Probiotics for Preemies: Can They Help?
Quick Summary: Research suggests that certain probiotics, including Streptococcus thermophilus, may help reduce serious gut problems in premature babies. This study looked at many previous studies to see which probiotics work best.
What The Research Found
The European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) reviewed many studies on probiotics and premature babies. They found that some probiotics might lower the risk of:
- Necrotizing enterocolitis (NEC): A serious gut infection.
- Sepsis: A life-threatening blood infection.
- Death: Sadly, some premature babies don't survive.
The study suggested that a combination of probiotics, including Streptococcus thermophilus, might be helpful.
Study Details
- Who was studied: Over 10,000 premature babies from many different studies around the world.
- How long: The study looked at the results of many different studies, so there wasn't one specific time frame.
- What they took: The study focused on different probiotic strains. One effective combination included Streptococcus thermophilus, along with Bifidobacterium infantis and Bifidobacterium lactis.
What This Means For You
If you have a premature baby, talk to your doctor about probiotics. They may help reduce the risk of serious health problems. However:
- Not all probiotics are the same: The study found that only certain strains are helpful.
- Quality matters: Make sure the probiotic product is high quality and safe.
- Talk to your doctor: They can help you decide if probiotics are right for your baby.
Study Limitations
- More research is needed: The study's findings are promising, but more research is needed to be completely sure.
- Dosage is unclear: The study didn't specify the best dose of probiotics.
- Safety first: It's important to make sure the probiotics are safe and don't have any harmful bacteria.
Technical Analysis Details
Key Findings
The study, a position paper by the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN), concluded that probiotics may reduce necrotizing enterocolitis (NEC), sepsis, and mortality in preterm infants. However, only specific strains demonstrated efficacy: a conditional recommendation (low certainty of evidence) was made for Lactobacillus rhamnosus GG ATCC53103 or a combination of Bifidobacterium infantis Bb-02, B. lactis Bb-12, and Streptococcus thermophilus TH-4. Safety concerns included avoiding strains with transferable antibiotic resistance genes and ensuring detection of probiotic sepsis.
Study Design
This was a network meta-analysis conducted by ESPGHAN, synthesizing data from over 10,000 preterm infants globally across randomized controlled trials (RCTs). The analysis focused on evaluating the efficacy and safety of various probiotic strains or combinations in reducing NEC, sepsis, and mortality. No specific duration of supplementation or trial timelines were provided in the summary.
Dosage & Administration
The study did not specify exact dosages for the probiotic strains. The combination containing Streptococcus thermophilus TH-4 was highlighted as potentially effective, but administration protocols (e.g., delivery method, duration) were not detailed. The authors emphasized the need for quality-assured products and strain-specific identification.
Results & Efficacy
The network meta-analysis identified that only a minority of probiotic strains or combinations significantly reduced mortality and morbidity in preterm infants. The L. rhamnosus GG and the B. infantis/B. lactis/S. thermophilus trio showed the greatest efficacy in lowering NEC rates. While the summary notes statistically significant outcomes, exact effect sizes, p-values, or confidence intervals were not provided in the study details.
Limitations
- Low-certainty evidence: The conditional recommendation reflects uncertainty in the quality of supporting RCTs.
- Heterogeneity: Variability in study designs, populations, and probiotic formulations may affect generalizability.
- Lack of dose-response data: Optimal dosage and duration remain undefined.
- Safety gaps: No standardized protocols for monitoring probiotic sepsis or antibiotic resistance were established.
- Commercial product variability: Many available products lack rigorous quality control, complicating clinical application.
Clinical Relevance
For preterm infants, this analysis suggests that probiotic supplementation with specific strains (e.g., S. thermophilus TH-4 in combination with B. infantis and B. lactis) may reduce NEC risk, but use should be cautious and evidence-based. Clinicians must prioritize products free of antibiotic resistance genes and ensure microbiology teams can detect probiotic sepsis. The findings underscore the importance of strain specificity, as most commercial probiotics lack proven efficacy. Parents and caregivers should consult healthcare providers to verify product quality and appropriateness for vulnerable preterm infants.
Note: This summary reflects the study’s conclusions as reported in the provided details; full interpretation requires access to the original paper’s methodology and statistical data.
Original Study Reference
Probiotics and Preterm Infants: A Position Paper by the European Society for Paediatric Gastroenterology Hepatology and Nutrition Committee on Nutrition and the European Society for Paediatric Gastroenterology Hepatology and Nutrition Working Group for Probiotics and Prebiotics.
Source: PubMed
Published: 2020
📄 Read Full Study (PMID: 32332478)
