It is difficult to distinguish if the prevention was a result of the probiotic supplementation or if it was a result of the properties of human milk. It is also still unclear if probiotic administration reduces LOS risk in extremely low birth weight infants due to the limited number of studies that investigated it. Out of the 37 studies included in this systematic review, none indicated any safety problems related to the probiotics. It would be beneficial to clarify the relationship between probiotic supplementation and human milk for future studies in order to prevent late onset sepsis in neonates.In a randomized controlled trial of 3,003 very low birth weight (VLBW) infants, Heart Rate Characteristics (HRC) monitoring reduced all-cause mortality by 22%, mortality after infection by 40%, reduced length of stay in the NICU after controlling for improved survival, and reduced mortality as well as mortality-or-severe-cerebral-palsy at 18–22 months corrected age among the extremely low birth weight (ELBW) patients. Neonatal Early-Onset Sepsis Calculator
From 1993 to 2007, doctors at Kaiser Permanente Medical Care Program hospitals, Brigham Womens Hospital, and Beth Israel-Deaconess Medical Center conducted a nested case-control study in an effort to create a better quantitative method for determining risk factors for neonatal early-onset sepsis. The study examined over 600,000 live births of infants born less than or equal to 34 weeks gestation.
The mother is not the only one who can contract the bacteria that contributes to sepsis. The child can contribute to the onset of sepsis through multiple factors. Mothers contribute to the risk through a variety of ways like diets during pregnancy and potential intake of foods that are contaminated, through invasive procedures like amniocentesis and cervical cerclage, or contamination of bacteria in the vaginal canal. Infants can contribute to early-onset sepsis through prematurity, congenital anomalies, complicated birth or instrument assisted birth, and low APGAR scores. Testing for neonatal sepsis is done because of how little it physically presents itself in babies. Infants showing no signs of neonatal sepsis will have a sepsis workup done only if concerning factors are shown. Only a small percentage of infants will have a sepsis workup done. Of this small population only 3% to 8% will show positive cultures. Research
Trials of probiotics for prevention of neonatal sepsis have generally been too small and statistically underpowered to detect any benefit, but a randomized controlled trial that enrolled 4,556 neonates in India reported that probiotics significantly reduced the risk of developing sepsis. The probiotic used in the trial was Lactobacillus plantarum. A very large meta-analysis investigated the effect of probiotics on preventing late-onset sepsis (LOS) in neonates. Probiotics were found to reduce the risk of LOS, but only in babies who were fed human milk exclusively.