Modi N et al. Arch Dis Child 2008; 93: A58-A59.
A double-blind, randomised, controlled trial of the effect of prebiotic bifidogenic oligosaccharides on enteral tolerance in preterm infants (abstract only).
Background Breast milk contains prebiotic oligosaccharides that promote enteral tolerance and intestinal colonisation with non-pathogenic bacteria. However, many mothers delivering preterm are unable to provide sufficient milk.
Aim To investigate the effect of a preterm formula containing 0.8% prebiotic oligosaccharides (90% galacto-oligosaccharides, 10% fructo-oligosaccharides) on enteral tolerance.
Study Design We conducted a UK multicentre randomised controlled trial involving 160 infants born <33 weeks. Infants were randomised within 24h of birth with stratification by gestational age and centre, to receive Nutriprem 1 (standard preterm formula) or Nutriprem 1 containing prebiotic oligosaccharides (trial formula), to augment insufficient maternal milk volume. Primary outcomes were time to establish a total milk intake of 150 ml/kg/day and extent to which a total milk intake of =150 ml/kg/day was tolerated between birth and term/discharge. Secondary outcomes included growth, faecal characteristics, gastrointestinal signs, necrotising enterocolitis and infection. Outcomes were adjusted for pre-specified covariates.
Results
There were no significant differences in baseline characteristics, time to tolerate 150 ml/kg/day or secondary outcomes. Significant benefit occurred in infants <29 weeks gestational age receiving trial formula with a 12.3% increase in the proportion of days between birth and term/discharge that a total daily milk intake of =150 ml/kg was tolerated (p=0.03).
Conclusions Prebiotic oligosaccharide supplementation improves enteral tolerance in extremely preterm infants.
