Probiotics and prebiotics in the newborn

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Probiotics and prebiotics in the newborn

• Alison Bedford Russell
• Consultant Neonatologist
• Birmingham Heartlands

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Probiotics and pre-biotics

• Probiotic A live microbial food supplement that
  beneficially affects the host by alteration of
  its intestinal microbial balance
• Prebiotic Non-digestible food ingredient that
  beneficially affects the host by stimulating the
  growth or activity of one or more bacterial
  species already present in the gut

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Kraehenbull Corbett, Science,2004 3031624-162
5 Macpherson Uhr, Science, 20043031662- 1624
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Hooper et al, 2001
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Normal microflora of the newborn

• E.coli Enterococcus spp first
• Bifidibacterium over next 5 days
• Heterogenous bacterial flora by day 10
• Bifidobacteria lactobacilli predominate in
  breastfed
• Mixed in formula

Knol et al Arch Dis Child,200184A22
JPGN,200031S26
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Factors affecting initial colonisation

• Broad-spectrum antibiotics
• Bennet et al, Pediatr Infect Dis,865533-9
• Breast vs Formula
• Hall et al, Arch Dis Child 199065185-8
• Caesarian section
• Gronlund et al, JPGN 19992819-25
• Separation of mother and baby on first night
• Montgomery et al Allergy 200055916-22

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Probiotic effects

• Different probiotics have different actions
• Modify bacteria from pathogenic to benign
• Possible increase in maturation and development
  of gut and gut function
• Reduction in allergy
• Kalliomaki et al, Lancet,20013571076-1079

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BJOG,20061131-8
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Any Questions?