Probiotics improve gastrointestinal structure and function in preterm pigs

Gastrointestinal (GI) diseases, such as necrotizing enterocolitis (NEC) in the preterm infant, are often precipitated by aberrant bacterial colonization. Early manipulation of the GI microbiota in preterm neonates may decrease their susceptibility to GI dysfunction and disease. A pig model was used to determine if probiotic administration during the immediate postnatal period could improve GI structure and function in preterm neonates. Twenty‐eight preterm pigs (93% gestation) were maintained on total perenteral nutrition (TPN) for 36 hrs then enterally fed either sow's colostrum or human milk formula. Pigs were allocated into three groups; colostrum (CLS), formula (FORM), or probiotic + formula (PROB). PROB piglets received orally administered probiotics throughout the TPN and enteral phases. Frequency of NEC‐like pathological lesions in the small intestine (SI) and colon was lowest in the CLS group, intermediate in PROB, and most frequent in the FORM group. Distal SI villus height measurements were increased 42% (P<0.01) for CLS compared to PROB pigs, while PROB pigs showed a 22% increase (P<0.05) compared to FORM pigs. PROB piglets tended to have the deepest crypt depths compared to FORM (P=0.28) and CLS pigs (P=0.05). Relative dry weights of the SI mucosa layer in the PROB and CLS pigs were increased (17‐20%, P<0.05), compared to FORM pigs. Similarly, SI aminopeptidase A and N activities were increased (P < 0.05) for PROB (30%) and CLS pigs (50–60%) compared to FORM pigs. Probiotic administration during early postnatal life improved the structure and function in the compromised GI tract of preterm pigs.