Clinical Report: Optimizing Probiotic Administration for Very Preterm Infants

Overview

Probiotic supplementation in very preterm infants is associated with lower risks of necrotizing enterocolitis (NEC) and mortality. In Sweden, the implementation of probiotics following national guidelines resulted in increased usage and a decrease in NEC incidence.

Background

Necrotizing enterocolitis (NEC) is a critical condition affecting very preterm infants, leading to significant morbidity and mortality. The U.S. has seen stagnant rates of NEC-related deaths. Recent studies from Sweden highlight the potential benefits of probiotics in reducing NEC and mortality rates in this vulnerable population.

Data Highlights

Key Findings

• Probiotic use in Swedish NICUs rose from 0% to 65% following national recommendations.
• Probiotic supplementation was associated with a 75% reduction in overall NEC risk.
• Severe NEC (Bell stage 3) occurred in only 0.1% of probiotic recipients compared to 1.3% in non-recipients.
• Probiotics did not significantly affect sepsis risk (ARR 1.22).
• Mortality was reduced by 84% among infants receiving probiotics.

Clinical Implications

The findings indicate that implementing probiotics in very preterm infants may reduce the incidence of NEC and associated mortality.

Conclusion

The evidence from Sweden indicates that probiotics can reduce NEC and mortality in very preterm infants.

Related Resources & Content

1. Mitha et al, JAMA Network Open, 2026 -- Optimizing Probiotic Administration for Very Preterm Infants
2. Imren et al, JAMA Network Open, 2026 -- Use of Probiotics to Reduce the Risk of Necrotizing Enterocolitis in Extremely Preterm Neonates
3. JAMA Network Open, 2026 -- Impact of Probiotics on Mortality, Necrotizing Enterocolitis, and Sepsis in Extremely Preterm Infants
4. American Academy of Pediatrics, Pediatrics, 2021 -- Use of Probiotics in Preterm Infants
5. Infection — Immune System Indicators and Infection Vulnerability in Preterm Infants Receiving Human Milk with Bovine Colostrum or Standard Fortifier: Insights from the FortiColos Trial Secondary Analysis
6. JAMA Network Open — The Role of Probiotics in Reducing Necrotizing Enterocolitis Risk Among Premature Infants
7. JAMA Network Open — The Role of Probiotics in Reducing Necrotizing Enterocolitis Risk Among Premature Infants
8. Probiotics and Risk of Death, Necrotizing Enterocolitis, and Sepsis in Very Preterm Infants