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Prematüre bebeklerde beslenme intoleransında Bifidobakteriyum laktis ve Hindiba inülinin beslenme intoleransı ve ağırlık artışı üzerine etkilerinin değerlendirilmesi

Year 2017, Volume: 42 Issue: 3, 419 - 426, 30.09.2017
https://doi.org/10.17826/cutf.323371

Abstract

Amaç: Bu çalışmanın amacı prematüre bebeklerde beslenme intoleransı ve ağırlık artışı üzerine Bifidobakteryum laktis ve Hindiba inülini’nin etkisinin değerlendirilmesidir. 

Gereç ve Yöntem: Beslenme intoleransı tanısıyla izlenmekte olan 89 prematüre bebek bu çalışmaya alınmıştır. Çalışma grubundaki olgulara Bifidobakteriyum laktis (5x109 CFU) + Hindiba inülini (900 mg) (Maflor şase) oral yolla verilirken, kontrol grubundaki olgulara beslenme intolransı için herhangi bir tedavi verilmedi.

Bulgular: Çalışma grubundaki olgulara B. Laktis ve Hindiba inülinine ortalama 10 gün devam edilmişti. Oral beslemeye başlama ve tam enteral beslenmeye geçiş zamanları çalışma grubunda daha uzundu ve istatistiksel açıdan anlamlı idi. Çalışma grubundaki olgularda daha düşük doğum tartısı, daha fazla sayıda yaşa göre düşük ağırlıklı olgu sayısı, daha uzun süre total parental nutrisyon almaları, oral beslenmeye daha geç başlama ve tam enteral beslenme geçiş zamanının daha uzun olmasına rağmen taburculuktaki kiloları karşılaştırıldığında kontrol grubu ile aralarında istatistiksel açıdan anlamlı fark yoktu. Gruplar kilo artışı yönünden karşılaştırıldığında çalışma grubundaki bebeklerin daha fazla kilo aldığı gözlendi ve bu sonuç istatistiksel açıdan anlamlı idi. Çalışmamızda nekrotizan enterokolit açısından gruplar arasında istatistiksel açıdan anlamlı fark yoktu. Ancak çalışma grubundaki olgular evre 1’de kalırken, kontrol grubundaki olguların %33.3’nün evre 2’ ye ilerlediği gözlendi.

Sonuç: Beslenme intoleransı olan prematüre bebeklerde B. laktis ve Hindiba inülini verilen grubun ağırlık artışının daha fazla oluşu ve neckrotizan enterokolitli olguların evrelerinin ilerlememesi probiyotik ve prebiyotiklerin olumlu etkileri olduğunu düşündürmektedir.


