The cycle of how we acquire bacteria—beginning with pregnancy, during birth (whether vaginal delivery or cesarian section), through diet, and exposure to antibiotics—influences the development of either healthy microbiota or dysbiosis, an abnormal colonization. The microbiota infants develop early in life can influence their gut microbiome as they get older, become adults, and then pass it on to their children. As clinicians continue researching the role of gut microbiome and microbial dysbiosis as in the development of adverse events such as necrotizing enterocolitis (NEC) and sepsis among preterm infants in the neonatal intensive care unit (NICU), data supporting the use of prebiotics and probiotics in both neonatal and infant nutrition to improve health is robust and growing.
Probiotics are one of the most frequently studied interventions for NEC, with numerous trials indicating they can reduce risk by 50%. In this program, a leading neonatologist and a pediatric gastroenterologist discuss reduced, or altered, bacterial diversity in microbiome as a theme across diseases in preterm and fullterm infants, children and adults, and provide comprehensive commentary on functional studies that address the benefits of treatment such as prebiotics and probiotics, as well as the importance of diet, the prebiotics delivered through human milk oligosaccharides, medicine, and exercise. They also share guidelines for infants regarding a number of diseases that may be affected by probiotics, including prevention of antibiotic-associated diarrhea and reducing colic.