Probiotics may promote weight gain, shorten hospital stay in preterm infants with feeding intolerances – meta-analysis

By Nurul Ain Razali

- Last updated on GMT

Usage of probiotics on preterm infants may alleviate feeding intolerances (FI), according to research. © Getty Images
Usage of probiotics on preterm infants may alleviate feeding intolerances (FI), according to research. © Getty Images

Related tags Probiotics preterm infants feeding intolerances

Preterm infants with feeding intolerances (FI) may gain more weight and spend less time in hospital if they are given probiotics.

According to a study conducted by Chinese researchers, probiotics supplementation could also alleviate the occurrences of FI.

The study titled “Clinical efficacy of probiotics on feeding intolerance in preterm infants: a systematic review and meta-analysis”​ was published in the journal Translational Pediatrics​.

Preterm babies face FI due to the immaturity of their physiological organ system.

For example, they have small gastrointestinal tracts and weak gastrointestinal tract barrier function.

Consequently, the infants cannot absorb the nutrients ingested, causing nutritional imbalance and inflammation of the gastrointestinal tract, like enteritis, colitis and gastritis.

Existing studies have shown that probiotics, such as Lactobacillus acidophilus​, Enterococcus faecalis​, Streptococcus thermophilus​ and Saccharomyces boulardii​, could improve the gastrointestinal system of these infants.

For example, improving their gastrointestinal system function could effectively reduce and prevent the invasion and reproduction of various harmful pathogens.

It can also build a good intestinal microbiota balance system, promote digestion, and improve feeding tolerance and immune function at varying degrees.

Hence, the researchers sought to validate the clinical efficacy of probiotics on FI in preterm infants via a meta-analysis of published research.

The analysis was derived from nine studies involving 1,244 preterm infants with FI. The studies were retrieved from the PubMed, Web of Science, EMBASE and MEDLINE databases from January 2002 to January 2021.


The meta-analysis showed significant improvements, especially in preterm infants’ total intestinal feeding time and weight gain when given probiotic supplementation.

These improvements were reported in six out of the nine studies assessed.

For instance, the researchers cited findings published in 2017 by Indrio F​, which showed that preterm infants supplemented with L. reuteri DSM 17938 ​had better weight gain than the placebo group after one month.

The weight of the infants from the probiotic group increased from approximately 1.5 to 1.8kg at birth to 1.9 to 2.6kg. The placebo group had a slower increase, from approximately 1.4 to 1.9kg at birth to 1.7 to 2.2 kg.

Four studies also showed a reduced duration in hospital stays for the infants.

In contrast, other papers showed a lower incidence of FI and improvements in enteral feeding than the control group.

Infancy in infant research

However, clinical research on probiotics supplementation in preterm infants is still in its infancy.

“Therefore, it is necessary to carry out larger-scale research and verification on its safety and effectiveness to evaluate better the benefits and risks of probiotics in preterm infants​.

“Although this combination regimen has achieved clinical results, more clinical sample data and data are needed to verify further because there are many related factors involved in the combination therapy, and it is more prone to adverse drug reactions,”​ the researchers said.

This project was supported by the Hainan province Clinical Medical Center.

Source: Translational Pediatrics

DOI: 10.21037/tp21-624

“Clinical efficacy of probiotics on feeding intolerance in preterm infants: a systematic review and meta-analysis.”

Authors: Wei Zhang et al

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