Main Article Content

Dayanara Geovanna Aldaz Álvarez
Dra. Diana Elizabeth Quizhpi Paredes
Anita Gabriela Jara Velez


Necrotizing enterocolitis, preterm neonates, Biotics, probiotics, prebiotics, Prophylactic treatment


Necrotizing enterocolitis in premature neonates is a disease that involves inflammation of the intestinal tissue, which leads to perforation of the intestinal wall or necrosis in the mucosa of the digestive tract. This pathological condition prevents the premature infant's body from retaining waste material, so bacteria and other pathogens can enter the bloodstream and cause life-threatening
Objective: to systematize the suitable scientific evidence on the use of biotics as prophylaxis of Necrotizing Enterocolitis in preterm neonates.
Methodology: This study is a bibliographic review approached under a descriptive - explanatory design and with a qualitative approach, considering the following sources of information: Science Direct, PubMed, Scopus, Lilacs, Cochrane, Redalyc, SciELO and Proquest.
Results: Between strategies to consider to prevent the appearance of necrotizing enterocolitis in preterm neonates is to achieve a functional balance of the microbiotics or intestinal flora. This situation is possible thanks to the administration of probiotics, which are responsible for producing a beneficial effect on the host, and prebiotics, which have the ability to induce the growth of beneficial
Conclusions: Lactobacillus and Bifidobacterium are the probiotics with the greatest benefit and encouraging results in the prevention and control of severe necrotizing enterocolitis in preterm neonates; while galactooligosaccharides, fructooligosaccharides and oligosaccharides are the prebiotics found naturally in breast milk and contribute to this end.

Abstract 347 | Pdf Downloads 182


1. World Health Organization [WHO]. Premature babies: stories of six mothers [Internet]. Publications. 2019 [cited 2023 Apr 16]. Available from: https://www 3.paho .org/hq/index.php?option=com_content&view=article&id=15581:by-a-appropriate-attention-in-the-just-time-and-in-the-right-place&Itemid=0&
2. Galvin M. If Your Baby Is Born Premature [Internet]. KidsHealth. 2021 [cited 2023 Apr 16]. Available from:
3. Rodrigues A, Coeli B, Barreto V, Rodrigues A, Vasconcelos E, Rodrigues A. Profile of at-risk infants related to thermoregulation in a Neonatal Intensive Care Unit. Nursing Glob [Internet]. 2021 Feb 5;20(1):59–97. Available from:
4. Ota A. Neonatal management of prematurity: advances in Peru. Rev Peru Ginecol and Obstet [Internet]. 2018 Sep;64(3):415–22. Available from: http://www.scielo ?script=sci_arttext&pid=S2304-51322018000300015
5. Chávez T, Byard D, Amaya C. Late preterm infant: incidence and early neonatal morbidity. Arch Venez Pueric Pediatr [Internet]. 2019;72(2):59–67. Available from: http://www.redalyc .org/articulo.oa?id=367937038005
6. Geronimo N. Preterm birth since live birth records in Colombia, period 2008 – 2017. Rev Médica Risaralda [Internet]. 2020 Dec;26(2). Available from: co/scielo. php?pid=S0122-06672020000200138&scrypt=sci_abstract &tlng=en
7. Economic Commission for Latin America [ECLAC]. Population notes [Internet]. Premature births. 2021 [cited 2023 Apr 16]. p. 11–37. Available from: /es/publicaciones/41954-notas-poblacion-vol-44-ndeg-104
8. World Health Organization [WHO]. 17 November, Prematurity Day: providing care is a right - PAHO/WHO | Pan American Health Organization [Internet]. News. 2020 [cited 2023 Apr 16]. p. 3. Available from: -brindar-atencion-cuidado-es-derecho
9. Hachi H, Chichande R, Montjoy W, Jaramillo M, Baños K. Necrotizing enterocolitis. Gastrointestinal emergency of the newborn. Rev Pertinencea Academic [Internet]. 2022;6(2):1–12. Available from:
