Possibilities of modulating the gut microbiome with probiotics in preterm neonates

Czech version

Authors: L. Nedvědová; J. Dušek; B. Sýkorová
Authors‘ workplace: Neonatologické oddělení Nemocnice České Budějovice, a. s.
Published in: Čes-slov Neonat 2025; 31 (2): 85-91.
Category: Original Paper

Overview

The intestinal microbiome of a newborn develops from early childhood throughout life under the influence of numerous factors. It plays a crucial role in maintaining homeostasis of the internal environment, metabolism, and the development of the immune and neurological systems. Intestinal dysbiosis (alteration of the intestinal microflora) in early childhood caused by preterm birth can seriously disrupt the healthy maturation of the microbiome and thus affect long-term health. The knowledge we have gained opens up new possibilities for influencing the intestinal microbiome of preterm newborns and thus mitigating the impact of negative factors (e.g., stay in the neonatal intensive care unit, antibiotic therapy, parenteral nutrition etc.). The greatest threat in this regard is the development of necrotizing enterocolitis. Currently, the use of probiotics has gained attention and is becoming common practice in neonatal intensive care units around the world. However, only a very limited number of probiotic preparations have demonstrated sufficient efficacy and safety, and many questions regarding the use of probiotics remain unanswered. In terms of the intestinal microbiome, the optimal strategy for caring for preterm newborns is to administer colostrum or the mother‘s own (or donor) breast milk, ensure early and frequent contact with the mother, shorten the stay in the intensive care unit, shorten the duration of parenteral nutrition, and restrict antibiotic treatment. In the future, thanks to new findings, we could focus on an individualized strategy to influence the intestinal microbiota and thus prevent a number of early and late health complications.

Keywords:

Preterm birth – Lactobacilli – probiotics – gut microbiome – necrotizing enterocolitis – bifidobacteria

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