Iranian Journal of Neonatology

Iranian Journal of Neonatology

The Effect of Probiotics on the Prevention of Necrotizing Enterocolitis (NEC) in Low Birth Weight (LBW) and Very Low Birth Weight (VLBW) Infants

Document Type : Review Article

Authors
Reza Saeidi 1
Shamsollah Nouripour 2
Parinaz Alizadeh 2
1 1. Neonatal Health Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2. Neonatal Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2 Neonatal Health Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
10.22038/ijn.2025.88290.2707
Abstract
Background: Necrotizing enterocolitis (NEC) is a life-threatening disease for premature and very low birth weight infants (VLBW).Traditional therapeutic methods such as administration of antibiotics and antacids and cessation of breastfeeding can exacerbate changes in the intestinal microbiota. The mechanisms of action are believed to involve modulation of the gut microbiome, enhancement of the gut barrier function, and immunomodulation. To review the current evidence regarding the use of probiotics for the prevention of NEC in low birth weight (LBW) and VLBW infants.
Methods: A literature search was conducted across major databases (MEDLINE, Embase, Cochrane Library), supplemented by hand-searching of relevant articles and review of reference lists. The search encompassed randomized controlled trials (RCTs), meta-analyses, and review articles published up to 2024. This review included studies that investigated the effect of probiotic supplementation on NEC incidence and related outcomes in LBW and VLBW infants. Excluded studies were those of poor methodological quality or that did not report relevant outcomes.
Results: In this study, a large number of studies on the effect of probiotics on the prevention of NEC in premature and low birth weight infants were found, which showed beneficial effects of probiotics. And probiotics have reduced the Incidence of NEC, Severity of NEC, Mortality. However, these studies were quite heterogeneous in terms of methodology and type of probiotic used. Adverse events associated with probiotic use were generally infrequent and mild, primarily involving transient diarrhea or vomiting. No significant increase in serious adverse events was reported in any of the included studies.
Conclusion: Probiotic supplementation appears to be a beneficial intervention for preventing NEC in LBW and VLBW infants  but yet The decision to use probiotics should be individualized, considering the infant’s risk factors, probiotic availability, and parental preferences.
 
Keywords
Low birth weight
Necrotizing enterocolitis
Probiotics
Very low birth weight
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Iranian Journal of Neonatology
Volume 16, Issue 3
Summer 2025
Pages 63-67