- Comments on the study validity: Were there variations in NEC incidence
throughout different time periods of the study? Could blinding have
been affected by physical differences in appearance of milk? What about
clues from patients stool consistencies/patterns? How consistent
were the guidelines for re-starting feeds if they were held?
- Hypothesized that probiotics may provide nonpathologic flora, with
an increased barrier to the translocation of pathogenic bacteria, while
also limiting growth of these other pathogens.
- Encouraging data thus far; still not universally recommended practice,
but further multi-center trials are underway.
- Different strains/formulations of probiotics, doses, timing, length
of treatment, and other factors still need to be considered.
- Study not adequately powered or designed to fully evaluate side effects
or long-term effects of probiotic administration.
- NEC remains multifactorial.
HC, Su BH, Chen AC, et al. Oral probiotics reduce the incidence and
severity of necrotizing enterocolitis in very low birth weight infants.