Chr. Hansen’s probiotics recommended to reduce intestinal disease in preterm infants

02 Mar 2020 --- The combination of Bifidobacterium infantis, Bifidobacterium lactis and Streptococcus thermophilus included in Chr Hansen’s probiotic strain blend has been recommended by the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) as effective in reducing the intestinal disease necrotizing enterocolitis (NEC) in preterm babies. This recommendation comes just three months after Chr. Hansen launched its probiotic blend that is touted for helping preterm babies develop healthy intestines and reducing the risk of NEC by up to 50 percent.

“The recommendation signals a significant step for the sector to have the highly recognized ESPGHAN actively communicate on probiotics with strong clinical support. This shows that recognized organizations also acknowledge that probiotic supplements can make a true difference. We hope that with this external validation, the probiotic solution may aid an even greater number of preterm infants across the globe,” Chr. Hansen’s Senior Scientific Advisor Ulla Holmboe Goldolf tells NutritionInsight.

Experts believe that an underdeveloped or damaged intestine is the main cause of NEC in preterm babies. Discussing Chr. Hansen’s probiotic strains specifically, the position paper states that “if all safety conditions are met, the panel conditionally recommends using the combination of B.infantis Bb-02, B. lactis Bb-12 and Str. thermophilus TH-4 at a dose of 3.0 to 3.5×108 CFU (of each strain) as it might reduce NEC stage 2 or 3 (low certainty of evidence).” 

More specifically, the administration of these three strains significantly reduced rates of NEC stage 2 and 3 in one larger and one smaller randomized control trial (RCT), with the inclusion of a total of 1,244 infants with an average birth weight of approximately 1,050 g. However, a beneficial effect of these three strains on reducing NEC could not be demonstrated in a retrospective cohort of 580 infants weighing approximately 1,100 g on average at birth. 

Recommendations and rejections
The ESPGHAN paper does not specifically recommend strains from a certain company, but rather refers to well-conducted RCTs with “sufficient power,” the paper’s first author Chris van den Akker, Department of Paediatrics and Neonatology, Amsterdam UMC, the Netherlands, flags to NutritionInsight. 

“We encourage using only those products that are tested as effective, safe, and produced under the highest standards currently available,” van den Akker highlights. 

More to the point, the paper’s panel did not provide a recommendation for B. breve BBG-001 and S. boulardii, nor the combination of B. bifidum NCDO 1453 with L. acidophilus NCDO 1748. There was also no consensus for probiotics producing D-lactate, such as L. reuteri DSM 17938.

Supporting intestinal health
About 1-2 percent of all infants are born very preterm or extremely preterm – i.e. two months or earlier than a due date – which is some 2.4 million babies globally every year. NEC affects approximately 5 percent of this group and results in a mortality rate of up to 30 percent.

Chr. Hansen's probiotic blend for preterm infants has shown in clinical trials to help reduce the risk of NEC by up to 50 percent.Last November, research led by UK-based Norfolk and Norwich University Hospital (NNUH) found that administering routine probiotics to premature babies via breast milk reduced the amount of NEC cases and may be the key to preventing severe gut infections. 

“The next step is that more neonatal intensive care units start using the probiotic solution so an even greater number of preterm infants across the globe may benefit from the product,” Goldolf notes. Available through customer partnerships in the US and in Europe, Chr. Hansen’s strains are already being used in several neonatal intensive care units.

The paper additionally spotlights the crucial role that active, comprehensive information plays for preterm babies’ parents. To do so, the paper identifies the best form of communication as “face-to-face” and “with written materials appropriate to the local context.”

Chr. Hansen concurs that accessible and correct information on probiotics is often incorrectly or poorly communicated, leading to confusion and misconceptions. “To address this, we are developing a new institute that will be a global, online, dual-experience platform designed to breakdown misconceptions and increase understanding around probiotics and their interplay with the human microbiome and our health. To begin with, the institute will be for the US market and will be launched within the nearest future,” Goldolf concludes.

By Anni Schleicher