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Nutrients 2018, 10(7), 871;

Para-probiotics for Preterm Neonates—The Next Frontier

Department of Neonatology, Nepean Hospital, Kingswood, NSW 2747, Australia
Sydney Medical School Nepean, University of Sydney, Kingswood, NSW 2747, Australia
Department of Neonatology, King Edward Memorial Hospital for Women, Perth, WA 6008, Australia
Author to whom correspondence should be addressed.
Received: 29 April 2018 / Revised: 28 June 2018 / Accepted: 2 July 2018 / Published: 5 July 2018
(This article belongs to the Special Issue Prebiotics and Probiotics)
Full-Text   |   PDF [218 KB, uploaded 5 July 2018]


Current evidence supports the use of probiotics in preterm neonates for prevention of necrotizing enterocolitis, mortality and late onset sepsis. Despite the strong evidence, the uptake of this intervention has not been universal due to concerns including probiotic sepsis, pro-inflammatory response and transmission of antibiotic resistance. Critically ill extremely preterm neonates with potentially compromised gut integrity are at higher risk of probiotic sepsis due to translocation. In most countries, probiotics are sold as food supplements with poor quality control. The traditional definition of probiotics as “live microorganisms” has been challenged as many experts have questioned the importance of viability in the context of the beneficial effects of probiotics. Paraprobiotics (ghost probiotics), are defined as non-viable microbial cells (intact or broken) or crude cell extracts (i.e., with complex chemical composition), which, when administered (orally or topically) in adequate amounts, confer a benefit on the human or animal consumer. Current evidence indicates that paraprobiotics could be safe alternatives to probiotics in preterm neonates. High-quality pre-clinical and clinical studies including adequately powered randomised controlled trials (RCTs) are warranted in preterm neonates to explore this new frontier. View Full-Text
Keywords: infant; newborn; probiotics; review; sepsis infant; newborn; probiotics; review; sepsis
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Deshpande, G.; Athalye-Jape, G.; Patole, S. Para-probiotics for Preterm Neonates—The Next Frontier. Nutrients 2018, 10, 871.

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