The aim of this study is to determine the effect of oral probiotics in prevention of necrotizing enterocolitis in premature neonates. This study is a double blind randomized controlled trial. Fifty premature neonates with gestational age of less than 36 weeks and birth weight of 1000-2500 gr who need NICU care will enroll in the study. Neonates with gasterointestinal obstruction, congenital heart diseases, omphalocele, gasterochesia, asphyxia (grades II or III) and maternal addiction will be excluded from the study. Neonates will be randomly allocated in two groups: Treatment and placebo. The treatment group, when milk volume reaches to 5 cc/kg/day, will receive 1 drop/kg of oral probiotic (diluted to 0.5 ml with normal saline) each 12 hours. The placebo group will receive 0.5 ml normal saline each 12 hours.
The drug and placebo which are prepared in similar syringes will be administered by a nurse, trained before the study.
NEC and its severity will be diagnosed according to the following criteria: Stage I(suspected NEC): apnea, lethargy, hematochezia, abdominal distention, temperature instability, gastric retention, without radiographic findings.
Stage II (documented NEC): signs of stage I plus thrombocytopenia with or without mild metabolic acidosis, abdominal tenderness, pneumatosis or gas in portal vein.
Stage III (advanced NEC): signs of stage II plus hypotension, bradycardia, severe apnea, respiratory and metabolic acidosis, DIC, abdominal tenderness, neutropenia, pneumoperitonitis.
After data collection, necrotizing enterocolitis, time to full enteral feeding and duration of hospitalization were compared between two groups .