Prebiotic supplementation of formula in preterm neonates: a systematic review

Clin Nutr. 2009 Jun;28(3):237-42. Epub 2009 Apr 9.

Prebiotic supplementation of formula in preterm neonates: a systematic review and meta-analysis of randomised controlled trials.

Srinivasjois R, Rao S, Patole S. Department of Neonatology, King Edward Memorial Hospital for Women, Perth, Western Australia, Australia.

BACKGROUND & AIMS: Review the efficacy and safety of prebiotic oligosaccharide supplementation of formula in reducing the incidence of NEC and sepsis; study its effect on growth, gut colonisation and stool characteristics in preterm neonates < or =37 weeks.

METHODS: The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL databases and proceedings of relevant conferences were searched. Only randomised control trials using prebiotic supplemented vs unsupplemented formula milk commenced within 28 days of life and continued for > or =2 weeks were included in the review.

RESULTS: Only one trial reported that NEC did not occur in any of the enrolled neonates. Others did not report on NEC or sepsis. All trials reported anthropometric parameters. Meta-analysis showed no significant effect on weight gain between the two groups. The two trials reporting on stool flora showed a statistically significant increase in bifidobacterial counts in the prebiotic supplemented group (Weighted mean difference (WMD)=0.53; 95% CI: 0.33, 0.73) logCFU/g of stool.

CONCLUSION: Prebiotic supplemented formula increased stool colony counts of bifidobacteria and lactobacilli in preterm neonates without adversely affecting weight gain.

PMID: 19359074 [PubMed - indexed for MEDLINE]