Held at the European Society of Paediatric Research (ESPR) in Newcastle, England, probiotics were backed by an Australian researcher who said dosage, not usage, was the key issue for infant nutrition.
“The evidence from a meta-analysis of randomized controlled trials 2,3 is quite clear, that prophylactic probiotic supplementation significantly reduces the risk of NEC (necrotising enterocolitis) and all cause mortality without significant adverse effects,” said professor Sanjay Patole, from the Department of Neonatal Paediatrics at the KEM Hospital for Women at the University of Western Australia in Perth.
NEC is an intestinal condition that plagues some infants.
Professor Patole also shone a light on probiotic strain selection. “It’s important to be careful in selecting strains because the effects of probiotics are very much strain specific and we know overall that bifidobacteria and lactobacilli are quite safe.”
VLBW and personalised nutrition
Associate Professor Magnus Domellöf from the Department of Clinical Sciences at Pediatrics Umea in Sweden, said very low birth weights (VLBWs) were a ‘nutritional emergency’. He said low protein and energy intakes in the first week of life were associated with neurological issues at 18 months.
“We have to remember that babies are not standardised,” he said. “So, as the foundation of an individualised approach, we should consider a proper assessment of intakes, nutritional status and oral motor development, as well as the provision of breast-feeding support.
Daily computer aided calculations of all parenteral and enteral nutrition are needed to assure optimal intakes of macro and micro-nutrients to track cumulative nutrient intakes.”
Low protein, kidney function, hypertension
The need for protein was emphasised by professor Umberto Simeoni from the division of Neonatology at the AP-HM University Hospital in Marseille, France.
He said human breast milk contained the lowest level of protein among terrestrial mammals.
“It is clear that breastfeeding is likely to have protective effects on the risk of being overweight or obese later in life. And, of course, breastfeeding is a model of low protein intake. High protein intakes in infants accelerate growth and there is increasing evidence that higher protein intake is also associated with a higher risk of later overweight and obesity.”
“The low protein/energy ratio of infant formulas should be considered for non-breast-fed infants, in order to reduce the incidence of cardiovascular and renal disease at adulthood.”