The effect of neutral oligosaccharides on fecal microbiota in premature infants fed exclusively with breast milk: A randomized clinical trial
Volume 5, Issue 1, Winter 2016, Pages 27-34
. Amir-Mohammad Armanian, . Alireza Sadeghnia, . Maryam Hoseinzadeh, . Maryam Mirlohi, . Awat Feizi, . Nima Salehimehr, . Moloud Torkan, . Zahra Shirani
Abstract Objective: This study was designed to compare the efficacy and safety of enteral
supplementation of a prebiotic mixture (SCGOS/LCFOS) on faecal microbiota in very
premature infants who fed exclusively with human-milk.
Methods: This double‑center randomized control trial was conducted from December
2012 to November 2013 in the tertiary Neonatal Intensive Care Units of the Isfahan
University of Medical Sciences. Fifty preterm infants (birth weight ≤1500 g who
were not fed with formula) were randomly allocated to have enteral (tube feeding)
supplementation with a prebiotic mixture (SCGOS/LCFOS; 9:1) or receive no prebiotics.
Findings: The primary outcome (e.g., the effect of the prebiotic mixture on fecal
microbiota pattern) was clearly different between the two groups. Despite greater
coliforms colony counts in first stool cultures in the prebiotic group (Group P)(P = 0.67),
coliforms were significantly lower in the third stool cultures in the Group P (P < 0.001).
Furthermore, despite the much higher Lactobacillus colony counts, in the first
stool cultures, in the control group (Group C) (P = 0.005); there was a trend toward
significantly increased Lactobacillus colony counts in the Group P during the study,
but the difference between Lactobacillus colony counts, in the third stool cultures,
between two groups was no longer statistically significant(P = 0.11). Interestingly, the
median length of hospital stay was significantly less in the Group P (16 [12.50–23.50]
vs. 25 [19.50–33.00] days; P = 0.003).
Conclusion: This suggests that it might have been “the complete removal of formula” which
manifests a synergistic effect between nonhuman neutral oligosaccharides (prebiotics)
and human oligosaccharides, which in turn, led to the rapid growth of beneficial
Lactobacillus colonies in the gut of breast milk‑fed preterm infants, while decreasing
the number of pathogenic coliforms microorganisms. Therefore, further studies with
larger sample sizes are recommended to investigate the issue.