{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T05:26:03Z","timestamp":1781501163429,"version":"3.54.1"},"reference-count":37,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2020,3,22]],"date-time":"2020-03-22T00:00:00Z","timestamp":1584835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Objective: To evaluate the nutrition-related effects of prophylactic Lactobacillus acidophilus\/Bifidobacterium infantis probiotics on the outcomes of preterm infants &lt;29 weeks of gestation that receive human milk and\/or formula nutrition. We hypothesize that human-milk-fed infants benefit from probiotics in terms of sepsis prevention and growth. Methods: We performed an observational study of the German Neonatal Network (GNN) over a period of six years, between 1 January, 2013 and 31 December, 2018. Prophylactic probiotic use of L. acidophilus\/B. infantis was evaluated in preterm infants &lt;29 weeks of gestation (n = 7516) in subgroups stratified to feeding type: (I) Exclusively human milk (HM) of own mother and\/or donors (HM group, n = 1568), (II) HM of own mother and\/or donor and formula (Mix group, n = 5221), and (III) exclusive exposure to formula (F group, n = 727). The effect of probiotics on general outcomes and growth was tested in univariate models and adjusted in linear\/logistic regression models. Results: 5954 (76.5%) infants received L. acidophilus\/B. infantis prophylactically for the prevention of necrotizing enterocolitis (NEC). Probiotic use was associated with improved growth measures in the HM group (e.g., weight gain velocity in g\/day: effect size B = 0.224; 95% CI: 2.82\u20134.35; p &lt; 0.001) but not in the F group (effect size B = \u22120.06; 95% CI: \u22123.05\u20130.28; p = 0.103). The HM group had the lowest incidence of clinical sepsis (34.0%) as compared to the Mix group (35.5%) and the F group (40.0%). Only in the Mix group, probiotic supplementation proved to be protective against clinical sepsis (OR 0.69; 95% CI: 0.59\u20130.79; p &lt; 0.001). Conclusion: Our observational data indicate that the exposure to L. acidophilus\/B. infantis probiotics may promote growth in exclusively HM-fed infants as compared to formula-fed infants. To exert a sepsis-preventive effect, probiotics seem to require human milk.<\/jats:p>","DOI":"10.3390\/nu12030850","type":"journal-article","created":{"date-parts":[[2020,3,23]],"date-time":"2020-03-23T04:03:01Z","timestamp":1584936181000},"page":"850","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Lactobacillus Acidophilus\/Bifidobacterium Infantis Probiotics Are Beneficial to Extremely Low Gestational Age Infants Fed Human Milk"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1676-8340","authenticated-orcid":false,"given":"Ingmar","family":"Fortmann","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janina","family":"Mari\u00dfen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bastian","family":"Siller","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1737-0628","authenticated-orcid":false,"given":"Juliane","family":"Spiegler","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Humberg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrin","family":"Hanke","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirstin","family":"Faust","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Pagel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of L\u00fcbeck, 23562 L\u00fcbeck, Germany"},{"name":"German Center for Infection Research (DZIF), Partner Site Hamburg-L\u00fcbeck-Borstel-Riems, 38124 Braunschweig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Eyvazzadeh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Brenner","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Roll","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Vestische Children\u2019s Hospital Datteln, 45711 Datteln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3624-6251","authenticated-orcid":false,"given":"Sabine","family":"Pirr","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Hannover Medical School, 30159 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothee","family":"Viemann","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Hannover Medical School, 30159 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitra","family":"Stavropoulou","sequence":"additional","affiliation":[{"name":"Center for Pediatrics and Adolescent Medicine, Medical Center and Medical Faculty, University of Freiburg, 79098 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Henneke","sequence":"additional","affiliation":[{"name":"Center for Pediatrics and Adolescent Medicine, Medical Center and Medical Faculty, University of Freiburg, 79098 Freiburg, Germany"},{"name":"Institute for Immunodeficiency, Medical Center and Medical Faculty, University of Freiburg, 79098 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birte","family":"Tr\u00f6ger","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Links der Weser Bremen, 28277 Bremen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thorsten","family":"K\u00f6rner","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Links der Weser Bremen, 28277 Bremen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0497-4609","authenticated-orcid":false,"given":"Anja","family":"Stein","sequence":"additional","affiliation":[{"name":"Department of Neonatology and General Pediatrics, University of Essen, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Derouet","sequence":"additional","affiliation":[{"name":"Department of Neonatology and General Pediatrics, Saar University of Homburg, 66424 Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9528-7419","authenticated-orcid":false,"given":"Michael","family":"Zemlin","sequence":"additional","affiliation":[{"name":"Department of Neonatology and General Pediatrics, Saar University of Homburg, 66424 Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1522-6649","authenticated-orcid":false,"given":"Christian","family":"Wieg","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Aschaffenburg-Alzenau, 63739 Aschaffenburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Rupp","sequence":"additional","affiliation":[{"name":"German Center for Infection Research (DZIF), Partner Site Hamburg-L\u00fcbeck-Borstel-Riems, 38124 Braunschweig, Germany"},{"name":"Department of Infectious Diseases and Medical Microbiology, University of L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Egbert","family":"Herting","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"G\u00f6pel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"H\u00e4rtel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of L\u00fcbeck, 23562 L\u00fcbeck, Germany"},{"name":"German Center for Infection Research (DZIF), Partner Site Hamburg-L\u00fcbeck-Borstel-Riems, 38124 Braunschweig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,3,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.1016\/j.jpeds.2013.07.017","article-title":"A comparison of two probiotic strains of bifidobacteria in premature infants","volume":"163","author":"Underwood","year":"2013","journal-title":"J. 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