Friday, December 4, 2015

Probiotics May Not Shield ‘Preemies’ From Serious Illness

Probiotics don’t protect very preterm infants from serious complications, such as a bowel condition called necrotizing enterocolitis, sepsis or death, according to a new study.

The findings challenge previous research that suggested potential benefits from probiotics, the British researchers said. Probiotics are good bacteria found in certain foods and supplements.

The study included more than 1,300 very preterm infants. The babies were given either the probiotic Bifidobacterium breve or a placebo. This probiotic was used because it was the only one previously reported to show any benefit when the study began, the study authors explained.

Sepsis (a potentially life-threatening complication of an infection) occurred in 11% of the probiotic group and 12% of the placebo group. Necrotizing enterocolitis occurred in 9% of the probiotic group and 10% of the placebo group. Death before hospital discharge occurred in 8% of the probiotic group and 9% of the placebo group.

The results of the study were published November 25 in The Lancet.

A previous study found probiotic reduced the risk of necrotizing enterocolitis in very preterm infants. But, the infants in that study had low overall complication rates. In addition, different strains of probiotics were included in the review, the authors of the new study explained.

“These two large trials suggest that, while probiotics are generally safe in the short term, they are not universally effective, and that different strains and combinations should be investigated separately,” Kate Costeloe, from Barts and the London School of Medicine and Dentistry, Queen Mary University of London, and colleagues said in a journal news release.

My Take:
There are some obvious flaws in this study. However, I totally agree with the statement made by Kate Costeloe.

Now back to the flaws – Natural probiotic inoculation of the infant gut occurs during vaginal delivery. Varieties of Lactobacillus, Prevotella, and Sneathia are swallowed by the infant as the head travels through the birth canal. These are all probiotic (healthy) in nature. However, C-section births involve contamination with Staphylococcus, Corynebacterium, and Propionibacterium, all sources of infection. Breastfeeding provides Bifidobacterium (probiotic) while formula feeding promotes Enterobacteriaceae, a family that includes Salmonella and E. coli. The study failed to account for other forms of probiotic introduction.

During pregnancy, the probiotics Bifidobacterium, Lactobacillus, and Enterococcus can also translocate from mother to unborn child. The length of gestation is the major factor here.

Maternal microbes, antibiotic use, infection, illness, diet and lifestyle effect probiotic status of the fetus. And finally, antibiotic use in the newborn results in a reduction in the microbial diversity. All of these factors would need to be taken into account to make this study valid.

The Bottom Line:
As Kate Costeloe stated, “Probiotics are generally safe in the short term, they are not universally effective.” Your microbiome (bacterial make-up of the gut) is unique to you and is based on many factors – genetics, diet, geographic location, and, as we learned from this study, gestational factors all play a role.

Source: November 25, 2015 National Institutes of Health

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