Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 10 (7)

Para-probiotics for Preterm Neonates-The Next Frontier


Para-probiotics for Preterm Neonates-The Next Frontier

Girish Deshpande et al. Nutrients.


Current evidence supports the use of probiotics in preterm neonates for prevention of necrotizing enterocolitis, mortality and late onset sepsis. Despite the strong evidence, the uptake of this intervention has not been universal due to concerns including probiotic sepsis, pro-inflammatory response and transmission of antibiotic resistance. Critically ill extremely preterm neonates with potentially compromised gut integrity are at higher risk of probiotic sepsis due to translocation. In most countries, probiotics are sold as food supplements with poor quality control. The traditional definition of probiotics as “live microorganisms” has been challenged as many experts have questioned the importance of viability in the context of the beneficial effects of probiotics. Paraprobiotics (ghost probiotics), are defined as non-viable microbial cells (intact or broken) or crude cell extracts (i.e., with complex chemical composition), which, when administered (orally or topically) in adequate amounts, confer a benefit on the human or animal consumer. Current evidence indicates that paraprobiotics could be safe alternatives to probiotics in preterm neonates. High-quality pre-clinical and clinical studies including adequately powered randomised controlled trials (RCTs) are warranted in preterm neonates to explore this new frontier.

Keywords: infant; newborn; probiotics; review; sepsis.

Conflict of interest statement

The authors declare no conflict of interest.

Similar articles

See all similar articles

Cited by 5 PubMed Central articles


    1. Glass H.C., Costarino A.T., Stayer S.A., Brett C.M., Cladis F., Davis P.J. Outcomes for extremely premature infants. Anesth. Analg. 2015;120:1337–1351. doi: 10.1213/ANE.0000000000000705. - DOI - PMC - PubMed
    1. Hornik C.P., Fort P., Clark R.H., Watt K., Benjamin D.K., Jr., Smith P.B., Manzoni P., Jacqz-Aigrain E., Kaguelidou F., Cohen-Wolkowiez M. Early and late onset sepsis in very-low-birth-weight infants from a large group of neonatal intensive care units. Early Hum. Dev. 2012;88(Suppl. 2):S69–S74. doi: 10.1016/S0378-3782(12)70019-1. - DOI - PMC - PubMed
    1. Mupsilonller M.J., Paul T., Seeliger S. Necrotizing enterocolitis in premature infants and newborns. J. Neonatal Perinat. Med. 2016;9:233–242. - PubMed
    1. Nino D.F., Sodhi C.P., Hackam D.J. Necrotizing enterocolitis: New insights into pathogenesis and mechanisms. Nat. Rev. Gastroenterol. Hepatol. 2016;13:590–600. doi: 10.1038/nrgastro.2016.119. - DOI - PMC - PubMed
    1. Henry M.C., Moss R.L. Neonatal necrotizing enterocolitis. Semin. Pediatr. Surg. 2008;17:98–109. doi: 10.1053/j.sempedsurg.2008.02.005. - DOI - PubMed

MeSH terms