Systematic Review of the Effect of Enteral Feeding on Gut Microbiota in Preterm Infants.
Wanli Xu, Michelle P Judge, Kendra Maas and 4 others
PMID 29040820WHAT IT FOUND
Mother's own milk was linked to higher early gut bacterial diversity in preterm infants than donor milk or formula.
Prebiotics generally promoted Bifidobacteria, but probiotic effects were inconsistent. These are bacterial patterns, not proven clinical benefits.
Key findings
01Infants fed mother's own milk had higher initial gut bacterial diversity, and their microbial communities clustered separately from infants fed donor milk or formula.
02Mother's own milk was associated with higher Clostridiales and higher Bifidobacteria than donor milk or formula.
03Commercial prebiotics were reported to promote Bifidobacteria, but probiotic effects on gut bacteria were contradictory.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The included studies used different designs, doses, frequencies and microbiome methods. This made the bacterial findings hard to compare directly. Only English articles were included, which may limit generalizability. Several included studies did not thoroughly describe design and interventions. There are no standard measures for evaluating and analyzing microbial taxa. Gestational age, birth weight, mode of delivery, feeding practices, formula manufacture, medication use and NICU environment may have influenced results. The review measured gut bacterial patterns, not patient-level clinical outcomes.
Declared interests
The authors reported no conflict of interest or relevant financial relationships.
The easy way to misread this
Do not conclude that adding prebiotics or probiotics to preterm infant feeds is proven to improve health outcomes. This review measured gut bacterial patterns, and those results were inconsistent across studies.