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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 [94–98]

  1. aLevel of evidence.
  2. bNecrotising enterocolitis.