10. González P, Escudero S, Gutiérrez F, González A. Use of probiotics in the prevention of necrotizing enterocolitis. Rev Electronic Pediatrics [Internet]. 2021;28(3):29–35. Available from: PROBIOTICS PREVE- NTION NECROTIZING ENTEROCOLITIS.pdf
11. Bernuy S, Loor N, Ruíz G, Cevallos D. Clinical characterization and morbimpostsurgical ortholity of the NB with necrotizing enterocolitis. Rev J Am Heal [Internet]. 2021;4(2):34–44. Available from:
12. Bonilla E, Ramírez L, Rojas P, Zuñiga B. Necrotizing enterocolitis. Rev Med Leg Costa Rica [Internet]. 2020;37(2):63–70. Available from: https://www.scielo. script=sci_ arttext&pid=S1409-00152020000200063
13. Adams M, Bassler D, Darlow BA, Lui K, Reichman B, Hakansson S, et al. Preventive strategies and factors associated with surgically treated necrotising enterocolitis in extremely preterm infants: an international unit survey linked with retrospective cohort data analysis. BMJ Open [Internet]. 2019 Oct 14;9(10):e031086. Available from: https://bmjopen.bmj. com/lookup/do i/10.1136/bmjopen-2019-031086
14. Denning N, Prince J. Neonatal intestinal dysbiosis in necrotizing enterocolitis. Mol Med [Internet]. 2018 ofC 15;24(1):4. Available from: https://molmed.biomedcentral .com/articles /10.1186/s10020-018-0002-0
15. Rodríguez A, Golombek S, Siben S. Necrotizing enterocolitis in the Ibero-American network: incidence, timing of presentation and mortality [Internet]. Presentación of posters. 2020 [cited 2023 Apr 16]. p. 1–10. Available from: https://www.siben. net/images/htmleditor /files/pantalla_c.pdf
16. Sandoval A, Cofré F, Hernández M, Izquierdo G, Labraña Y, Reyes A, et al. Clinical-epidemiological characterization of neonatal necrotizing enterocolitis from seven public hospitals. Rev Chil infectology [Internet]. 2020 Dec;37(6):667–74. Available from:
17. Martinez D, Jaimes M, Vargas F, Chaparro D, Manrique E. Necrotizing enterocolitis: sociodemographic, clinical and histopathological neonatal findings in a series of neonatal autopsies. Rev la Fac Ciencias la Salud [Internet]. 2020;23(1):35–42. Available from:
18. National Institute of Statistics and Censuses [INEC]. Statistical Compendium [Internet]. 2018 [cited 2023 Apr 16]. Available from:
19. Lapo N, Vasquez F. Necrotizing enterocolitis [Internet]. Presentation of two clinical cases. 2018 [cited 2023 Apr 16]. Available from:
20. Ministry of Public Health of Ecuador [MSP]. Deaths and mortality profile of the National Health System [Internet]. Facts and figures. 2018 [cited 2023 Apr 16]. Available from:!/vizhome/defunciones2016/Histori a1?publish=yes.
21. Escalona P. Enterocolitis Necrotisante. Rev Médica Sinerg [Internet]. 2018;3(4):3–8. Available from:
22. Zozaya C, Avila A, Somoza I, García F, Encinas J. Prevention, diagnosis and treatment of necrotizing enterocolitisand in newborns less than 32 weeks at birth in Spain. Rev An Pediatrics [Internet]. 2020;93(3):161–9. Available from:
23. Casal B, García M, Novoa A, Somoza A, Dargallo T. Appendicitis as a cause of acute abdomen in neonatal stage. About a case. An Sist Sanit Navar [Internet]. 2018 Aug 29;41(2):249–53. Available from:
24. Demestre G, Raspall T. Necrotizing enterocolitis [Internet]. Spanish Association of Pediatrics. 2019 [cited 2023 Apr 16]. p. 405–11. Available from: /sites/ default/files/documentos/42.pdf
25. Cochran W. Enteroconecrotizing litis [Internet]. Gastrointestinal and liver problems newborn. 2021 [cited 2023 Apr 16]. Available from:áticos-en-recién-nacidos/enterocolitis-necrotizante-ecn
26. Murphy K, Ross P, Ryan A, Dempsey E, Stanton C. Probiotics, Prebiotics, and Synbiotics for the Prevention of Necrotizing Enterocolitis. Front Nutr [Internet]. 2021 Sep 7;8( 12):23–31. Available from:
27. World Health Organization [WHO]. Preterm Birth [Internet]. Facts and figures. 2022 [cited 2023 Apr 16]. Available from: alls countries%2C the,18%25 of births.
