Reducing Risk Factors for Necrotizing Enterocolitis: What Is the Recent Evidence and Biologic Plausibility Supporting Probiotics?
Linda Dickison, Carmela Gonzalez-Shalaby
PMID 35446273WHAT IT FOUND
Oral probiotics lowered risk of necrotizing enterocolitis in preterm infants in recent reviews.
In units using them, follow feeding protocols, monitor for NEC and infection, and support human milk feeding.
Key findings
01All included systematic reviews found a statistically significant reduction in necrotizing enterocolitis after probiotic supplementation.
02The certainty of evidence varied across included reviews, with some rating it high and others downgrading it for publication bias or methodological limitations.
03No included systematic review reported adverse effects from probiotics, including late-onset sepsis or negative neurodevelopmental outcomes, but long-term follow-up was not described.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The included reviews used different probiotic strains, doses and durations, so the findings cannot be applied to a specific product. Some included reviews downgraded certainty because of publication bias or methodological limitations. Long-term neurodevelopmental outcomes and allergy outcomes were not described. The review used English-language studies only. Evidence is limited for extremely low birth weight infants. The paper is a review of previous reviews, not a new trial in patients.
The easy way to misread this
Do not conclude that probiotics should be given to every preterm infant or that long-term safety is proven. The included reviews varied in strains, doses and durations, some certainty was downgraded for publication bias, and long-term follow-up was not described.