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Table 3 Specific recommendations for major clinical decisions

From: Evidence-based guidelines for use of probiotics in preterm neonates

Specific recommendations LOEa[reference]
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]
Dose 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 [9498]
  1. aLevel of evidence.
  2. bNecrotising enterocolitis.