Necrotizing Enterocolitis: Probiotics Can Help

Necrotizing enterocolitis (NEC) is a serious gastrointestinal (GI) disorder that frequently affects premature newborns. It results in a highly diseased state, a high rate (nearly 50%) of necessary surgery and has a high rate of mortality, especially in very low-birth weight infants. NEC affects approximately 7.0% of all very low-birth weight infants and carries a death rate greater than 20%.

The exact causes of NEC are unknown, but it is suspected that it is related to multiple factors such as genetic susceptibility, prematurity, formula feeding and gut dysbiosis (disruption in normal flora.) It is known that the immune system in premature babies is immature and dysbiosis may be the factor which accentuates dysregulation of the immune system. It is also known that maternal breastfeeding reduces the incidence of NEC.

A 2019 study narrowed the factors involved in gut dysbiosis to an increase in Enterobacteriaceae not bound to maternal IgA in infants who develop NEC compared with healthy controls. This study showed that maternal immunoglobulin A (IgA) is an important factor for protection against NEC. It also showed that maternal milk was the predominant source of IgA in the first month of life, and that a relative decrease in IgA-bound bacteria is associated with the development of NEC. There is a scientific reason that breastfeeding is recommended for infants.

There have been several studies showing the benefits of probiotics for NEC. One study caught my eye. You don’t often hear of Bifidobacterium adolescentis in the media, but in a new study this probiotic showed protective effects against NEC. Research published in January, 2017 used 100 million CFU of B. adolescentis from Livzon, Zhuhai, China in a rat model of NEC.

In this rat study, neonatal rats were divided into 3 groups: surrogate mother-fed, formula fed or formula fed+probiotic. The formula-fed and formula+probiotic groups were exposed to conditions via a well-established NEC model which, indeed, induced NEC. Throughout the experiment, the surrogate-fed rats increased their body weights and the formula+probiotic rats maintained their body weights, but the formula-fed rats lost weight, which is reflective of NEC. Additionally, other symptoms of NEC, including abdominal distention and diarrhea, appeared in the rats that developed NEC, but the formula+probiotic rats had a significantly better survival rate than the formula-only rats.

After sacrifice, the ileum (distal part of the small intestine) of all rats were evaluated and results showed that B. adolescentis significantly decreased the rate of NEC-like intestinal injury.

The Takeaway for Necrotizing Enterocolitis Prevention from This Study

Conclusions from this study were that B. adolescentis can prevent necrotizing enterocolitis in premature rats and the mechanism may be protection against inflammation.

One takeaway from this rat study and others is that if you are pregnant or planning on becoming pregnant, getting your gut microbiome balanced so that your child has a better chance of having a more-balanced gut microbiome is very important. It is also very important to breastfeed your child if at all possible.

Nutritional consultations with me can help balance your microbiota so that your vaginal environment and breast milk contain beneficial microbes.

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