Objective: To test the hypothesis that normalizing the intestinal flora by adm inistration of prophylactic probiotics would provide a natural defense, thereby reducing both the incidence and severity of necrotizing enterocolitis (NEC) in p reterm neonates. Study design: Neonates ≤1500 g birth weight were randomized to either receive a daily feeding supplementation with a probiotic mixture (Bifido bacteria infantis, Streptococcus thermophilus, and Bifidobacteria bifidus; Solga r, Israel) of 109 colony forming units (CFU)/day or to not receive feed suppleme nts. NEC was graded according to Bell’s criteria. Results: For 72 study and 73 control infants, respectively, birth weight (1152 ±262 g vs 1111 ±278 g), gest ational age (30 ±3 weeks vs 29 ±4 weeks), and time to reach full feeds (14.6 ±8.7 days vs 17.5 ±13.6 days) were not different. The incidence of NEC was red uced in the study group (4%vs 16.4%; P = .03). NEC was less severe in the prob iotic-supplemented infants (Bell’s criteria 2.3 ±0.5 vs 1.3 ±0.5; P = .005). Three of 15 babies who developedNEC died, and all NEC-related deaths occurred in control infants. Conclusion: Probiotic supplementation reduced both the incid ence and severity of NEC in our premature neonatal population.
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