Safely Building a Healthy Infant Microbiome in a Hospital Environment
Feeding tolerance and competency are important milestones for the newborn infant. Maturation of the gut begins when feeding starts and evidence-based pragmatic feeding strategies in the hospital highlight the care and attention needed to feed newborns appropriately.
There are increasing studies supporting early adoption of human milk in the NICU. Human milk has many benefits for the newborn infant. However, an important question to ask is: What are you feeding in the microbiome? Appropriate bacterial colonization of the infant gut is the foundation for intestinal health and is inextricably linked to diet in the newborn infant.
The NICU environment poses unique challenges to the development of a healthy intestinal microbiome. Antibiotics are frequently used in the NICU, but as they eliminate both pathogenic and beneficial bacteria in the gut, they disrupt the microbiome. Taken together, C-sections, formula use, hospital-acquired pathogens, hygiene protocols, use of instruments such as feeding tubes, and frequent antibiotic use in the underdeveloped infant gut and immune system puts the healthy microbiome at risk in the NICU.1,2
Evivo is a once-daily serving of Bifidobacterium longum subspecies infantis specially formulated for use in the NICU. Research indicates that B. infantis may be both restorative and protective in infants.2 Administering Evivo with breast milk is clinically proven to allow B. infantis to grow and dominate the infant gut microbiome while also reducing relative populations of less desirable bacteria.3
Evivo helps protect the NICU baby’s gut microbiome through a variety of actions derived from its ability to consume HMOs. It is anti-inflammatory, decreases intestinal permeability, and increases the production of short-chain fatty acids, particularly lactate and acetate, which can be protective in infants.2,4,5
A meta-analysis review found that administration of probiotics to infants in the NICU is safe and effective, and can reduce incidence of NEC and mortality.6 The authors also found that probiotic administration leads to shorter time to full feeds and may reduce incidence of sepsis.6 In the four years since the meta-analysis review was completed, further clinical research has concluded that not all probiotics are created equal. It is critical for the hospital to understand the mechanism by which the probiotic is working in their infants.
Evivo™ (activated B. infantis EVC001, ActiBif®) is able to utilize all the HMOs in breast milk and is able to consume them in a unique and superior manner compared to other bacteria. Evivo is then able to convert HMOs into nutrients that nourish both the infant and the gut microbiome and suppress the growth of potentially harmful bacteria.
Evivo is intended for use in term infants consuming human milk. If you have any questions about the use of the product, please consult a physician.
Choose Evivo for your patients for an optimal start to a healthy life.
1. Wang Y, Hoenig JD, Malin KJ et al. 16S rRNA gene-based analysis of fecal microbiota from preterm infants with and without necrotizing enterocolitis. ISME J. 2009;3(8):944-954.
2. Underwood MA, German JB, Lebrilla CB, Mills DA. Bifidobacterium longum subspecies infantis: champion colonizer of the infant gut. Pediatr Res. 2015;77:229-235.
3. Underwood MA, Sohn K. The microbiota of the extremely preterm infant. Clin Perinatol. 2017;44(2):407-427.
4. Bubnov RV, Spivak MY, Lazarenko LM et al. Probiotics and immunity: provisional role for personalized diets and disease prevention. EPMA J. 2015;6:14.
5. Fukuda S, Toh H, Hase K et al. Bifidobacteria can protect from enteropathogenic infection through production of acetate. Nature. 2011; 469(7331):543-547.
6. AlFaleh K, Anabrees J. Probiotics for prevention of necrotizing enterocolitis in preterm infants. Cochrane Database Syst Rev. 2014;(4):CD005496.
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