From the Guidelines
For newborns, especially premature infants, the recommended probiotic supplementation is a combination of Lactobacillus spp and Bifidobacterium spp, with a daily dosage ranging from 1-10 billion CFU, administered under medical supervision. The administration of probiotics can be done by giving liquid probiotics directly by dropper into the mouth or mixing with breast milk or formula, while powdered forms can be mixed with a small amount of expressed breast milk or formula before feeding 1.
Key Considerations
- The specific strains of probiotics that have shown benefit in preterm infants include Lactobacillus rhamnosus ATCC 53103 and Bifidobacterium longum subsp infantis, among others 1.
- The use of probiotics in newborns, particularly those who are premature or have specific health concerns, should be guided by medical professionals to ensure the safest and most effective approach.
- Breast milk naturally contains beneficial bacteria and prebiotics, so most healthy, full-term breastfed babies may not require additional probiotic supplementation.
Administration and Dosage
- The dosage of probiotics for newborns generally ranges from 1-10 billion CFU daily.
- Consistency in administration is crucial for establishing beneficial gut flora.
- Probiotics work by introducing beneficial bacteria to the newborn's developing gut microbiome, supporting immune function, and potentially reducing the risk of certain conditions.
Recent Evidence
A recent study published in 2023 in Gut Microbes highlighted the benefits of multi-strain probiotic formulations in promoting compositional and functional microbiome maturation toward a term-like state and an anti-inflammatory intestinal landscape in preterm infants 1. This study supports the use of probiotics containing Bifidobacterium strains, which have been shown to colonize and increase in abundance in the gut microbiome of preterm infants.
Conclusion Not Applicable
Instead, focusing on the key points:
- Probiotic supplementation in newborns, especially premature infants, should be considered under medical guidance.
- The choice of probiotic strain and dosage is critical, with combinations of Lactobacillus and Bifidobacterium spp being recommended.
- Further research continues to elucidate the benefits and optimal strategies for probiotic use in newborns, emphasizing the importance of staying updated with the latest evidence 1.
From the Research
Administration of Probiotics to Newborns
The administration of probiotics to newborns is a topic of ongoing research, with some studies suggesting potential benefits in reducing the risk of certain diseases.
- The use of probiotics in newborns has been shown to be modestly effective in preventing necrotizing enterocolitis in very low birth weight infants 2.
- Probiotics have also been found to have several effects that might be of benefit to the neonate, including modulating the establishment of intestinal microbiota and enhancing the maturation of the innate and adaptive immune systems 3.
Recommended Dosage and Administration
However, there is currently no consensus on the recommended dosage and administration of probiotics for newborns.
- The available evidence suggests that the beneficial effects of probiotics seem to be strain specific, and more research is needed to determine which products should be administered, at what dose, and for how long 4.
- Some studies have used multiple-strain probiotics, while others have used single-strain probiotic preparations, making it difficult to compare results 5.
Safety Concerns
There are also safety concerns with the use of probiotics in infants and children who are immunocompromised, chronically debilitated, or seriously ill with indwelling medical devices 2.
- The use of probiotics in preterm infants is not universally recommended, and more research is needed to determine the efficacy and safety of probiotics in this population 5.
- The lack of FDA-regulated pharmaceutical-grade products in the United States also raises concerns about the potential for contamination and harm in vulnerable populations 5.
Potential Benefits
Despite these limitations, some studies suggest that probiotics may have potential benefits in reducing the risk of certain diseases, such as necrotizing enterocolitis and infectious disease in infancy 3.