Personalized probiotics key to improving premature babies’ mortality rates and health, experts say

28 Sep 2022 --- Prescribing probiotic bacteria, personalized to the microbiomes of premature babies in neonatal intensive care units (NICUs), could help to reduce the risk of development of premature birth-related diseases and improve the overall health of premature infants, according to a new study.

Probiotics are already given to preterm babies in some NICUs, following a recommendation given two years ago by the European Society for Paediatric Gastroenterology Hepatology and Nutrition. However, the new study emphasizes that even though many probiotics, such as Bifidobacterium, are assumed to improve the balance of “healthy” and “non-healthy” bacteria, a more personalized approach may have a greater benefit.

“There probably isn’t a one size fits all probiotic,” says Lauren Beck, a Ph.D. student at Newcastle University’s Faculty of Medical Sciences in the UK and lead author of the study. “Different probiotics contain different strains, in different doses, and, as a result, they are going to have a different impact on gut flora development in infants.”

“What our results show is the importance of probiotic selection because each different product, even though on the surface it might appear to have similar bacteria, could have very different impacts on the structure and the function of the infant’s gut.”

Digging through the evidenceThe study found that the introduction of probiotics had the greatest effect on the preterm infant’s microbiome.
The study found that a blanket blend of probiotics does not give consistent results to all preterm infants and calls for the prescription of “customized probiotics,” following an analysis of each infant’s gut flora and microbiome makeup. 

The researchers split the samples into three groups: infants who were not given probiotics and infants given Infloran or Labinic. Infloran includes a mix of Bifidobacterium bifidum and Lactobacillus acidophilus, while Labinic includes a mix of both strains as Infloran as well as Bifidobacterium longum. 

The team also investigated factors known to affect the infant microbiome, such as breastfeeding, whether the child was given antibiotics and whether the child was delivered vaginally or by cesarean.

The authors state that doing so may improve the health and raise the survival rates of this vulnerable group of newborns.

Early intervention likely the key
The study, published in Nature Microbiology, included 1,431 samples from 123 premature babies born before 32 weeks of gestation and examined the participants’ feces from the first week of life up to the 70th day. 

The infant feces samples were provided by Newcastle University’s Great North Neonatal Biobank, and the microbiome’s bacterial makeup was examined and identified using metagenomic sequencing. 

“Clinically, we are interested in the potential of probiotics to improve gut health and the current work, which focuses on healthy babies, highlights they are having impacts,” underscored Dr. Janet Berrington, senior co-author of the study. 

“We are excited to continue this important work to understand what impacts probiotics are having on infants who develop intestinal disease, in the hope this will lead to more personalized and effective therapies in the near future.”

Unexpected improvementsProbiotics may have a larger influence on bacterial makeup than breastfeeding or vaginal birth.
The researchers found higher numbers of probiotic bacteria in the samples of infants who had been given probiotics as compared to those who had been breastfed or born via vaginal delivery. According to the authors, this reveals that the introduction of probiotics to preterm babies is “the single most significant factor” in shaping the makeup of the infant’s microbiomes.

Next, the researchers examined which of the two probiotics used had the greatest effect. Though they state that both probiotics were found to be significant factors in the health of preterm babies in the NICU, they also found two very different responses to the two probiotics. According to the study, these individualized and different responses reveal the need for a prescribed and personalized treatment of probiotics.

“Given probiotics are the deliberate administration of viable bacteria, it was somewhat expected that they would be found to impact the preterm infant gut microbiome,” says Dr. Christopher Stewart, a co-author of the study. 

“What was less expected was the extent of this impact on the preterm infants’ own gut cells, which we found interacted in a unique way when exposed to feces from infants receiving probiotics.”

The team states they will continue to study how personalized probiotics may help preterm infants.

Edited by William Bradford Nichols