Infant Journal
for neonatal and paediatric healthcare professionals

AAP issues clinical report urging caution in use of probiotics in preterm infants

The American Academy of Pediatrics (AAP) has published a clinical report, Use of Probiotics in Preterm Infants, to provide guidance on the dietary supplement, which has not been approved by the US Food and Drug Administration yet is increasingly given to preterm infants.

The AAP, finding conflicting data on its safety and efficacy in this vulnerable population, does not support the routine, universal administration of probiotics to preterm infants, particularly those with birth weight <1,000g. The clinical report highlights differences among commercially available probiotic preparations and lack of regulatory standards in the US.

The report outlines potential risks associated with the use of probiotics with preterm infants and supports a cautionary approach. It reviews the current evidence evaluating use of probiotics in both prevention and treatment of necrotising enterocolitis, late-onset sepsis, and mortality. The report also highlights the need for pharmaceutical grade probiotics that have been rigorously evaluated for safety and efficacy.

Reference

Poindexter B, Committee on Fetus and Newborn. Use of probiotics in preterm infants. Pediatrics 2021;147:e2021051485.

The AAP does not support the routine, universal administration of probiotics to preterm infants.