More than 10,000 preterm infants have participated in randomised controlled trials on probiotics worldwide, suggesting that probiotics in general could reduce rates of necrotising enterocolitis (NEC), sepsis, and mortality. Answers to relevant clinical questions as to which strain to use, at what dosage, and how long to supplement are, however, not available. On the other hand, an increasing number of commercial products containing probiotics are available from sometimes suboptimal quality. Also, a large number of units around the world are routinely offering probiotic supplementation as the standard of care despite lacking solid evidence. Our recent network meta-analysis identified probiotic strains with greatest efficacy regarding relevant clinical outcomes for preterm neonates. Efficacy in reducing mortality and morbidity was found for only a minority of the studied strains or combinations. In the present position paper, we aim to provide advice, which specific strains might potentially be used and which strains should not be used. In addition, we aim to address safety issues of probiotic supplementation to preterm infants, who have reduced immunological capacities and occasional indwelling catheters. For example, quality reassurance of the probiotic product is essential, probiotic strains should be devoid of transferable antibiotic resistance genes, and local microbiologists should be able to routinely detect probiotic sepsis. Provided all safety issues are met, there is currently a conditional recommendation (with low certainty of evidence) to provide either Lactobacillus rhamnosus GG ATCC53103 or the combination of Bifidobacterium infantis Bb-02, Bifidobacterium lactis Bb-12, and Streptococcus thermophilus TH-4 in order to reduce NEC rates.

• MeSH
• dítě MeSH
• gastroenterologie * MeSH
• kojenec MeSH
• lidé MeSH
• nekrotizující enterokolitida * epidemiologie   prevence a kontrola   MeSH
• novorozenec nedonošený MeSH
• novorozenec MeSH
• prebiotika MeSH
• probiotika * MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• energetický příjem MeSH
• fyziologie výživy kojenců MeSH
• gastroenterologie * MeSH
• kojenec MeSH
• konzumní sacharóza aplikace a dávkování   MeSH
• lidé MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• komentáře MeSH

The consumption of sugars, particularly sugar-sweetened beverages (SSBs; beverages or drinks that contain added caloric sweeteners (ie, sucrose, high-fructose corn syrup, fruit juice concentrates), in European children and adolescents exceeds current recommendations. This is of concern because there is no nutritional requirement for free sugars, and infants have an innate preference for sweet taste, which may be modified and reinforced by pre- and postnatal exposures. Sugar-containing beverages/free sugars increase the risk for overweight/obesity and dental caries, can result in poor nutrient supply and reduced dietary diversity, and may be associated with increased risk of type 2 diabetes mellitus, cardiovascular risk, and other health effects. The term "free sugars," includes all monosaccharides/disaccharides added to foods/beverages by the manufacturer/cook/consumer, plus sugars naturally present in honey/syrups/unsweetened fruit juices and fruit juice concentrates. Sugar naturally present in intact fruits and lactose in amounts naturally present in human milk or infant formula, cow/goat milk, and unsweetened milk products is not free sugar. Intake of free sugars should be reduced and minimised with a desirable goal of <5% energy intake in children and adolescents aged ≥2 to 18 years. Intake should probably be even lower in infants and toddlers <2 years. Healthy approaches to beverage and dietary consumption should be established in infancy, with the aim of preventing negative health effects in later childhood and adulthood. Sugar should preferably be consumed as part of a main meal and in a natural form as human milk, milk, unsweetened dairy products, and fresh fruits, rather than as SSBs, fruit juices, smoothies, and/or sweetened milk products. Free sugars in liquid form should be replaced by water or unsweetened milk drinks. National Authorities should adopt policies aimed at reducing the intake of free sugars in infants, children and adolescents. This may include education, improved labelling, restriction of advertising, introducing standards for kindergarten and school meals, and fiscal measures, depending on local circumstances.

• MeSH
• diabetes mellitus 2. typu prevence a kontrola   MeSH
• dítě MeSH
• energetický příjem * MeSH
• kardiovaskulární nemoci prevence a kontrola   MeSH
• kojenec MeSH
• konsensus MeSH
• konzumní sacharóza aplikace a dávkování   škodlivé účinky   klasifikace   MeSH
• lidé MeSH
• mladiství MeSH
• nápoje škodlivé účinky   analýza   MeSH
• obezita dětí a dospívajících prevence a kontrola   MeSH
• označování potravin normy   MeSH
• potraviny škodlivé účinky   MeSH
• předškolní dítě MeSH
• společnosti lékařské MeSH
• výživové doporučené dávky * MeSH
• zubní kaz prevence a kontrola   MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Evropa MeSH

• MeSH
• dítě MeSH
• enterální výživa * statistika a číselné údaje   MeSH
• fyziologie výživy kojenců MeSH
• jednotky intenzivní péče o novorozence využití   MeSH
• kojenec MeSH
• lidé MeSH
• novorozenec nedonošený * fyziologie   růst a vývoj   MeSH
• novorozenec MeSH
• sběr dat MeSH
• statistika jako téma MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• Geografické názvy
• Austrálie MeSH
• Dánsko MeSH
• Irsko MeSH
• Kanada MeSH
• Norsko MeSH
• Nový Zéland MeSH
• Spojené království MeSH
• Švédsko MeSH