Over 10,000 preterm newborns have taken part in randomized controlled studies on probiotics throughout the world, suggesting that probiotics, in general, might lower risks of necrotizing enterocolitis (NEC), sepsis, and death. However, there are no answers to important clinical concerns like which strain to use, what dosage to utilize, and how long to supplement for. On the other hand, an increasing variety of commercial probiotic supplements of varying quality are available. Furthermore, despite the absence of strong proof, a vast number of units throughout the world frequently give probiotic supplements as the standard of care. In a recent network meta-analysis, researchers identified probiotic strains with the highest effectiveness in terms of important clinical outcomes for preterm newborns. Only a subset of the strains or combinations examined showed efficacy in lowering mortality and morbidity. The purpose of this position paper is to advise on which specific strains should be utilized and which strains should not be used. Furthermore, they hope to address concerns about the safety of probiotic administration in preterm babies with compromised immune systems and periodic indwelling catheters.

For example, probiotic product quality assurance is critical; probiotic strains should be free of transferrable antibiotic resistance genes, and local microbiologists should be able to identify probiotic sepsis on a regular basis. To lower NEC rates, there is presently a conditional recommendation to administer Lactobacillus rhamnosus GG ATCC53103 or a combination of Bifidobacterium infantis Bb-02, Bifidobacterium lactis Bb-12, and Streptococcus thermophilus TH-4.