some insight into mechanisms of how at least one probiotic might benefit preterm infants. In this pilot study, the investigators studied the reported the impact of a probiotic preparation (Lactobacillus reuteri ATCC 55730 at 108 per day for 30 days) on clinical symptoms and gastric emptying in infants born at 34 weeks gestation. Thirty infants were enrolled. Ten were exclusively breastfed and the other 20 were randomized into groups receiving formula with or without the probiotics. Results indicated that L. reuteri improved feeding tolerance, reduced regurgitation, and reduced crying time in preterm newborns. Measures indicated that gastric emptying rate increased in the probiotic group. The probiotic used here was well tolerated and no adverse incidents were reported. These findings, in addition to studies conducted on NEC, suggest that probiotics can improve gut function in this susceptible population of preterm infants and suggest how probiotics might help these infants avoid the morbidities associated with NEC.