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Effect of a Probiotic Infant Formula on Infections in Child Care Centers: Comparison of Two Probiotic Agents

doi 10.1542/peds.2004-1815

Zvi Weizman, MD; Ghaleb Asli, MD; and Ahmed Alsheikh, MD
Soroka Medical Center, BeerSheva, Israel
Translate. Original: Pediatrics 2005; 115; 59. doi 10.1542/peds.20041815.
The online version of this article, along with updated information and services, is located on the World Wide Web at: http: //www.pediatrics.org/cgi/content/full/115/1/5
PEDIATRICS (ISSN 0031 4005). Copyright© 2005 the American Academyof Pediatrics.

Objective. To investigate the effect of 2 different species of probiotics in preventing infections in infants attending child care centers.
Methods. A double-blind, placebo-controlled, randomized trial was conducted from December 1, 2000, to September 30, 2002, at 14 child care centers in the Beer-Sheva area of Israel in healthy term infants 4 to 10 months old. Infants were assigned randomly to formula supplemented with Bifidobacterium lactis (BB-12), Lactobacillus reuteri (American Type Culture Collection 55730 (DSM 17938)), or no probiotics. Duration of feeding, including follow-up, for each participant was 12 weeks. All infants were fed only the assigned formula and were not breastfed due to parental decision before recruitment to the study. Probiotic or prebiotic food products or supplements were not allowed. Main outcome measures were number of days and number of episodes with fever (>38°C) and number of days and number of episodes with diarrhea or respiratory illness.
Results. Participants (n=201) were similar regarding gestational age, birth weight, gender, and previous breastfeeding. The controls (n=60), compared with those fed B lactis (n=73) or L reuteri (n=68), had significantly more febrile episodes (mean [95% confidence interval]: 0.41 [0.28–0.54] vs 0.27 [0.17– 0.37] vs 0.11 [0.04–0.18], respectively). The controls also had more diarrhea episodes (0.31 [0.22–0.40] vs 0.13 [0.05–0.21] vs 0.02 [0.01–0.05], respectively) and episodes of longer duration (0.59 [0.34–0.84] vs 0.37 [0.08–0.66] vs 0.15 [0.12–0.18] days, respectively). The L reuteri group, compared with BB-12 or controls, had a significant decrease of number of days with fever, clinic visits, child care absences, and antibiotic prescriptions. Rate and duration of respiratory illnesses did not differ significantly between groups.
Conclusions. Child care infants fed a formula supplemented with L reuteri or B lactis had fewer and shorter episodes of diarrhea. These effects were more prominent with L reuteri, which was also the only supplement to improve additional morbidity parameters.
Key words: probiotics, infant formula, child care, infections.


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