Lactobacillus rhamnosus in Preterm Neonates

Primary Recommendations

The American Academy of Pediatrics recommends the use of Lactobacillus rhamnosus ATCC 53103 in combination with Bifidobacterium species to reduce necrotizing enterocolitis, sepsis, and all-cause mortality in preterm neonates with low birth weight 1, 2

Combination therapy with L. rhamnosus ATCC 53103 plus Bifidobacterium longum subspecies infantis significantly reduces all-cause mortality with high certainty of evidence in preterm, low birth weight infants 1, 3
L. rhamnosus ATCC 53103 combined with various Bifidobacterium species reduces severe NEC compared to placebo in preterm, low birth weight infants 1, 2
The European Society for Paediatric Gastroenterology Hepatology and Nutrition provides a recommendation for the use of L. rhamnosus ATCC 53103 in preterm, low birth weight infants, although the certainty of evidence is low when used alone 1, 2

Manufacturing contaminants have caused fatal infections in preterm infants, emphasizing the critical importance of pharmaceutical-grade product quality 2, 4

The American Academy of Pediatrics recommends exercising extreme caution or avoiding the use of L. rhamnosus in immunocompromised infants, critically ill patients with indwelling central venous catheters, infants with cardiac valvular disease, and infants with short-gut syndrome 2, 3, 4

Choose combination products containing L. rhamnosus ATCC 53103 with one or more Bifidobacterium species rather than L. rhamnosus monotherapy for preterm, low birth weight infants 1, 2
Prioritize pharmaceutical-grade products over dietary supplements to minimize contamination risk in preterm, low birth weight infants 4

B. animalis subspecies lactis alone demonstrates superior reduction in hospitalization days compared to L. rhamnosus combinations in preterm, low birth weight infants 2, 4
Single-strain B. animalis subsp. lactis DSM 15954 reduces severe NEC with moderate-to-high quality evidence, potentially offering a safer alternative to L. rhamnosus-containing products in preterm, low birth weight infants 4