The Effects of Lactulose Supplementation to Enteral Feedings in Premature Infants: A Pilot Study

Arieh Riskin, Ori Hochwald, David Bader, Isaac Srugo, Gabi Naftali, Amir Kugelman, Ella Cohen, Frida Mor, Bela Kaufman, Ron Shaoul

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To assess the safety and prebiotic effects of lactulose in preterm infants. Study design: This was a prospective, double-blinded, placebo-controlled, single-center study in 23- to 34-weeks premature infants. The study group received 1% lactulose, and control infants received 1% dextrose in all feeds (human milk or formula). Results: Twenty-eight infants participated (15 lactulose, 13 placebo). Small doses of lactulose appeared to be safe and did not cause diarrhea. Premature infants on lactulose had more Lactobacilli-positive stool cultures that appeared earlier with larger number of colonies. The lactulose group tended to have less intolerance to enteral feedings, to reach full oral feeds earlier, and to be discharged home earlier. They also tended to have fewer episodes of late-onset sepsis, lower Bell stage necrotizing enterocolitis, and their nutritional laboratory indices were better, especially calcium and total protein. Conclusions: This pilot study supports the safety of supplementing preterm infants' feeds with low doses of lactulose. It also demonstrated trends that may suggest positive prebiotic effects.

Original languageEnglish
Pages (from-to)209-214
Number of pages6
JournalJournal of Pediatrics
Volume156
Issue number2
DOIs
StatePublished - Feb 2010
Externally publishedYes

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