References

  • 1. Johnston M, Landers S, Noble L, Szucs K, Viehmann L. Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012;129:827-41.
  • 2. Agostoni C, Buonocore G, Carnielli VP, De Curtis M, Darmaun D, Decsi T, et al. ESPGHAN Committee on Nutrition. Enteral nutrient supply for premature infants: commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2010;50:85-91
  • 3. Manzoni P, Lista G, Gallo E, Marangione P, Priolo C, Fontana P et.al. Routine Lactobacillus rhamnosus GG administration in VLBW infants: A retrospective, 6-year cohort study. Early Hum Dev 2011;81:35-8.
  • 4. Di Lorenzo M, Bass J, Krantis A. An intraluminal model of necrotizing enterocolitis in the developing neonatal piglet. J Pediatr Surg. 1995;30:1138-42.
  • 5. Lin J. Too much short chain fatty acids cause neonatal necrotizing enterocolitis. Med Hypotheses. 2004;62:291-93.
  • 6. Moore TA, Wilson ME. Feeding intolerance; a concept analysis. Adv Neonatal Care. 2011;11:149-154.
  • 7. Dodrill P. Feeding difficulties in premature infants. Infant Child Adolesc Nutr. 2011;3:324-31.
  • 8. Alan S, Erdeve Ö. Enteral beslenmede gelişen sorunlar ve yönetimi. In: Prematüre Bebeğin Enteral Beslenmesi (Eds A Bülbül, HS Uslu, A Nuhoğlu):83-98. İstanbul, İstanbul Medikal, 2013.
  • 9. Fanoro S. Strategies to improve feeding tolerance in premature infants. J Matern Fetal Neonatal Med. 2012;4:54-6.
  • 10. Szajewska H. Probiotics and prebiotics in preterm infants: where are we? where are we going? Early Hum Dev. 2010;86;81-6.
  • 11. Köksal N, Akpınar R, Köse HN, Sayrım K. Prematüre ve yenidoğan beslenmesi. Güncel Pediatri. 2003;1:59-72.
  • 12. Weizman Z, Asli G, Alsheikh A. Effect of probiotic infant formula on infections in child care centers: comparison of two probiotic agents. Pediatrics. 2005;115:5-9.
  • 13. Gibson GR, Roberfroid MB. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics. J Nutr. 1995;125:1401-12.
  • 14. Brannon C. Prebiotics: feeding friendly bacteria. Today’s Dietitian. 2003;14:123-8.
  • 15. Lin PW, Nasr TR, Stoll BJ. Necrotizing enterocolitis: recent scientific advances in pathophysiology and prevention. Semin Perinatol. 2008;32:70-82.
  • 16. Lubchenco LO, Hansman C, Boyd E: Intrauterine growth in length and head circumference as estimated from live births at gestational ages from 26 to 42 weeks. Pediatrics. 1966;37:403-8.
  • 17. Luoto R, Ruuskanen O, Waris M, Kalliomäki M, Salminen S, Isolauri E. Prebiotic and probiotic supplementation prevents rhinovirus infections in preterm infants: a randomized, placebo-controlled trial. J Allergy Clin Immunol. 2014;133:405-13.
  • 18. Fanaro S, Jelinek J, Stahl B, Boehm G, Kock R, Vigi V. Acidic oligosaccharides from pectin hydrolysate as new component for infant formulae: effect on intestinal flora, stool characteristics, and pH. J Pediatr Gastroenterol Nutr. 2005;41:186-90.
  • 19. Deshpande GC, Rao SC, Keil AD, Patole SK. Evidence- based guidelines for use of probiotics in preterm neonates. BMC Med. 2012;9:92.
  • 20. Dani C, Biadaioli R, Bertini G, Martelli E, Rubaltelli FF. Probiotics feeding in prevention of urinary tract infection, bacterial sepsis and necrotizing enterocolitis in premature infants: a prospective double-blind study. Biol Neonate. 2002;82:103-8.
  • 21. Lin HC, Su BH, Chen AC, Lin TW, Tsai CH, Yeh TF et al. Oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants. Pediatrics. 2005;115:1-4.
  • 22. Underwood MA, Salzman NH, Bennett SH, Barman M, Mills DA, Marcobal A et al. A randomized placebo-controlled comparison of 2 prebiotic/probiotic combinations in preterm infants: impact on weight gain, intestinal microbiota, and fecal short-chain fatty acids. J Pediatr Gastroenterol Nutr. 2009;48:216-25.
  • 23. Mugambi MN, Musekiwa A, Lombard M, Young T, Blaauw R. Synbiotics, probiotics or prebiotics in infant formula for full term infants: a systematic review. Nutr J. 2012;11:81.
  • 24. Dilli D, Aydın B, Fettah ND, Özyazıcı E, Beken S, Zenciroğlu A et al. The propre-save study: effects of probiotics and prebiotics alone or combined on necrotizing enterocolitis in very low birth weight infants. J Pediatr. 2015;166:545-51.
  • 25. Oncel MY, Sari FN, Arayici S, Guzoglu N, Erdeve O, Uras N et al. Lactobacillus Reuteri for the prevention of necrotising enterocolitis in very low birth weight infants: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed. 2014;99:F110-5.
  • 26. Guthmann F, Kluthe C, Buhrer C. Probiotics for prevention of necrotizing enterocolitis: an updated meta-analysis. Klin Pediatr. 2010;222:284-90.
  • 27. Deshpande G, Rao S, Patole S, Bulsara M. Updated meta-analysis of probiotics for preventing necrotizing enterocolitis in preterm neonates. Pediatrics. 2010;125:921-30.
  • 28. AlFaleh K, Anabrees J. Probiotics for prevention of necrotizing enterocolitis in preterm infants. Cochrane Database Syst Rev. 2014;4:CD005496.
  • 29. Athalye-Jape G, Rao S, Patole S. Lactobacillus reuteri DSM 17938 as a probiotic for preterm neonates: a strain-specific systematic review. JPEN J Parenter Enteral Nutr. 2016;40:783-94.
  • 30. Mihatsch WA, Braegger CP, Decsi T, Kolacek S, Lanzinger H, Mayer B et al. Critical systematic review of the level of evidence for routine use of probiotics for reduction of mortality and prevention of necrotizing enterocolitis and sepsis in preterm infants. Clin Nutr. 2012;31:6-15.
  • 31. Lin HC, Hsu CH, Chen HL. Oral probiotics prevent necrotizing enterocolitis in Very low birthweight premature infants: a multicenter, randomized, controlled trial. Pediatrics. 2008;122:693-700.

