Based on the available research, let me break down what the evidence shows regarding Lactobacillus rhamnosus GG and serious complications like sepsis in premature infants.

What the Evidence Shows

Lactobacillus rhamnosus GG is one of the most studied probiotic strains in the context of preterm infant care. According to the Pillser research database, here are the relevant findings:

For Sepsis and Serious Complications

• Reduced Mortality Risk: 2 studies recorded, both finding neutral results — meaning no significant reduction in mortality was observed with this specific strain¹.
• Reduced Inflammation: 2 studies showing beneficial effects, suggesting L. rhamnosus GG may help reduce systemic inflammation, which is relevant to sepsis prevention¹.
• Reduced Intestinal Inflammation: 2 studies, both showing beneficial effects¹.

Other Relevant Outcomes

• Reduced Time to Achieve Full Feeds: 2 studies, both neutral¹.
• Reduced Duration of Diarrhea: Mixed evidence, with some benefit at high doses (≥10¹⁰ CFU/day)¹.

Summary

The evidence for Lactobacillus rhamnosus GG specifically preventing sepsis in preterm infants is not conclusive. While it shows promise in reducing inflammation (both systemic and intestinal), the two studies on mortality risk found neutral effects. It's worth noting that broader meta-analyses of multi-strain probiotics in preterm infants have shown more robust reductions in necrotizing enterocolitis (NEC) and late-onset sepsis, but this specific strain alone has more limited evidence for preventing sepsis directly.

Important: The use of probiotics in preterm infants should only be done under strict medical supervision in a neonatal intensive care unit (NICU) setting, as these infants are extremely vulnerable and there are rare but serious safety considerations (e.g., probiotic sepsis in extremely low birth weight infants).

Footnotes

1. Pillser research database, Lactobacillus rhamnosus GG. ↩ ↩² ↩³ ↩⁴ ↩⁵