Remarks

• The recommendation is conditional on shared decision-making with parents; this includes informing parents about the benefits and risks and the need for further research.
• The GDG noted that there are many infant probiotic formulations available in the public domain that have variable quality control and formulation (127,128).
• The GDG considered that only probiotics especially formulated for preterm or LBW infants that meet regulatory standards should be used, and clear instructions for safe use should be given to health workers.
• The GDG did not make a recommendation for infants born after 32 weeks’ gestation because the data were insufficient.
• Only five trials (254 participants) included infants fed formula as the sole diet, so the GDG did not make a recommendation for these infants.
• The GDG was not able to make a recommendation on type (i.e. genera, species or strain), formulation (e.g. powder or drops), dose, timing or duration of probiotic administration as there was insufficient evidence. The GDG considered that type, formulation, dose, timing and duration should be based on clinical judgement.