Evaluation of influence of Bifidobacterium lactis and Hindiba inulin on feeding intolerance and weight gain in premature babies

Year 2017, Volume: 42 Issue: 3, 419 - 426, 30.09.2017
https://doi.org/10.17826/cutf.323371

Abstract

Purpose: The aim of this study was to evaluate the influence of Bifidobacterium lactis and Hindiba inulin on feeding intolerance and weight gain in premature babies.

Material and Methods: Eighty nine premature babies with the diagnosis of feeding intolerance were enrolled in the study. Study group had Bifidobacterium lactis (5x109 CFU) + Hindiba inulin (900 mg) (Maflor) per oral, while control group did not have any medication for feeding intolerance. 

Results: B. lactis ve H. inulin was continued for a mean of  10 days. Time of full enteral feeding and time of starting oral feeding were longer in study group and this was statistically significant. Although lower birth weight, longer total parenteral nutrition duration, later starting of oral feeding and longer duration for start of full enteral feeding in the study group, there was no statistical difference in weights of the babies at discharge time when compared with the control group. When the groups were compared according to weight gain, study group gained more weight and it was statistically significant. Although necrotizing enterocolitis was not significantly different between groups, babies in the study group diagnosed as in Stage 1 and did not worsen. 33.3% of the babies in the control group progressed to Stage 2.  

Conclusion: Probiotics and prebiotics might have positive effects due to higher weight gain especially >1500 g birth weight infants and not advancing necrotizing enterocolitis in the study group having B. Lactis and H. inulin.


