Review suggest lack of evidence for probiotics in pre-term infant formula

The systematic review – published in Nutrition Journal​ – assessed a total of eight clinical studies investigating whether probiotics and prebiotics can lead to improved growth and clinical outcomes in formula fed preterm infants.

Led by Mary Mugambi of Stellenbosch University, South Africa, the research tea noted that growth is a major challenge for premature and low birth weight infants:

“Preterm infants require increased energy and nutrients for rapid growth and may need a 10 fold increase in weight gain in order to achieve optimum catch up growth,”​ they reveal. “They have several factors that put them at risk for nutritional deficiencies resulting in poor growth. Decreased nutrient stores result in low body stores of glycogen, fat, protein, fat soluble vitamins, calcium, phosphorus, magnesium and trace minerals.”​

Intake of probiotics and probiotics has been suggested to be beneficial for such low birth weight infants, with previous clinical reviews suggesting supplementation as part of infant formula could lead to increased weight gain – however the new review concludes that there simply is not enough data.

“There is not enough evidence to state that supplementation of preterm infant formula with probiotics or prebiotics does result in improved growth and clinical outcomes in preterm infants,”​ said Mugambi and her colleagues.

“Therefore this review does not support the routine supplementation of preterm formula with probiotics or prebiotics.”​

Study details​

The new review assessed data from eight clinical trials – including data from 338 pre-term births.  

“Cochrane methodology was followed using randomized controlled trials (RCTs) which compared preterm formula containing probiotic(s) or prebiotic(s) to conventional preterm formula in preterm infants,”​ noted the authors.

The team reviewed data from four studies investigating probiotics supplements (including 212 participants) and four prebiotics studies (126 participants).

No significant differences were found in levels of weight gain between infants given probiotics when compared to those not receiving supplementation.

Prebiotics, including galacto-oligosaccharide and fructo-oligosaccharide, yielded no significant difference in weight gain or length gain, the researchers added.

“There were​ [also] no significant differences in head growth,” ​said the researchers.

“There is not enough evidence to state that supplementation with probiotics or prebiotics results in improved growth and clinical outcomes in exclusively formula fed preterm infants,”​ they condluded.

Source: Nutrition Journal​
Volume 11, Issue 58, doi: 10.1186/1475-2891-11-58​
“Probiotics, prebiotics infant formula use in preterm or low birth weight infants: a systematic review”​
Authors: Mary N Mugambi, Alfred Musekiwa, Martani Lombard, Taryn Young and Reneé Blaauw