Role of oral probiotics in prevention of necrotising enterocolitis in preterm neonates in a tertiary care centre in Northern India

Background: Necrotising enterocolitis (NEC) is primarily a disease of premature infants, but may also be present in 10% of term and near term babies. It is the most common gastrointestinal (GI) medical/surgical emergency occurring in neonates. The objective was to study the r ole of oral probiotics in prevention of necrotising enterocolitis in preterm neonates. Methods: Prospective randomized controlled trial was done in tertiary care centre in Northern India for a period of 18 months. 300 preterm neonates, 150 in the test group and 150 in the control group were studied . The neonates in the test group were fed probiotics with breastmilk twice daily till they reached oral feeds. The neonates in the control group were fed breastmilk alone. Incidence and severity of NEC were measured. Results: 300 neonates (study group n = 150, control group n = 150) were randomized. The incidence of NEC was lower in test group (2.7%) than the control group (9.3%). The severity of NEC was reduced in test group (stage 2 and 3- 0.7%) than the control group (stage 2 and 3-6%). The mortality was also significantly lower in the intervention group (0% versus 20%). Conclusions: Probiotic supplementation has reduced the incidence and severity of necrotising enterocolitis in preterm neonates.