SMOKINCHOICES (and other musings)

May 27, 2013

Nursing – probiotics prevent NEC

Probiotics show potential in preventing disease

Pediatric Research

Dr. John Barnard

Necrotizing enterocolitis, or NEC, is one of the most tragic diseases I have seen as a pediatrician. Occurring almost exclusively in fragile premature babies, this devastating condition is all too often fatal.

There is no specific treatment, except breast milk, which reduces the chances of developing the disease.

Research has led experts to understand that NEC is caused by multiple interacting factors. For example, an infant’s immature immune system plus milk feeding and various bacterial factors occasionally intersect in a decidedly sinister manner, causing bacteria to run amuck in the premature intestine.

  • Severe inflammation develops over a matter of hours, rapidly progressing to intestinal gangrene. Surviving infants might be left with severe nutritional and developmental problems for months, years or a lifetime.

Because intestinal bacteria are involved, there has been great interest in studying probiotics in premature infants as a preventative agent. Probiotics are living bacteria or yeasts that have a beneficial effect on human health.

  • Over the past 15 years, 20 clinical trials have compared placebos with oral probiotics in preventing NEC. In virtually every instance, probiotics have substantially reduced the occurrence. And they appear to be safe.

Last year, scientists aggregated all existing trials in a meta-analysis and found probiotics decreased the occurrence of the disease by about 30 percent in nearly 2,000 infants. Interestingly, many other complications of prematurity also were decreased.

  • The bottom line is that we now know probiotics can prevent this serious intestinal disorder and have the potential to save thousands of lives a year.
  • Remarkably, though, probiotics are not commonly used in the United States. No probiotic is approved by the Food and Drug Administration and premature babies are going untreated, even in leading academic medical centers.

How can this be happening? After all, there are dozens of over-the-counter probiotic formulations in local markets and drug stores. Most people recognize yogurt as a probiotic food and eat it without a second thought.

On the surface, it seems a simple and logical step to use probiotics to prevent NEC.

But the reality is that neonatal specialists and regulatory agencies are rightly cautious about recommending probiotics for premature infants. Probiotics are living organisms that come in a multitude of types and strengths that have not been assessed in a scientifically rigorous manner in premature infants.

Probiotics cross traditional FDA regulatory bounds, as they have characteristics both of a drug and a medical food, leading some to propose they be called pharmabiotics.

Most of the published studies concerning NEC have used a combination of Bifidobacterium and Lactobacillus bacterial strains, but the proportions vary from study to study.

We know that strain differences are important and that a single strain is less potent than combination preparations. Probiotic stability has not been established, nor have the long term effects been studied in infant health.

  • By treating newborns, we might be changing their intestinal health for the rest of their lives. (*)

Notwithstanding these challenges, it seems to me we are tantalizingly close to a major advance in premature newborn care. A few well-designed studies, designed by consensus collaboration between the probiotic industry, newborn specialists and regulatory agencies, can move us to an era when NEC is a historical footnote.

Dr. John Barnard is president of the Research Institute at Nationwide Children’s Hospital. john.barnard@ nationwidechildrens

(My Comment: 

It appears the Dr Barnard is a rare specimen of physicians – – not only a doctor of medicine, but the possessor of an open mind which is the mark of an inquisitive “scientist”.   This is practically a hallmark in that orthodox medicine rarely will do studies on natural properties as they cannot be patented and without patent potential, there is no point in studying any  naturally endowed product of  ‘mother nature’.  Yet, the hint of what is to come is shown by the need to call it by a different name – – pharmabiotics!  Then presumably, following that, the restricting of the public ability to buy the natural substance as freely as it now does.   Isn’t that pretty much the way things work?  But, hey, glad to see someone – anyone is truly looking at this problem.

The newborn’s delicate, immature immune system is referenced above (*).  The Medical establishment is doing this all the time anyway – from birth on, by the inoculations and vaccinations given to that immature immune system.  There is no other possible reasoning  which can explain all the damage we are seeing amongst vaccinated infants of our current generation.   One in fifty with Autism and one in five with mental mal-function and impairment.  Other classes of healers among the alternative descriptions such as naturopaths have been safely using digestive aids and enzymes and probiotics for  a very long time.  

This is good news.  It is a blessing and a move in the right direction and it saves lives.  so be it  Jan)


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