Ask the Doctors

Dear Doctor: I recently read that probiotic bacteria could protect newborns from sepsis. Does that mean I should be giving probiotics to my newborn?

Dear Reader: Sepsis occurs when the body's immune response to infection goes haywire and winds up injuring its own organs and tissues. The World Health Organization estimates that neonatal sepsis, a bloodstream infection in newborns, claims the lives of up to 1 million newborns each year. About 34,000 of these cases occur in the United States. Even among infants who are properly diagnosed and receive timely medical treatment with antibiotics, the mortality rate for sepsis can reach 60 percent.

In response to this heartbreaking health crisis, researchers in the U.S. and India looked to probiotic bacteria, which have proven effective in combating other types of infections in both infants and adults. Probiotics have been successful in treating necrotizing enterocolitis, a bacterial infection that results in the death of the tissues of the intestine. It's a condition that affects mostly newborns, and researchers hoped that probiotics could turn the tide of neonatal sepsis as well.

After screening and testing close to 300 strains of bacteria, the researchers settled on Lactobacillus plantarum, a microorganism with a well-documented history of safety in fermented foods. They combined the bacterium with food sources for its survival, known as prebiotics. The final product, known as a synbiotic, was fed for one week to the 4,500 or so healthy infants taking part in the trial. They were randomly selected from 149 villages in the state of Odisha in India, where sepsis is a major cause of infant death.

The idea was that by colonizing the newborns' intestines with these beneficial bacteria, the adverse organisms that cause sepsis would fail to flourish. Researchers then followed the medical histories of the inoculated babies, as well as a control group of healthy infants who did not get the synbiotic. The result was a 40 percent drop in the rate of sepsis and death from sepsis among the infants who ingested the synbiotic.

In addition, researchers noted that of the infants who took the synbiotic, infections of the lower respiratory tract were reduced by one-third. This exciting news suggests that synbiotics may promote immunity against infections other than those that arise within the gut.

While it took us just a few hundred words to sketch out the (very) basics of these studies, the trials themselves took a decade to complete. Now the scientists say they want to know whether these results can translate to premature infants, who face a host of medical challenges. They also want to expand the sepsis trial to other parts of the world.

As for whether you should begin giving probiotics to your own baby, the science is young and many outlandish claims are being made. The American Academy of Pediatrics has thus far weighed in with a "not yet." We believe this is something you need to discuss with your pediatrician, and move forward only with his or her guidance.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

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