Feature Articles: Continuing EducationUnderstanding the Biologic Therapies of Probiotics, Prebiotics, and Synbiotics Exploring Current Evidence for Use in Premature Infants for the Prevention of Necrotizing EnterocolitisAsmerom, Mussie BSN, RN; Crowe, Lindsay BSN, RN; Marin, Terri PhD, NNP-BCAuthor Information Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia (Mr Asmerom and Ms Crowe and Dr Marin); and Department of Pediatrics, Division of Neonatology, Emory University School of Medicine, Atlanta, Georgia (Dr Marin). Corresponding Author: Mussie Asmerom, BSN, RN, Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, GA 30322 (Mussie.Asmerom@emory.edu). Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Submitted for publication: September 5, 2014; accepted for publication: May 16, 2015. The Journal of Perinatal & Neonatal Nursing: July/September 2015 - Volume 29 - Issue 3 - p 240-247 doi: 10.1097/JPN.0000000000000120 Buy Take the CE Test Metrics Abstract Necrotizing enterocolitis remains a significant cause of morbidity and mortality in very low-birth-weight infants (<1500 g), with current preventive strategies unclear. Scientific evidence has recently emerged, suggesting that probiotics, prebiotics, and synbiotics may effectively and safely alter the premature intestinal microbiota, enhancing a deficient innate immune response and maturing the intestinal barrier to prevent necrotizing enterocolitis development. Currently, formal recommendations do not support routine use of these dietary supplementations for premature infants. Here, we examine how probiotic, prebiotic, and synbiotic preparations physiologically alter the underdeveloped intestinal microbial environment to potentially reduce necrotizing enterocolitis incidence and discuss current evidence that has examined safety and efficacy factors potentially supporting routine use among the premature infant population. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.