References

  • 1. Johnston M, Landers S, Noble L, Szucs K, Viehmann L. Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012;129:827-41.
  • 2. Agostoni C, Buonocore G, Carnielli VP, De Curtis M, Darmaun D, Decsi T, et al. ESPGHAN Committee on Nutrition. Enteral nutrient supply for premature infants: commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2010;50:85-91
  • 3. Manzoni P, Lista G, Gallo E, Marangione P, Priolo C, Fontana P et.al. Routine Lactobacillus rhamnosus GG administration in VLBW infants: A retrospective, 6-year cohort study. Early Hum Dev 2011;81:35-8.
  • 4. Di Lorenzo M, Bass J, Krantis A. An intraluminal model of necrotizing enterocolitis in the developing neonatal piglet. J Pediatr Surg. 1995;30:1138-42.
  • 5. Lin J. Too much short chain fatty acids cause neonatal necrotizing enterocolitis. Med Hypotheses. 2004;62:291-93.
  • 6. Moore TA, Wilson ME. Feeding intolerance; a concept analysis. Adv Neonatal Care. 2011;11:149-154.
  • 7. Dodrill P. Feeding difficulties in premature infants. Infant Child Adolesc Nutr. 2011;3:324-31.
  • 8. Alan S, Erdeve Ö. Enteral beslenmede gelişen sorunlar ve yönetimi. In: Prematüre Bebeğin Enteral Beslenmesi (Eds A Bülbül, HS Uslu, A Nuhoğlu):83-98. İstanbul, İstanbul Medikal, 2013.
  • 9. Fanoro S. Strategies to improve feeding tolerance in premature infants. J Matern Fetal Neonatal Med. 2012;4:54-6.
  • 10. Szajewska H. Probiotics and prebiotics in preterm infants: where are we? where are we going? Early Hum Dev. 2010;86;81-6.
  • 11. Köksal N, Akpınar R, Köse HN, Sayrım K. Prematüre ve yenidoğan beslenmesi. Güncel Pediatri. 2003;1:59-72.
  • 12. Weizman Z, Asli G, Alsheikh A. Effect of probiotic infant formula on infections in child care centers: comparison of two probiotic agents. Pediatrics. 2005;115:5-9.
  • 13. Gibson GR, Roberfroid MB. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics. J Nutr. 1995;125:1401-12.
  • 14. Brannon C. Prebiotics: feeding friendly bacteria. Today’s Dietitian. 2003;14:123-8.
  • 15. Lin PW, Nasr TR, Stoll BJ. Necrotizing enterocolitis: recent scientific advances in pathophysiology and prevention. Semin Perinatol. 2008;32:70-82.
  • 16. Lubchenco LO, Hansman C, Boyd E: Intrauterine growth in length and head circumference as estimated from live births at gestational ages from 26 to 42 weeks. Pediatrics. 1966;37:403-8.
  • 17. Luoto R, Ruuskanen O, Waris M, Kalliomäki M, Salminen S, Isolauri E. Prebiotic and probiotic supplementation prevents rhinovirus infections in preterm infants: a randomized, placebo-controlled trial. J Allergy Clin Immunol. 2014;133:405-13.
  • 18. Fanaro S, Jelinek J, Stahl B, Boehm G, Kock R, Vigi V. Acidic oligosaccharides from pectin hydrolysate as new component for infant formulae: effect on intestinal flora, stool characteristics, and pH. J Pediatr Gastroenterol Nutr. 2005;41:186-90.
  • 19. Deshpande GC, Rao SC, Keil AD, Patole SK. Evidence- based guidelines for use of probiotics in preterm neonates. BMC Med. 2012;9:92.
  • 20. Dani C, Biadaioli R, Bertini G, Martelli E, Rubaltelli FF. Probiotics feeding in prevention of urinary tract infection, bacterial sepsis and necrotizing enterocolitis in premature infants: a prospective double-blind study. Biol Neonate. 2002;82:103-8.
  • 21. Lin HC, Su BH, Chen AC, Lin TW, Tsai CH, Yeh TF et al. Oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants. Pediatrics. 2005;115:1-4.
  • 22. Underwood MA, Salzman NH, Bennett SH, Barman M, Mills DA, Marcobal A et al. A randomized placebo-controlled comparison of 2 prebiotic/probiotic combinations in preterm infants: impact on weight gain, intestinal microbiota, and fecal short-chain fatty acids. J Pediatr Gastroenterol Nutr. 2009;48:216-25.
  • 23. Mugambi MN, Musekiwa A, Lombard M, Young T, Blaauw R. Synbiotics, probiotics or prebiotics in infant formula for full term infants: a systematic review. Nutr J. 2012;11:81.
  • 24. Dilli D, Aydın B, Fettah ND, Özyazıcı E, Beken S, Zenciroğlu A et al. The propre-save study: effects of probiotics and prebiotics alone or combined on necrotizing enterocolitis in very low birth weight infants. J Pediatr. 2015;166:545-51.
  • 25. Oncel MY, Sari FN, Arayici S, Guzoglu N, Erdeve O, Uras N et al. Lactobacillus Reuteri for the prevention of necrotising enterocolitis in very low birth weight infants: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed. 2014;99:F110-5.
  • 26. Guthmann F, Kluthe C, Buhrer C. Probiotics for prevention of necrotizing enterocolitis: an updated meta-analysis. Klin Pediatr. 2010;222:284-90.
  • 27. Deshpande G, Rao S, Patole S, Bulsara M. Updated meta-analysis of probiotics for preventing necrotizing enterocolitis in preterm neonates. Pediatrics. 2010;125:921-30.
  • 28. AlFaleh K, Anabrees J. Probiotics for prevention of necrotizing enterocolitis in preterm infants. Cochrane Database Syst Rev. 2014;4:CD005496.
  • 29. Athalye-Jape G, Rao S, Patole S. Lactobacillus reuteri DSM 17938 as a probiotic for preterm neonates: a strain-specific systematic review. JPEN J Parenter Enteral Nutr. 2016;40:783-94.
  • 30. Mihatsch WA, Braegger CP, Decsi T, Kolacek S, Lanzinger H, Mayer B et al. Critical systematic review of the level of evidence for routine use of probiotics for reduction of mortality and prevention of necrotizing enterocolitis and sepsis in preterm infants. Clin Nutr. 2012;31:6-15.
  • 31. Lin HC, Hsu CH, Chen HL. Oral probiotics prevent necrotizing enterocolitis in Very low birthweight premature infants: a multicenter, randomized, controlled trial. Pediatrics. 2008;122:693-700.
There are 31 citations in total.

Details

Subjects Health Care Administration
Journal Section Research
Authors

Çiğdem El This is me

Mehmet Satar

Hacer Yapıcıoğlu Yıldızdaş This is me

Ferda Özlü This is me

Hüseyin Selim Asker This is me

Publication Date September 30, 2017
Acceptance Date December 30, 2016
Published in Issue Year 2017 Volume: 42 Issue: 3

Cite

MLA El, Çiğdem et al. “Prematüre Bebeklerde Beslenme intoleransında Bifidobakteriyum Laktis Ve Hindiba inülinin Beslenme Intoleransı Ve ağırlık artışı üzerine Etkilerinin değerlendirilmesi”. Cukurova Medical Journal, vol. 42, no. 3, 2017, pp. 419-26, doi:10.17826/cutf.323371.