Discussion
pneumonia, well-nourished, diarrhea, infections, weight gain, height gain, upper gastrointestinal system, sepsis, breast milk
VITAMIN DEFICIENCIES, PNEUMONIA, INFECTIONS, MALNOURISHED, MALNUTRITION, SEPSIS
There is paucity of studies assessing the impact of probiotic and synbiotic supplementation on rate of weight gain among young malnourished infants. In this respect, this is the first randomized clinical trial on probiotic and synbiotic supplementation in young infants with severe acute malnutrition. The most important finding of this study was that the infants supplemented with The mean rate of weight gain for SAM infants (discharge from hospital to study completion) was 4.35 g/kg/day in placebo arm, 5.90 g/kg/day in probiotic arm and 4.77 g/kg/day in synbiotic arm, with the rate for the probiotic arm being graded as moderate by WHOMore complex HMOs, LNT, and LNnT core can comprise up to 70% of total HMOsFollow-up after discharge from NRU can help to assess the growth and development of children. Previous studies have highlighted the mortality outcome after discharge from facility-based management of SAMThe importance of the gut microbiome in child growth has been well recognized in previous studies. Some probiotics may help to improve child growth indirectly through the prevention of infections and micronutrient and vitamin deficiencies (e.g., calcium, zinc and vitamin B12)The effect of a four-probiotic supplement (Synbiotic 2000 Forte) comprising The benefit of dietary intake of probiotics mixed with infant formula in terms of weight and height gain in malnourished children and possible benefits in terms of weight gain in well-nourished children in developing countries has been reviewedDietary carbohydrates, especially the fibre that is not digested in the upper gastrointestinal system, are known to boost growth and functionality of the gut microbiota communityWe have observed that probiotic supplements comprising A systematic review has shown the effect of different probiotics in different studiesWe have observed that approximately 15% of the study infants with SAM (n = 9) became sick and were shifted to the longer stay ward while on supplementation in NRU and then treated accordingly. When they became well and were discharged from hospital they continued with the study supplements at home. The reasons of transfer from the NRU were pneumonia (6 cases), diarrhea (2 cases) and sepsis (1 case). These infections were thought to be hospital acquired and the rate was similar to a previous study conducted in same settingOne limitation of the study was that the infants were only followed for a period of 8 weeks so longer term outcome effects of the supplements are unknown. We had no record on the volume of breast milk or infant formula during follow up period. We could not control the use of antibiotics during follow up period in the community as they may have visited local physicians or pharmaciess without informing the study staff. Although our research assistants collected data twice a week from SAM infants the actual intake of feed was not meticulously measured and we had to rely on the mothers’ information on diet and supplemetation. Daily visit of field staffs could minize these undue activities of caregivers. Finally, some of the infants started complementary feeding after 6 months and such feeding data were not included in the analysis.The findings from the study support the possibility of establishing a moderate weight gain in infants hospitalized with SAM by using a probiotic supplementation protocol comprising 