Elsevier

The Journal of Pediatrics

Volume 163, Issue 5, November 2013, Pages 1272-1277.e2
The Journal of Pediatrics

Original Article
Effects of Early Prebiotic and Probiotic Supplementation on Development of Gut Microbiota and Fussing and Crying in Preterm Infants: A Randomized, Double-Blind, Placebo-Controlled Trial

https://doi.org/10.1016/j.jpeds.2013.05.035Get rights and content
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open access

Objective

To evaluate the impact of early prebiotic and probiotic intervention on preterm infants' well-being, crying, growth, and microbiological programming.

Study design

Ninety-four preterm infants (gestational age 32-36 weeks and birth weight >1500 g) randomized to receive prebiotics (mixture of galacto-oligosaccharide and polydextrose 1:1), probiotics (Lactobacillus rhamnosus GG), or placebo during the first 2 months of life were followed up for 1 year. Infants were categorized based on the extent of crying and irritability during the first 2 months of life, and their gut microbiota was investigated by fluorescence in situ hybridization (n = 66) and quantitative polymerase chain reaction (n = 63).

Results

A total of 27 of 94 infants (29%) infants were classified as excessive criers, significantly less frequently in the prebiotic and the probiotic groups than in the placebo group (19% vs 19% vs 47%, respectively; P = .02). The placebo group had a higher percentage of Clostridium histolyticum group bacteria in their stools than did the probiotic group (13.9% vs 8.9%, respectively; P = .05). There were no adverse events related to either supplementation.

Conclusions

Early prebiotic and probiotic supplementation may alleviate symptoms associated with crying and fussing in preterm infants. This original finding may offer new therapeutic and preventive measures for this common disturbance in early life.

Cy3
Carbocyanine 3
FISH
Fluorescence in situ hybridization
FITC
Fluorescein isothiocyanate
PCR
Polymerase chain reaction
qPCR
Quantitative polymerase chain reaction

Cited by (0)

Supported by the Juho Vainio Foundation, the Päivikki and Sakari Sohlberg Foundation, the Foundation for Pediatric Research, an EVO grant from Turku University Hospital and Satakunta Central Hospital, and Mead Johnson Nutrition (covered the costs of the prebiotic and probiotic products [prepared by Turku University Hospital Pharmacy] and part of the salary for R.L.). The sponsors had no influence on the design or conduct of the study, data management and analysis, writing of the report, or the decision to submit the manuscript for publication. The authors declare no conflicts of interest.

Registered with ClinicalTrials.gov: NCT00167700.