Nutritional outcomes with implementation of probiotics in preterm infants

Objective:To assess nutritional outcomes in preterm infants after the implementation of probiotics.Study Design:Retrospective chart review of infants with birth weight≤1250 grams and/or≤28 weeks of gestational age admitted to the KCH-Neonatal Intensive Care Unit was done. Data were collected over two periods, period 1 (before probiotics) and period 2 (after probiotics) and included demographic data, daily weight gain, feeding strategies (type, amount, caloric content and frequency of feeds) and comorbidities affecting feedings (Patent ductus arteriosus, Sepsis). Primary outcomes - extra uterine growth restriction (EUGR) status and incidence of necrotizing enterocolitis (NEC) as well as secondary outcomes - time to reach full feeds, feeding intolerance episodes and weight gain were compared between the two groups.Results:A total of 113 infants (period 1) were compared with 108 infants (period 2). The odds of EUGR was significantly lower with probiotics (odds ratio: 0.3, 95% confidence interval 0.138 to 0.611). Time to reach full feeds was significantly reduced and weight gain was significantly better in period 2. Significant reduction was also noted in number of total parental nutrition days, central line days, nil per os days and number of feeding intolerance episodes in period 2. There was no significant difference in the incidence of NEC.Conclusion:Probiotics improve feeding tolerance leading to better overall growth and decreases the incidence of EUGR in preterm infants.