Use of probiotics in preterm neonate

The gastrointestinal tract of a premature infant is characterized by abnormal bacterial colonization which has been linked to poorly developed intestinal immunity and upregulated intestinal inflammatory responses. Probiotic supplementation creates an exciting approach in modulating gastrointestinal development, potentially affecting intestinal and nonintestinal diseases. Majority of the clinical trials involving preterm neonates have evaluated the effect of probiotics on necrotizing enterocolitis, death, and eventually on feeding tolerance and growth. Less commonly on infectious complications/sepsis, neurodevelopment and immune function developments/responses have been measured. While the results of recent meta-analysis suggesting reduction of necrotizing enterocolitis and mortality due to probiotics administration are promising, the data at present time are insufficient to recommend routine probiotics use in preterm newborn population.