Prebiotic supplementation of formula in preterm neonates: A systematic review and meta-analysis of randomised controlled trials

SummaryBackground & aimsReview the efficacy and safety of prebiotic oligosaccharide supplementation of formula in reducing the incidence of NEC and sepsis; study its effect on growth, gut colonisation and stool characteristics in preterm neonates ≤37 weeks.MethodsThe Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL databases and proceedings of relevant conferences were searched. Only randomised control trials using prebiotic supplemented vs unsupplemented formula milk commenced within 28 days of life and continued for ≥2 weeks were included in the review.ResultsOnly one trial reported that NEC did not occur in any of the enrolled neonates. Others did not report on NEC or sepsis. All trials reported anthropometric parameters. Meta-analysis showed no significant effect on weight gain between the two groups. The two trials reporting on stool flora showed a statistically significant increase in bifidobacterial counts in the prebiotic supplemented group (Weighted mean difference (WMD) = 0.53; 95% CI: 0.33, 0.73) log CFU/g of stool.ConclusionPrebiotic supplemented formula increased stool colony counts of bifidobacteria and lactobacilli in preterm neonates without adversely affecting weight gain.