Effects of Probiotic Lactobacillus Reuteri (DSM 17938) on the Incidence of Necrotizing Enterocolitis in Very Low Birth Weight Premature Infants

Feeding intolerance is a common problem among premature infants. There is limited information on the safety and effects of oral probiotic supplements, especially products containing Lactobacillus reuteri, and the incidence of necrotizing enterocolitis (NEC) in low birth weight preterm infants. This study aimed to evaluate the effects of Lactobacillus reuteri on the gastrointestinal complications and feeding tolerance in premature infants. This randomized triple-blind clinical trial was conducted on 60 premature infants divided into two groups of intervention and placebo. Subjects in the intervention group received one drop/kg of supplementary oral probiotic with 0.5 ml of distilled water, and infants in the placebo group only received 0.5 ml of distilled water. Probiotic administration continued to reach full enteral feeding. In this study, mean time to reach full enteral feeding was 12.83 and 16.75 days in the intervention and placebo groups, respectively, which was indicative of a significant difference (P=0.01). However, mean of neonatal weight at discharge had no significant difference between the two groups. In addition, 6.7% and 36.7% of infants in the intervention and placebo groups were diagnosed with NEC, respectively, which showed a significant difference (P=0.005). Also, prevalence of jaundice and sepsis was not significantly different between the study groups. According to the results of this study, Lactobacillus reuteri could reduce the time to reach full enteral feeding while diminishing the incidence of NEC in very low birth weight premature infants.