Abstract
BackgroundPreterm infants have immature gastrointestinal tracts and poor immunity. In this study, the effects of Lactobacillus reuteri DSM 17938 first on early feeding tolerance, growth, and second on infection prevention in preterm infants were evaluated.MethodsOne hundred fourteen formula-fed preterm infants with a gestational age between 30 weeks and 37 weeks, and a birth weight between 1500 and 2000 g were enrolled; 57 in the intervention and 57 in the control group:the intervention group was given a dose of 1 × 108 colony-forming units (5 drops) of L. reuteri DSM 17938 once daily, beginning with the first feeding until discharge. The control group did not receive probiotics. Early feeding tolerance (as time to full enterla feeding and number of reflux), growth, incidences of sepsis, localized infection, NEC, and adverse effects were recorded for both groups.ResultsThe number of Daily reflux episodes (times/d) was lower (2.18 ± 0.83 vs. 3.77 ± 0.66, P < 0.01) and time to full enteral feedings (120 mL/kg/d) (9.95 ± 2.46 d vs. 13.80 ± 3.47 d, P < 0.05) was shorter in the intervention group. Average daily weight gain (14.55 ± 3.07 g/d vs. 10.12 ± 2.80 g/d), head circumference increas e(0.0760 ± 0.0157 cm/d vs. 0.0681 ± 0.0108 cm/d), and body length increase (0.1878 ± 0.0151 cm/d vs. 0.1756 ± 0.0166 cm/d) of the intervention group were higher (P < 0.01). There were no significant differences in the incidences of sepsis (4.44% vs. 8.33%), localized infection (6.67% vs. 8.33%), or NEC (2.22% vs. 10.42%) between the 2 groups (P > 0.05). The number of daily defecations (times/d) in the intervention group was higher (3.08 ± 0.33 vs. 2.29 ± 0.20, P < 0.01) and the length of hospital stay was shorter than that in the control group (20.60 ± 5.36 d vs. 23.75 ± 8.57 d, P < 0.05). No adverse effects were noted among the infants receiving L. reuteri.ConclusionL. reuteri may be an useful tool in improving early feeding tolerance in preterm infants, promoting growth, increasing the frequency of defecation, and shortening the length of hospital stay.Trial registrationChiCTR, ChiCTR1900025590. Registered 1 February 2019- Retrospectively registered, http://www.chictr.org.cn/listbycreater.aspx.
Highlights
Preterm infants have immature gastrointestinal tracts and poor immunity
The aim of the study was to investigate the efficacy of L. reuteri in early feeding tolerance, growth, infection prevention, and other aspects of preterm infant development
Patient description A total of 114 cases were eventually enrolled and randomly allocated in the study. 57 patients received L. reuteri and 57 neonates were included in the control group
Summary
Preterm infants have immature gastrointestinal tracts and poor immunity. The effects of Lactobacillus reuteri DSM 17938 first on early feeding tolerance, growth, and second on infection prevention in preterm infants were evaluated. Due to their immature development, are characterized by underdeveloped gastrointestinal tracts, delayed colonization of intestinal flora, and low immune function. Probiotics seem to be useful in nourishing the intestines, adjusting the microbiota, ameliorating immunity and reducing inflammation. A large amount of clinical trials confirmed that probiotics have a beneficial effect on the prevention and treatment of digestive diseases [3]. The clinical application of probiotics in neonates is increasingly widespread for many indications, including the prevention and treatment of feeding intolerance, diarrhea, NEC, neonatal jaundice, and allergic diseases [4]
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