Probiotics are ‘live micro-organisms providing health benefits when consumed in adequate amounts’ , according to the World Health Organisation and International Scientific Association for Probiotics and Prebiotics¹.

Necrotising enterocolitis (NEC) is a condition where sections of the bowel tissue die, and is one of the most common gastrointestinal emergencies in newborn babies, usually associated with prematurity and a high (30-50 per cent) mortality rate.

Evidence from systematic reviews of randomised² and non-randomised controlled³ trials have shown several significant benefits of probiotics in preterm high-risk population by reducing the risk of NEC, a life-threatening condition, late onset sepsis (LOS) and mortality.

Our researchers have conducted comprehensive systematic reviews which show probiotic supplementation contributes to a significant reduction in the risk of NEC and death⁴, as well as the risk of late-onset sepsis⁵.

Additionally, probiotics improve enteral nutrition by reducing the time to reach full enteral feeds,⁶ thereby reducing the length of hospital stay, need for parenteral nutrition and risk of nosocomial infections.

We carried out the first randomised clinical trial at King Edward Memorial Hospital (KEMH) Neonatal Intensive Care Unit which indicated rates of NEC decreased after probiotic supplementation⁷. Our second clinical trial investigated the health benefits of single-strain probiotic against multi-strain probiotic⁸.

Researchers at the Centre for Neonatal Research and Education (CNRE) are now evaluating the beneficial effects of probiotics in newborn babies with bowel conditions requiring surgery⁹.

We believe probiotic supplementation may confer long-term neurodevelopmental benefits through their effects on the ‘gut microbiome brain’ axis. Overall, probiotic supplementation could be the right ‘head start’ as a potential preventive therapy against multiple conditions.

Key statistics

• CNRE researchers, led by Clinical Professor Sanjay Patole, found probiotic supplementation reduces the risk of NEC¹⁰, 2007
• KEMH Perth was one of the pioneer units across the Australia and New Zealand Network to support supplementation of preterm infants with probiotics. This team was led by Professor Patole and has assisted other neonatal units to implement probiotics into their clinical practice to support neonatal care

Probiotics for newborn babies with surgical conditions of the gut (PRINS)

The PRINS trial is a single-centre randomised controlled trial aiming to evaluate the effect oral probiotics have in improving the gut flora and overall health of newborn babies with gastrointestinal anomalies that require surgery.

Newborn babies undergoing surgery for gastrointestinal anomalies usually receive intravenous fluids and strong antibiotics, as well as experience delayed feeding with breastmilk.

These factors prevent normal development of healthy microbiota, and promote proliferation of harmful bacteria in their gut. In the PRINS trial, we are testing our hypothesis that surgical infants who receive probiotic supplements will have healthier gut bacterial flora and overall health compared to placebo.

Our target population for this project is babies born greater than or equal to 35 weeks gestational age with major congenital gastrointestinal anomalies.

To learn more, visit the Australia and New Zealand Clinical Trials Registry and search the ANZCTR registry number: ACTRN12617001401347

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