ABSTRACT
Abstract Objective: The use of probiotics is increasingly popular in preterm neonates, as they may prevent necrotizing enterocolitis sepsis and improve growth and feeding tolerance. There is only limited literature on Saccharomyces boulardii CNCM I-745 (S. boulardii) in preterm infants. Method: A prospective, randomized, case-controlled trial with the probiotic S. boulardii (50 mg/kg twice daily) was conducted in newborns with a gestational age of 30-37 weeks and a birth weight between 1500 and 2500 g. Results: 125 neonates were enrolled; 63 in the treatment and 62 in the control group. Weight gain (16.14 ± 1.96 vs. 10.73 ± 1.77 g/kg/day, p < 0.05) and formula intake at maximal enteral feeding (128.4 ± 6.7 vs. 112.3 ± 7.2 mL/kg/day, p < 0.05) were significantly higher in the intervention group. Once enteral feeding was started, the time needed to reach full enteral feeding was significantly shorter in the probiotic group (0.4 ± 0.1 vs. 1.7 ± 0.5 days, p < 0.05). There was no significant difference in sepsis. Necrotizing enterocolitis did not occur. No adverse effects related to S. boulardii were observed. Conclusion: Prophylactic supplementation of S. boulardii at a dose of 50 mg/kg twice a day improved weight gain, improved feeding tolerance, and had no adverse effects in preterm infants >30 weeks old.
Resumo Objetivo: O uso de probióticos está cada vez mais popular em neonatos prematuros, já que podem prevenir a enterocolite necrosante (ECN) e a sepse e aumentar o crescimento e a tolerância de alimentação. Há apenas uma literatura limitada sobre a Saccharomyces boulardii CNCM I-745 (S. boulardii) em neonatos prematuros. Método: Um ensaio de caso-controle prospectivo randomizado com o probiótico S. boulardii (50 mg/kg duas vezes por dia) foi feito com recém-nascidos com idade gestacional de 30 a 37 semanas e peso ao nascer entre 1.500 e 2.500 g. Resultados: Foram incluídos 125 neonatos, 63 no grupo de tratamento e 62 no de controle. O ganho de peso (16,14 ± 1,96 em comparação com 10,73 ± 1,77 g/kg/dia, p < 0,05) e a ingestão de fórmula com nutrição enteral máxima (128,4 ± 6,7 em comparação com 112,3 ± 7,2 mL/kg/dia, p < 0,05) foram significativamente maiores no grupo de intervenção. Assim que a nutrição enteral foi iniciada, o tempo necessário para atingir a nutrição enteral completa foi significativamente menor no grupo probiótico (0,4 ± 0,1 em comparação com 1,7 ± 0,5 dia, p < 0,05). Não houve diferença significativa em sepse. Não ocorreu ECN. Não foi observado efeito colateral relacionado à S. boulardii. Conclusão: A suplementação profilática de S. boulardii em uma dose de 50 mg/kg duas vezes por dia melhorou o ganho de peso, aumentou a tolerância de alimentação e não teve efeito colateral em neonatos prematuros > 30 semanas de idade.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant, Low Birth Weight , Probiotics/therapeutic use , Infant Formula , Saccharomyces boulardii , Infant, Premature , Weight Gain , Case-Control Studies , Double-Blind Method , Prospective Studies , Gestational Age , Sepsis/prevention & control , Infant, Very Low Birth Weight , Enterocolitis, Necrotizing/prevention & controlABSTRACT
Objective To study whether a lactose-free,hydrolyzed protein formula would ameliorate feeding intolerance and weight gain in very low birth weight infants.Methods The study was conducted on very low birth weight infants ( gestational age ≤34 weeks, birth weight ≤1500 g) in our NICU from August 2010 to August 2013. According to the number of admission, the cases were assigned into lactose-free hydrolyzed protein formula group ( hydrolyzed protein group) and preterm formula group. The data of basic information ( gestational age, birth weight, way of labor, sex, asphyxia ), commencement of feeding time ( days) , enteral caloric intake, parenteral nutrition caloric intake, The time ( days) required to regain birth weight, weight gain index, days of parenteral nutrition, prealbumin level, feeding intolerance, the incidence of necrotizing enterocolitis ( NEC ) and extrauterine growth retardation(EUGR)werecollected.Results A total of 83 infants were recruited in the study. 40 infants were in hydrolyzed protein group and 43 infants were in preterm formula group. There were no differences between groups for basic information ( P>0. 05). The weight gain index of hydrolyzed protein group was higher than that of preterm formula group (13. 5 ± 2. 4 g/d vs. 11. 9 ± 3. 7 g/d, P=0. 036). There were less cases of feeding intolerance in hydrolyzed protein group than in preterm formula group & nbsp;(28/40 vs. 38/43, P=0. 038). The differences of the incidence of NEC (1/40 vs. 2/43) and EUGR (21/40vs.25/43)showed no significance statistically.Conclusions Lactose-free hydrolyzed protein formula can obviously improve feeding intolerance and early weight gain of premature infants.