Effect of early administration of probiotics on gut microflora and feeding in pre-term infants: a randomized controlled trial.

Background: This study aimed to evaluate the effect of early probiotic administration on gut microflora and influence on feeding in pre-term infants.

Methods: A double-blind, randomized, controlled clinical study was conducted to assess the effect of probiotics [live, combined lactobacillus and bifidobacterium (LCB)] supplementation in pre-term infants. Sixty hospitalized pre-term babies were randomly assigned to two groups: a probiotics-supplemented group and the control group. The primary endpoint was measurement of lactobacillus and bifidobacterium in the gut. The secondary outcome was the rate of feeding intolerance.

Results: In the first weekend, the quantity of gut lactobacillus and bifidobacterium was significantly higher in the probiotics-supplemented group than in the control group [7.84 ± 0.35 versus 6.39 ± 0.53 (log copy number/g wet fecal weight), p = 0.013; 8.52 ± 0.23 versus 7.01 ± 0.48, p = 0.024, respectively]. In the second weekend, the amount of gut lactobacillus and bifidobacterium in the probiotics-supplemented group remained significantly higher (8.62 ± 0.28 versus 7.34 ± 0.59, p = 0.036 and 9.45 ± 0.64 versus 7.85 ± 0.43, p = 0.007, respectively). Fewer patients in the probiotics-supplemented group developed a feeding intolerance (13.3% versus 46.7%, p = 0.013).

Conclusions: Probiotic supplementation in the hospitalized pre-term infants in the first 2 weeks of life resulted in higher amounts of lactobacillus and bifidobacterium in the gut and a concomitant lower rate of feeding intolerance.