Necrotizing enterocolitis (NEC) is a serious gastrointestinal disease seen predominantly in very low birth weight (VLBW) infants during their hospitalization in a neonatal intensive care unit (NICU). NEC is probably a complex, multifactorial disease associated with immaturity of intestinal function as well as immature systemic and mucosal immune responses, enteric feeding, and microbiologic influences such as abnormal bacterial gas production that produces the pathognomonic radiographic finding of pneumatosis intestinalis.1,2 

Currently, the precise contribution of each of these factors is unknown. Without this understanding, preventive measures have been theoretical and not consistently effective. In this issue of Pediatrics, Lin et al demonstrate that prophylactic administration of a probiotic mixture of Lactobacillusacidophilus and Bifidobacterium infantis given to VLBW infants reduces the incidence of all cases of NEC as well as severe stage III NEC.

An important rationale for the use of probiotics in neonates at...

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