To start or not: Factors to consider when implementing routine probiotic use in the NICU

Early Hum Dev. 2019 Aug:135:66-71. doi: 10.1016/j.earlhumdev.2019.05.009. Epub 2019 Jun 10.

Abstract

Supplementation of probiotics to very low birth weight (VLBW) infants has been extensively studied, with multiple meta-analyses reporting probiotics decrease the risk of necrotizing enterocolitis (NEC) and death. Despite availability of this evidence, the decision to initiate routine probiotic supplementation to preterm infants continues to be a complex one. There are uncertainties regarding the use of probiotics, including selecting the appropriate product, dose and target population. Additionally, availability of specific probiotic products and regulatory oversight varies by country, raising concerns regarding the safety and efficacy of specific probiotic products. In this review, we summarize the latest evidence on probiotic use in preterm infants and discuss considerations that may help guide clinicians who are considering routine probiotic supplementation.

Keywords: Infant; Microbiome; Necrotizing enterocolitis; Neonate; Preterm; Probiotics; Sepsis.

Publication types

  • Review

MeSH terms

  • Clinical Decision-Making
  • Enterocolitis, Necrotizing / prevention & control
  • Enterocolitis, Necrotizing / therapy*
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight*
  • Intensive Care, Neonatal
  • Probiotics / administration & dosage
  • Probiotics / adverse effects*
  • Probiotics / therapeutic use
  • Randomized Controlled Trials as Topic