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Randomized Controlled Trial
. 2017 Aug 31;9(9):965.
doi: 10.3390/nu9090965.

Probiotic Supplementation in Preterm: Feeding Intolerance and Hospital Cost

Flavia Indrio  1 , Giuseppe Riezzo  2 , Silvio Tafuri  3 , Maria Ficarella  4 , Barbara Carlucci  5 , Massimo Bisceglia  6 , Lorenzo Polimeno  7 , Ruggiero Francavilla  8
Affiliations
Randomized Controlled Trial

Probiotic Supplementation in Preterm: Feeding Intolerance and Hospital Cost

Flavia Indrio et al. Nutrients. .

Abstract

We hypothesized that giving the probiotic strain Lactobacillus reuteri (L. reuteri) DSM 17938 to preterm, formula-fed infants would prevent an early traumatic intestinal inflammatory insult modulating intestinal cytokine profile and reducing the onset of feeding intolerance. Newborn were randomly allocated during the first 48 h of life to receive either daily probiotic (10⁸ colony forming units (CFUs) of L. reuteri DSM 17938) or placebo for one month. All the newborns underwent to gastric ultrasound for the measurement of gastric emptying time. Fecal samples were collected for the evaluation of fecal cytokines. Clinical data on feeding intolerance and weight gain were collected. The costs of hospital stays were calculated. The results showed that the newborns receiving L. reuteri DSM 17938 had a significant decrease in the number of days needed to reach full enteral feeding (p < 0.01), days of hospital stay (p < 0.01), and days of antibiotic treatment (p < 0.01). Statistically significant differences were observed in pattern of fecal cytokine profiles. The anti-inflammatory cytokine interleukin (IL)-10, was increased in newborns receiving L. reuteri DSM 17938. Pro-inflammatory cytokines: IL-17, IL-8, and tumor necrosis factor (TNF)-alpha levels were increased in newborns given placebo. Differences in the gastric emptying and fasting antral area (FAA) were also observed. Our study demonstrates an effective role for L. reuteri DSM 17938 supplementation in preventing feeding intolerance and improving gut motor and immune function development in bottle-fed stable preterm newborns. Another benefit from the use of probiotics is the reducing cost for the Health Care service.

Keywords: feeding intolerance; preterm newborn; probiotic.

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Conflict of interest statement

BioGaia AB, Sweden supported this study by kindly providing active study product and placebo. BioGaia AB had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. Flavia Indrio (FI) and Ruggiero Francavilla (RF) serve as speakers for Biogaia. The other authors disclose no conflicts of interest.

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