Published online August 1, 2005
PEDIATRICS Vol. 116 No. 2 August 2005, pp. 522-523 (doi:10.1542/peds.2005-1121)
This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via ISI Web of Science (1)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Marini, A.
Right arrow Articles by Agosti, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Marini, A.
Right arrow Articles by Agosti, M.
Related Collections
Right arrow Infectious Disease & Immunity

Probiotics, Prebiotics, or Both in a Very Low Birth Weight Infant

Antonio Marini, MD
Department of Pediatrics and Neonatology
University of Milan
20122 Milano, Italy

Guenther Boehm, MD
Numico Research
61381 Friedrichsdorf, Germany

Franco Negretti, PhD
Institute of Pharmacology
University of Milan
20100 Milano, Italy

Massimo Agosti, MD
Neonatal Intensive Care
Varese Hospital
21100 Varese, Italy

To the Editor.—

Three articles on probiotics administration that appeared in Pediatrics1–3 prompt us to present our data, which recently were briefly summarized.4

We examined in low birth weight infants the effects of 3 different kinds of probiotics (Saccharomyces boulardii, Bacillus subtilis, and Lactobacillus GG) versus placebo on intestinal colonization, changes in the fecal flora, and production of specific IgA and IgM. We found that after an initial very good colonization with probiotics, despite continuous administration, at 10 to 12 days only few viable probiotics were recovered in the stools concomitantly with a marked increase of fecal-specific IgA and IgM. However, even with a very low presence of viable probiotics, changes in intestinal flora (aerobic/anaerobic, Gram positive/Gram negative) were observed, probably resulting from the liberation of substances (bacteriocidins) released from the dead probiotics. In this regard, almost 40 years ago we observed that administration of a cocktail of lysate germs was able to reduce the amount of pathogenetic stool flora and improved the growth in low birth weight infants.

From another side, we have observed good results of permanent colonization with bifidobacteria in low birth weight infants after administration of a preterm formula enriched with prebiotics (oligosaccharides, mixture of neutral oligosaccharides consisting of galactose and fructose). In this way, intestinal bifidobacteria probably are intrinsically produced and thus are recognized as "self"; therefore, they are not destroyed, at variance from foreign administered probiotics. Furthermore, a positive influence was observed in the fecal flora: in the initial flora numerous pathogens germs were seen and almost disappeared after 15 days of prebiotic administration.5

These data indicate that for favoring a good microbial gut colonization in low birth weight infants, with a possible positive influence on prevention of later diseases, when breast milk is lacking, a preterm formula enriched with prebiotics could be a possible choice. The formula is well tolerated by the infants and no adverse effects have been noticed. However, for treatment of already established disease, the administration of probiotics can induce a quicker effect. The eventual response might be potentiated, giving the association of both probiotics and prebiotics (symbiotics).

REFERENCES

  1. Van Niel CW. Probiotics: not just for treatment anymore. Pediatrics. 2005;115 :174 –177[Free Full Text]
  2. Bell EF. Preventing necrotizing enterocolitis: what works and how safe? Pediatrics. 2005;115 :173 –174[Free Full Text]
  3. Kliegman RM, Willoughby RE. Prevention of necrotizing enterocolitis with probiotics [commentary]. Pediatrics. 2005;115 :171 –172[Free Full Text]
  4. Marini A, Negretti F, Boehm G, et al. Pro- and pre-biotics administration in preterm infants: colonization and influence on faecal flora. Acta Paediatr Suppl. 2003;91 :80 –81[Medline]
  5. Boehm G, Lidestri M, Casetta P, et al. Effect of increasing number of intestinal bifidobacteria on the presence of clinically relevant pathogens. Abstracts ESPGHAN 36th Annual Meeting, Prague 2003. J Pediatr Gastroenterol Nutr. 2003;36 :578
PEDIATRICS (ISSN 1098-4275). ©2005 by the American Academy of Pediatrics




This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via ISI Web of Science (1)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Marini, A.
Right arrow Articles by Agosti, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Marini, A.
Right arrow Articles by Agosti, M.
Related Collections
Right arrow Infectious Disease & Immunity