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

• Published in: The Journal of pediatrics Vol. 156; no. 2; pp. 209 - 214
• Main Authors: Riskin, Arieh, MD, Hochwald, Ori, MD, Bader, David, MD, MHA, Srugo, Isaac, MD, Naftali, Gabi, Mgr, Kugelman, Amir, MD, Cohen, Ella, MSc, Mor, Frida, RN, BA, Kaufman, Bela, RN, BA, Shaoul, Ron, MD
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Mosby, Inc 01.02.2010; Elsevier
• Subjects: Biological and medical sciences; Breast milk; Colony Count, Microbial; Double-Blind Method; Enteral Nutrition; Female; Gastrointestinal Agents - administration & dosage; Gastrointestinal Agents - therapeutic use; General aspects; Humans; Infant, Newborn; Infant, Premature; Lactobacillus - growth & development; Lactulose - administration & dosage; Lactulose - therapeutic use; Male; Medical sciences; Pediatrics; Pilot Projects; Prebiotics - adverse effects; Prospective Studies; Safety; LOS; Necrotizing enterocolitis; NICU; Neonatal intensive care unit; NEC; Length of stay; Human; Premature; Pediatrics; Lactulose; Infant; Laxative; Supplementation; Enteral administration
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2009.09.006

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.