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Prebiotic supplementation in full-term neonates: a systematic review of randomized controlled trials

 

 

 

Arch Pediatr Adolesc Med. 2009 Aug;163(8):755-64.

 

Prebiotic supplementation in full-term neonates: a systematic review of randomized controlled trials.

 

Rao S, Srinivasjois R, Patole S. Department of Neonatal Pediatrics, Princess Margaret Hospital for Children, Roberts Road, Subiaco, Perth, Western Australia 6008, Australia. This email address is being protected from spambots. You need JavaScript enabled to view it.

 

 

OBJECTIVE: To systematically review randomized controlled trials evaluating the efficacy and safety of prebiotic supplementation in full-term neonates.

 

DATA SOURCES: Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and CINAHL databases and proceedings of relevant conferences.

 

STUDY SELECTION: Eleven of 24 identified trials (n = 1459) were eligible for inclusion. Intervention Trials comparing formula milk supplemented with or without prebiotics, commenced at or before age 28 days and continued for 2 weeks or longer.

 

MAIN OUTCOME MEASURES: Stool colony counts (bifidobacteria, lactobacilli, and pathogens), pH, consistency, frequency, anthropometry, and symptoms of intolerance. RESULTS: Six trials reported significant increases and 2 reported a trend toward increases in bifidobacteria counts after supplementation. Meta-analysis estimated significant reduction in stool pH in infants who received prebiotic supplementation (weighted mean difference, -0.65; 95% confidence interval, -0.76 to -0.54; 6 trials). Infants who receive a supplement had slightly better weight gain than did controls (weighted mean difference, 1.07 g; 95% confidence interval, 0.14-1.99; 4 trials) with softer and frequent stools similar to breastfed infants. All but 1 trial reported that prebiotic supplementation was well tolerated. In that trial, diarrhea (18% vs 4%; P = .008), irritability (16% vs 4%; P = .03), and eczema (18% vs 7%; P = .046) were reported more frequently by parents of infants who received prebiotic supplements.

 

CONCLUSIONS: Prebiotic-supplemented formula is well tolerated by full-term infants. It increases stool colony counts of bifidobacteria and lactobacilli and results in stools similar to those of breastfed neonates without affecting weight gain. Larger trials with long-term follow-up are needed to determine whether these short-term benefits are sustained.

 

PMID: 19652109 [PubMed - indexed for MEDLINE]

 


 

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