Efficacy of Bifidobacterium breve and Lactobacillus casei oral supplementation on necrotizing enterocolitis in very-low-birth-weight preterm infants: a double-blind, randomized, controlled trial

• Published in: The American journal of clinical nutrition Vol. 93; no. 1; pp. 81 - 86
• Main Authors: Braga, Taciana Duque, da Silva, Giselia Alves Pontes, de Lira, Pedro Israel Cabral, de Carvalho Lima, Marilia
• Format: Journal Article
• Language: English
• Published: Bethesda, MD American Society for Clinical Nutrition 2011; American Society for Nutrition; American Society for Clinical Nutrition, Inc
• Subjects: absorption barrier; Administration, Oral; Babies; Bifidobacterium - physiology; Bifidobacterium breve; Biological and medical sciences; Birth weight; breast milk; Clinical trials; Dietary Supplements; disease incidence; Double-Blind Method; enterocolitis; Enterocolitis, Necrotizing - prevention & control; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastrointestinal Motility; Gram-positive bacteria; Humans; Infant, Newborn; Infant, Premature; Infant, Very Low Birth Weight; infants; Inflammatory diseases; Intervention; intestinal mucosa; Lacticaseibacillus casei - physiology; Lactobacillus casei; low birth weight; Male; necrotizing enterocolitis; neonates; oral administration; Pediatrics; premature birth; Probiotics; Probiotics - therapeutic use; Prospective Studies; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Human; Premature; Bifidobacterium; Pregnancy disorders; Lactobacillus casei; Eubacteria; Oral administration; Bifidobacteriaceae; Necrotizing enterocolitis; Very low birthweight; Newborn diseases; Newborn; Prematurity; Actinobacteridae; Double blind study; Actinobacteria; Bacteria; Lactobacillaceae; Digestive diseases; Intestinal disease; Bifidobacteriales; Supplementation
• ISSN: 0002-9165; 1938-3207
• DOI: 10.3945/ajcn.2010.29799

BACKGROUND: Probiotics are used for the prevention of necrotizing enterocolitis (NEC) because of their positive effects on intestinal motor function, modulation of inflammatory response, and mucosal barrier function. OBJECTIVE: The objective was to assess whether the combined use of Lactobacillus casei and Bifidobacterium breve may prevent the occurrence of NEC stage ≥2 by the criteria of Bell in very-low-birth-weight preterm infants. DESIGN: A double-blind, randomized, controlled clinical trial was conducted in 231 preterm infants weighing from 750 to 1499 g at birth. The intervention group was composed of 119 infants who received human milk with probiotic supplementation (B. breve and L. casei) and a control group of 112 infants who received human milk containing no probiotics. The primary outcome was the occurrence of NEC stage ≥2 as defined by Bell's modified criteria. RESULTS: Four confirmed cases of NEC stage ≥2 by Bell's criteria occurred only in the control group. CONCLUSIONS: Oral supplementation of B. breve and L. casei reduced the occurrence of NEC (Bell's stage ≥2). It was considered that an improvement in intestinal motility might have contributed to this result. This trial was registered at www.isrctin.org as number 67165178 (International Standard Randomized Controlled Trial).