Abstract
Reducing the incidence of gastrointestinal infections (GIs) that occur at early stages to mitigate hospitalizations and treatments with adverse effects is a promising strategy for providing well-being to infants and their families. This systematic review and meta-analysis explores whether the early administration of Limosilactobacillus fermentum CECT5716 might be effective as a preventive therapy for GIs. We reviewed the literature to identify randomized controlled trials (RCTs) investigating the effectiveness of milk formulas supplemented with L. fermentum CECT5716 administered to infants at early stages to reduce the incidence of GIs. The MEDLINE (via PubMed), Web of Science (WoS), and Cochrane Central Register of Controlled Trials (via CENTRAL) databases were searched up to 15 June 2021. GI data from the included studies were synthesized in a random-effects model. Three RCTs were finally selected including 435 infants. There was a significant reduction in the incidence rate of GIs for those receiving L. fermentum CECT5716 compared with those receiving placebo (IRR: 0.52, 95% CI: 0.36–0.74, p = 0.0004). Heterogeneity between studies was moderate (I2 = 54.5%). Based on the present systematic review and meta-analysis, the administration of L. fermentum CECT5716 at doses from 1 × 109 to 8.4 × 108 cfu/day in milk formulas may prevent GIs in infants up to 12 months old. Longer-term studies including a higher number of infants are needed to determine whether the use of this probiotic during the early stages of life is an efficient way to reduce the incidence of GIs.
Highlights
Breast milk was once considered a sterile fluid, it is widely accepted that it has its own unique microbiome, consisting of many commensal bacteria [1,2]
incidence rate ratio (IRR) withgroup noted, noted, with the incidence rate
The authors reported no significant differences compared with controls regarding the incidence of gastrointestinal infections, in accordance with the findings reported in other randomized clinical trial (RCT) combining B. animalis subsp. lactis BB-12 with prebiotics [44]
Summary
Breast milk was once considered a sterile fluid, it is widely accepted that it has its own unique microbiome, consisting of many commensal bacteria [1,2]. The lactic acid bacteria present in human milk, in addition to other bifidogenic compounds such as oligosaccharides, are transferred from the mother to the infant through lactation [2], which may, at least in part, be responsible for some of the beneficial effects observed in breastfed infants [4]. There is a large body of evidence documenting the benefits of human breast milk in infants, including reduction of morbidity and mortality and protection against specific infections during the breastfeeding period [5,6]. This fact is extremely relevant for public health, because infectious diseases are the most common type of illness among infants worldwide. International guidelines recommend exclusive breastfeeding for all infants in the first six months of life, as it provides the best nutritional start for infants and promotes their healthy growth and development [7]
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