Work package 1.5

Hypothesis: Use of pro- or antibiotics improves feeding tolerance and health in preterm infants.

Probiotics, feeding and infections

Treatment from day 3 to discharge with probiotics has been standard clinical care for preterm infants in Copenhagen since March 2010. However, reports on the addition of probiotics to milk feeds for compromised newborn infants are not conclusive (23).

Methods

In retro- and prospective cohort studies, we compare clinical records (feeding, growth, antibiotic use, infection, other clinical complications), routine laboratory data, and fecal samples from day 3, 10 and 30 between untreated and treated infants born before 30 weeks of gestation. Comparison of 3+3 years allows us to detect a decrease in NEC incidence of 50%, i.e. what is expected based on recent meta-analyses (23).

Results

We document the association among probiotics treatment, NEC, feeding tolerance and clinical records of infections over the first 4 weeks after birth. Gut bacterial composition is analyzed by conventional culture-based and molecular techniques. The results will support decisions to implement new early feeding protocols, with and without addition of probiotics.