28. Hakan O, Demirezen S, Demir M. Necrotizing enterocolitis: retrospective analysis of 1428 preterm infants in a level III neonatal intensive care unit over a period of four toYears. Arch Argent Pediatr [Internet]. 2020 Dec 1;118(6):405–10. Available from: ar/docs/publicaciones/archivosarg/2020/v118n6a09.pdf
29. Sharif S, Meader N, Oddie S, Rojas M, McGuire W. Probiotics to prevent necrotising enterocolitis in very preterm or very low birth weight infants. Cochrane Database Syst Rev [Internet]. 2020 Oct 15;2020(10). Available from: 1002/14651858. CD005496.pub5
30. National Institute of Health [NIH]. Probiotics [Internet]. Dietary Supplement Fact Sheets. 2020 [cited 2023 Apr 16]. Available from: Espanol/
31. Álvarez G, Guarner F, Requena T, Marcos A. Diet and microbiota. Impact on health. Nutr Hosp [Internet]. 2018 Sep 7;35(6). Available from: index. php/nh/article/view/2280
32. Suárez M, Solís G. Probiotics and necrotizing enterocolitis: where are we in 2021? Rev Evidencias en Pediatría [Internet]. 2021;17(3). Available from: https:// evidenciasenpediatria. es/articulo/7889/probioticos-y-enterocolitis-necrotizante-donde-estamos-en-2021
33. Gutiérrez C, Bustos L, Caniulao K, Taito K, Gallegos Y. Probiotic intervention for the prevention of necrotizing enterocolitis in extreme preterm infants less than 1500 grams or 32 weeks. Arch Argent Pediatr [Internet]. 2021 Jun 1;119(3):185–91. Available from: https:// www.
34. Tamayo M, Arango M, Tamayo C. Pathophysiology and risk factors for the development of necrotizing enterocolitis in neonates smaller than 1,500 g. Rev Iatreia [Internet]. 2019;19(4):108–17. Available from: 006000400003
35. Dirnberger D. Necrotizing enterocolitis [Internet]. Nemours Kids Health. 2021. Available from:
36. Pantoja S, Chamorro M. Scoliosis in children and adolescents. Rev Médica Clínica Las Condes [Internet]. 2019 Jan;26(1):99–108. Available from: https://linkinghub. pii/S0716864015000164
37. Bracho E, Torrecilla M, Zalles C, Ibarra D, Fernández E, Dávila R. Prognostic factors for mortality in neonates with necrotizing enterocolitis. Cir Cir [Internet]. 2019 Jul;83(4):286–91. Available from:
38. Guzmán J, Cabañas M, Ruíz D. Prevention of necrotizing enterocolitis in the newborn. Rev An Pediatrics Contin [Internet]. 2020;10(5):295–7. Available from:
39. Martinez D, Sanabria J, Jiménez F, Chaparro D, Manrique E. Necrotizing enterocolitis: sociodemographic, clinical and histopathological findings in a series of neonatal autopsies. MedUNAB [Internet]. 2020 Mar 31;23(1):35–42. Available from: https://revistas. index.php/medunab/article/view/3682
40. Bracho E, Torrecilla M, Zalles C, Ibarra D, Fernández E, Dávila R. Prognostic factors for mortality in neonates with necrotizing enterocolitis. Cir Cir [Internet]. 2020 Jul;83(4):286–91. Available from:
41. Rodriguez M, Saavedra N. Intestinal microbiota and modulation of adipose tissue in the pathogenesis of obesity. Rev Arch Latinoam Nutr [Internet]. 2022;72(2):100–8. Available from:
42. Merino J, Taracena S, Díaz E, Rodríguez F. Intestinal microbiota: "the forgotten organ." Acta médica Grup Ángeles [Internet]. 2021;19(1). Available from: mx/ scielo.php?pid=S1870-72032021000100092&script=sci_arttext
