The Effect of Enteral Nutrition with Low-Dose Lactulose on the Occurrence of Late-Onset Neonatal Sepsis in Infants with Very Low Birth Weight

This study aimed to investigate the effect of low-dose lactulose as a prebiotic on the prevention of sepsis in infants with very low birth weight. In a clinical trial study, 50 infants with very low birth weight were selected, and randomly divided into two groups of 25. The first group received low-dose lactulose feeding, and the second group received distilled water feeding as placebo. The frequency of late-onset neonatal sepsis was determined and compared between the two groups. Late onset neonatal sepsis was seen in 14.8% and 40.0% of infants in lactulose and placebo group, respectively (P = 0.040). Moreover, the time to reach full dose enteral nutrition was significantly shorter in the lactulose group (12.85 ± 3.33 days) compared to placebo group (15.20 ± 5.24 days) (P = 0.030). As a prebiotic in infants with very low birth weight, lactulose feeding is beneficial and without side effects in late-onset neonatal sepsis. These findings show the possible beneficial effects of prebiotics, and requires further studies with larger sample sizes. Keywords: Sepsis, Neonate, Lactulose, Prebiotics