Table 3

Specific recommendations for major clinical decisions

Specific recommendations


Selection of strains

Combination containing Lactobacillus and at least one Bifidobacterium species is preferable. Lactobacillus GG alone may not be effective

I [14]; II [55,56,60]; III-[3,15]


3 × 109 organisms per day, preferably in a single dose

I [14]; II [55,56,60]

When to start?

When the neonate is ready for enteral feeds, preferably within first 7 days of life

I [14]; II [55,56,60]; III [3,15]

How long to continue?

At least until 35 weeks corrected age, or discharge

II [55,56,60]

Supplementation during acute illness

Stopping the supplementation during an acute illness such as sepsis, NECbor perinatal asphyxia may be safe

IV [94-98]

aLevel of evidence.

bNecrotising enterocolitis.

Deshpande et al. BMC Medicine 2011 9:92   doi:10.1186/1741-7015-9-92

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