Using probiotics to prevent necrotizing enterocolitis: Why have we not changed practice?

Very low birth weight preterm infants are at risk to develop multiple health co-morbities; one of the most devastating of which is necrotizing enterocolitis (NEC). NEC is a life altering infection with increased morbidity and mortality. While the exact etiology of NEC remains unknown, several factors related to gut proliferation seems to be linked to this infection. A thorough review of the literature revealed that evidence does support the use of probiotics to prevent NEC. Although clinical research implies the use of probiotics, practice guidelines have yet to adopt this change. This article presents the evidence behind the justification for probiotics, and suggestions for future practice.