Probiotics for Preterm Infants

After completing this article, readers should be able to: 1. Describe some of the known functions of the microbiota of the intestinal tract. 2. Define probiotics and explain how they have been used. 3. Review current understanding of the mechanisms of probiotic action. 4. Explain how probiotics might provide benefits to the preterm infant, including the prevention of necrotizing enterocolitis. A better understanding of the intestinal ecosystem in sick preterm neonates may hold the key to prevention of several important diseases as well as improvement of short- and long-term health. The intestinal ecosystem is composed of three primary components that interact closely: host cells, nutrients, and microflora. Recently, a fourth component has been recognized to be important as it pertains to pediatric medicine, especially in neonatology: How the changes in intestinal microflora during maturation affect the developing intestine and how these interact with the changing nutrient environment. Interaction between these components affects numerous processes that are mutually beneficial to the microorganisms and the host. New knowledge of these interactions and the effects of maintaining normal homeostasis or perturbing the interactions should be highly applicable for disease prevention both during infancy and later life. In this article, we present information about the intestinal microflora, how they interact with the intestine and the nutritional environment (“cross talk”), what can go wrong (especially as pertains to the preterm infant), and the potential use of probiotics. ### Functional Aspects The microflora of the adult human is found primarily in the colon and distal mall intestine and consists of more than 1013 microorganisms (the “microbiota”), comprising nearly 500 species and nearly 2 million genes (the “microbiome”). For the most part, this is a mutually beneficial relationship. The microbiota is a metabolically active entity that allows for the synthesis and breakdown of numerous dietary compounds and obviates the need for the host …