PEN® eNews 14(9) September 2024 - What's the latest evidence for your practice?

Are probiotics recommended for the treatment of functional constipation in infants and children?  

The Question

Recommendation

For infants and children (aged six months to 18 years) with functional constipation we suggest: not using probiotics to manage constipation symptoms. not using probiotics as an adjunct to lactulose to manage constipation symptoms. There is insufficient evidence to provide a recommendation regarding the efficacy of probiotics compared to magnesium oxide in children (aged six months to 18 years) with functional constipation. There is insufficient evidence to provide a recommendation for infants aged birth to six months.

Conditional recommendation | Low quality evidence 

To see the full GRADE practice question, including the Evidence Statements, Remarks and References, click here.

Are probiotics effective in the prevention and treatment of necrotizing enterocolitis in preterm or low birth weight infants?  

The Question

Recommendation

There is some evidence that certain probiotic strains may reduce the risk of necrotizing enterocolitis (NEC) in preterm (<37 weeks gestation) and very preterm (<32 weeks gestation), as well as low birth weight (<2500 g) and very low birth weight (<1500 g) infants. Probiotics of the genuses Bifidobacterium, Lactobacillus, Streptococcus or a combination of the above have shown the most promise, while Sacchromyces, Bacillus and combinations including Sacchromyces have not been shown to be effective. These results should be interpreted with caution due to methodological flaws in the evidence base that may overestimate the treatment effect. The effect of probiotics on risk of NEC in extremely preterm (<28 weeks gestation) and extremely low birth weight (<1000 g) infants has been studied in a few trials, which found no clear effect. More research is necessary to elucidate this effect. There are safety concerns with the administration of probiotics to very preterm or very low birth weight infants, as they have reportedly caused bacteraemia or fungaemia in some instances. Differences in safety between probiotic genuses or strains have not been elucidated.

Grade of Evidence C 

To see the full practice question, including the Evidence Statements, Remarks and References, click here.

PEN^® Team Surprising Findings 

Jane is the PEN Resource Manager. Her work focuses on the related tools and resources within the PEN Knowledge Pathways (KPs). There are two main categories – one for nutritional professionals to learn more detailed information within a topic area to help them be evidence-informed in their practice, and the other providing resources that are provided to clients to support a counselling/education session.

Hematology/Haematology - Anemia/Anaemia: Sickle Cell Disease Summary of Recommendations and Evidence (SRE)  

September is International Sickle Cell Awareness Month. Take 10 minutes to boost your knowledge about the nutritional considerations for individuals with Sickle Cell Disease in PEN's Summary of Recommendations and Evidence.

Are you looking for a new way to apply your nutrition practice knowledge? 

Become a PEN System Contributor - it’s good for the PEN System and good for you, too!

As a reviewer, you will:

• Contribute to advancing evidence-based nutrition practice by helping nutrition practitioners access timely, current and authoritative guidance on food and nutrition practice.

• Become aware of the most up-to-date research and evidence-informed recommendations before the content is published on the PEN System. 

• Support your professional portfolio by demonstrating your knowledge of the field or critical appraisal skills. Reviewers are acknowledged on published content and can download a Letter of Contribution summarizing their contributions.

Opportunities are available to contribute as a Topic Advisor for Knowledge Pathways and Content Reviewer for PEN Backgrounds, Practice Questions and (Canadian) Client Handouts. Learn more about our current opportunities to get involved here! You can also visit our FAQ page or reach out with additional questions to coordinator@dietitians.ca