Update on the Role of Probiotics in Preventing Necrotizing Enterocolitis in Preterm Neonates
Mahaveer Singh Lakra, Amar Taksande, Bhavana Lakhkar, Ashwini Lakra
Abstract
Necrotizing enterocolitis (NEC) mostly affects preterm neonates because of their immature gut, and adds to a significant burden of mortality and morbidity in the NICU. NEC is one of the important causes of severe sepsis, prolonged hospital stays, and mortality. The cause of NEC is multifactorial and includes factors related to the host such as gut colonization, neonatal feeding practices, prematurity, mucosal injury, and other immunologic factors.
Probiotics and prebiotics have been studied extensively as a modality to prevent NEC. However, the efficacy of probiotics in preventing NEC in neonates is still not well documented and is debatable. When administered enterally at an appropriate dose and a proper route, probiotics have been found to alter the gut microbiota, augment host immune response, and benefit the host. There are limitations pertaining to their routine use—there are concerns about their safety, and there is a lack of precise guidelines and recommendations on these preparations, dosage, and duration of use in neonates. This review covers the definition, types of probiotic agents available, their mechanism of action, and evidence regarding their use. This article also describes the current scenario on the protective effect of probiotics on the gut, and in turn, prevention of NEC in NICUs.
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