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Selections from Journal Watch Pediatrics and Adolescent Medicine Copyright © 2005 Massachusetts Medical Society. All rights reserved.

Probiotics for infants: two studies, two successes ▸

Probiotics are nonpathogenic bacteria that, when ingested, might improve immunity, particularly resistance to gastrointestinal disease.

Investigators in Israel conducted a double-blind, randomized trial, sponsored by a formula manufacturer, that involved 201 healthy infants (age range, 4 to 10 months) who attended day care. They received either plain formula or formula supplemented with probiotics (Bifidobacterium lactis or Lactobacillus reuteri). During the 12-week study, infants who received L. reuteri were significantly healthier on 7 of 9 outcome measures (fewer days with fever or diarrhea, episodes of fever or diarrhea, clinic visits, absences from child care, and antibiotic prescriptions) than were infants who received plain formula. Infants who received B. lactis were healthier than controls on 3 measures. Respiratory illness measures were similar in all groups.

Investigators from China randomized 214 very-low-birth-weight infants (age, >7 days), who began enteral feeding, to receive either breast milk only or breast milk supplemented with two probiotics (L. acidophilus and B. infantis). Compared with infants in the probiotic group, those in the breast-milk-alone group were more likely to die (3.9% vs. 10.7%) or to develop necrotizing enterocolitis (1.1% vs. 5.3%).

Comment ▸

Should all infants receive probiotics? The authors of three separate editorials raise the issue of safety. These trials, and a handful of others on this topic, have involved relatively small numbers of subjects, so concerns about safety remain. Although probiotics aren’t quite ready for prime time, they likely exemplify future therapeutic interventions.

Howard Bauchner, MD

Published in Journal Watch February 11, 2005

The missed PPD reading: can this wait a week? ▸

The interpretation of purified-protein-derivative (PPD) …

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