43. Castañeda C. Intestinal microbiota and mental behavior disorders. Rev Cubana Pediatr [Internet]. 2020;92(2):106–15. Available from: scielo.php?script=sci_ arttext&pid= S0034-75312020000200016
44. Perez S. Resources Biotic resources in the care of the disease. Rev científica Investig Reg [Internet]. 2019;39(1):33–54. Available from: https://pesquisa. resource/ pt/biblio-947721
45. González J, Muñoz M. ProbióTicos and necrotizing enterocolitis of prematurity; to NEC or not to NEC?, this is the question. Rev Nutr Hosp [Internet]. 2019;28(6):2115–23. Available from:
46. Barclay A, Stenson B, Simpson J, Weaver L, Wilson D. Probiotics for necrotizing enterocolitis: a systematic review. Pediatr Gastroenterol Nutr [Internet]. 2019;8( 45):569–75. Available from:
47. Szajewska H, Guandalini S, Morelli L, Van Goudoever J, Walker A. Effect of Bifidobacterium animalis subsp lactis supplementation in preterm infants: a systematic review of randomized controlled trials. Rev Pediatr Gastroenterol Nutr [Internet]. 2020;8( 51):203–9. Available from:
48. Rappaccioli R, Zaror V, Herrera S. Probiotics: challenges, review and scope. Rev Medica Sinerg [Internet]. 2021 Jun 1;6(6):e686. Available from: https://revistamedicasinergia. com/index.php/ rms/article/view/686
49. Castro C, Díaz C, Gutiérrez C. Probiotics and prebiotics in plant-based matrices: Advances in the development of fruit beverages. Rev Chil Nutr [internet]. 2019;44(4):383–92. Available from:
50. Sharif S, Meader N, Oddie S, Rojas M. Probiotics for preventing necrotizing enterocolitis in Very premature or very low birth weight infants. Cochrane Database Syst Rev [Internet]. 2020;10(8). Available from:
51. Escáratea C, Gutiérrez M, Bustos L, Caniulao K, Taito C, Gallegos Y, et al. Probiotic intervention for the prevention of necrotizing enterocolitis in extreme preterm infants less than 1500 grams or 32 weeks. Rev Arch Argent Pediatr [Internet]. 2021;119(3):185–91. Available from:
52. Rojas M, Lozano J, Rojas M, Rodriguez V, Rondon M. Prophylactic probiotics to prevent death and nosocomial infection in preterm infants. Rev Pediatr. 2020;130(5):113–20.
53. Flavia M, Riezzo G, Raimondi F, Bisceglia M, Cavallo L, Francavilla R. The Effects of Probiotics on Feeding Tolerance, Bowel Habits, and Gastrointestinal Motility in Preterm Newborns. J Pediatric. 2019;152(6):801–6.
54. James B, Mercadal M, Tenesor A, Figueras J. Probiotic associations for the prevention of necrotizing enterocolitis and the reduction of late sepsis and neonatal mortality in preterm newborns of less than 1,500g: a rsystematic vision. Rev An Pediatrics [Internet]. 2020;85(5):247–55. Available from:
55. Chi C, Li C, Buys N, Wang W, Yin C, Sun J. Effects of Probiotics in Preterm Infants: A Network Meta-analysis. Rev Pediatr. 2021;174(1).
56. Duffield S, Clarke P. Current use of probiotics to prevent necrotising enterocolitis. Arch Dis Child - Fetal Neonatal Ed [Internet]. 2019 Mar;104(2):F228–F228. Available from:
57. Nolan LS, Rimer J, Good M. The Role of Human Milk Oligosaccharides and Probiotics on the Neonatal Microbiome and Risk of Necrotizing Enterocolitis: A Narrative Review. Nutrients [Internet]. 2020 Oct 6;12(10):3052. Available from: 2/10/3052