{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T23:55:35Z","timestamp":1768434935884,"version":"3.49.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T00:00:00Z","timestamp":1671408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:p>The objective of this retrospective cohort study was to assess the impact of an enteral probiotics supplementation protocol on the incidence of necrotizing enterocolitis (NEC) in infants born &amp;lt;33 weeks gestational age (GA) or birth weight (BW) &amp;lt;1,500 g. In addition, a 6-year follow-up is presented after instigation of probiotic use. In October 2014, our NICU introduced an enteral probiotics supplementation protocol for infants born &amp;lt;33 weeks GA or BW &amp;lt;1,500 g. Infants received 0.5 g of <jats:italic>Bifidobacterium breve<\/jats:italic> HA-129, <jats:italic>Lacticaseibacillus rhamnosus<\/jats:italic> HA-111, <jats:italic>Bifidobacterium bifidum<\/jats:italic> HA-132, <jats:italic>Bifidobacterium longum<\/jats:italic> subsp. <jats:italic>infantis<\/jats:italic> HA-116, and <jats:italic>Bifidobacterium longum<\/jats:italic> subsp. <jats:italic>longum<\/jats:italic> HA-135 (FloraBABY<jats:sup>\u24c7<\/jats:sup>) daily until discharge or transfer from hospital. The incidence of NEC was compared among infants for 2 years pre- and post implementation of the protocol then 6-years following continuous implementation of the probiotic use. In total, 370 infants not treated with probiotics between 2012 and 2014 were included with an incidence of NEC at 4.9%. In comparison, the 367 infants who received had a 67% reduction (4.9\u20131.6%, <jats:italic>p<\/jats:italic> = 0.01) in our Neonatal Intensive Care Unit (NICU). The results remained significant (aOR = 0.26; 95% CI: 0.09, 0.72; <jats:italic>p<\/jats:italic> &amp;lt; 0.01) after adjusting for GA, small for gestational age, and antenatal corticosteroid use. Data from the Canadian Neonatal Network not only showed a consistently high rate of NEC in October 2014, but also identified exceedingly high rates (8.7\u201315.6%) in some hospitals up to 2021, while our rates have been consistently low with using the probiotic as standard therapy for low BW premature babies, with no serious side effects reported. In conclusion, the introduction of a five-strain probiotic natural health product has coincided with a reduced incidence and complications of NEC in our NICU setting.<\/jats:p>","DOI":"10.3389\/fnut.2022.1063121","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T14:26:16Z","timestamp":1671459976000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Enteral supplementation with probiotics in preterm infants: A retrospective cohort study and 6-year follow-up"],"prefix":"10.3389","volume":"9","author":[{"given":"Beth Ellen","family":"Brown","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Huisman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael R.","family":"Miller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cindy","family":"Ulrich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregor","family":"Reid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orlando","family":"da Silva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,12,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.pathophys.2013.11.009","article-title":"Neonatal necrotizing enterocolitis: clinical challenges, pathophysiology and management","volume":"21","author":"Huda","year":"2014","journal-title":"Pathophysiology."},{"key":"B2","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1038\/nrgastro.2016.119","article-title":"Necrotizing enterocolitis: new insights into pathogenesis and mechanisms","volume":"13","author":"Nino","year":"2016","journal-title":"Nat Rev Gastroenterol Hepatol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"562594","DOI":"10.5402\/2012\/562594","article-title":"Necrotizing enterocolitis in very low birth weight infants: a systemic review","volume":"2012","author":"Patel","year":"2012","journal-title":"ISRN Gastroenterol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"e298","DOI":"10.1542\/peds.2011-2022","article-title":"Incidence and timing of presentation of necrotizing enterocolitis in preterm infants","volume":"129","author":"Yee","year":"2012","journal-title":"Pediatrics."},{"key":"B5","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1542\/pir.2017-0002","article-title":"Necrotizing enterocolitis","volume":"38","author":"Rich","year":"2017","journal-title":"Pediatr Rev."},{"key":"B6","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1038\/jp.2011.176","article-title":"Hospital and neurodevelopmental outcomes of extremely low-birth-weight infants with necrotizing enterocolitis and spontaneous intestinal perforation","volume":"32","author":"Shah","year":"2012","journal-title":"J Perinatol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"F193","DOI":"10.1136\/adc.2006.099929","article-title":"Neurodevelopmental outcomes of neonates with medically and surgically treated necrotizing enterocolitis","volume":"92","author":"Rees","year":"2007","journal-title":"Arch Dis Child Fetal Ed."},{"key":"B8","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1542\/neo.7-3-e143","article-title":"Necrotizing enterocolitis: relationship to innate immunity, clinical features, and strategies for prevention","volume":"7","author":"Jesse","year":"2006","journal-title":"Neoreviews."},{"key":"B9","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1177\/1535370219891971","article-title":"Necrotizing enterocolitis: It's not all in the gut","volume":"245","author":"Meister","year":"2020","journal-title":"Exp Biol Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1097\/00001432-200308000-00007","article-title":"Neonatal necrotizing enterocolitis: an overview","volume":"16","author":"Kafetis","year":"2003","journal-title":"Curr Opp Infect Dis."},{"key":"B11","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1016\/S1201-9712(99)90024-3","article-title":"Reduced incidence of necrotizing enterocolitis associated with enteral administration of Lactobacillus acidophilus and Bifidobacterium infantis to neonates in an intensive care unit","volume":"3","author":"Hoyos","year":"1999","journal-title":"Int J Infect Dis."},{"key":"B12","volume-title":"Evaluation of Health and Nutritional Properties of Powder Milk and Live Lactic Acid Bacteria","year":"2001"},{"key":"B13","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1038\/nrgastro.2014.66","article-title":"Expert consensus document. 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