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Efficacy of Bifidobacterium breve and Lactobacillus casei oral supplementation on necrotizing enterocolitis in very-low-birth-weight preterm infants: a double-blind, randomized, controlled trial

Braga, Taciana Duque, da Silva, Giselia Alves Pontes, de Lira, Pedro Israel Cabral, de Carvalho Lima, Marilia
American journal of clinical nutrition 2011 v.93 no.1 pp. 81-86
Bifidobacterium breve, gastrointestinal motility, enterocolitis, absorption barrier, premature birth, low birth weight, probiotics, breast milk, intestinal mucosa, Lactobacillus casei, disease incidence, neonates, dietary supplements, oral administration
BACKGROUND: Probiotics are used for the prevention of necrotizing enterocolitis (NEC) because of their positive effects on intestinal motor function, modulation of inflammatory response, and mucosal barrier function. OBJECTIVE: The objective was to assess whether the combined use of Lactobacillus casei and Bifidobacterium breve may prevent the occurrence of NEC stage ≥2 by the criteria of Bell in very-low-birth-weight preterm infants. DESIGN: A double-blind, randomized, controlled clinical trial was conducted in 231 preterm infants weighing from 750 to 1499 g at birth. The intervention group was composed of 119 infants who received human milk with probiotic supplementation (B. breve and L. casei) and a control group of 112 infants who received human milk containing no probiotics. The primary outcome was the occurrence of NEC stage ≥2 as defined by Bell's modified criteria. RESULTS: Four confirmed cases of NEC stage ≥2 by Bell's criteria occurred only in the control group. CONCLUSIONS: Oral supplementation of B. breve and L. casei reduced the occurrence of NEC (Bell's stage ≥2). It was considered that an improvement in intestinal motility might have contributed to this result. This trial was registered at as number 67165178 (International Standard Randomized Controlled Trial).