Gabriela Agnieszka Marcinkiewicz, Ewelina Lubieniecka‑Archutowska, Wioletta Kaliszan, Robert Kowalski

The impact of parenteral nutrition on the state of the intestinal microbiota in newborns

 

 

2026-06-01

Breastfeeding is considered a key factor in supporting proper microbial colonization and immune maturation during the neonatal period, as reflected in the recommendations of the World Health Organization (WHO) and European guidelines on promoting breastfeeding. The development of the newborn’s gut microbiota is a dynamic process dependent on prenatal, perinatal, and postnatal factors. Oral intake of breast milk is not always possible; therefore, parenteral nutrition constitutes one of the essential therapeutic interventions used in newborns. It involves the intravenous administration of a mixture of nutrients, bypassing the gastrointestinal tract. It is implemented in situations where enteral nutrition is impossible or insufficient. It takes the form of a liquid mixture containing nutrients essential for proper growth and maintenance of homeostasis. The main components include carbohydrates, lipids, amino acids, vitamins, trace elements, electrolytes, and water. Depending on the proportions, parenteral nutrition preparations may have high osmolarity. The selection of the nutritional formula and the rate of administration require monitoring of metabolic parameters and fluid balance. Parenteral nutrition is initiated in specific clinical cases, and the composition of the formula should be tailored to the patient’s condition. Parenteral nutrition prevents malnutrition and accelerates wound healing and regeneration. It plays an important role in the neonatal ward. In the first days of a newborn’s life, it influences, among other things, proper neurological development. However, prolonged restriction of enteral feeding is associated with changes in the composition of the gut microbiota. Stimulation of the mucosa decreases, which contributes to a weakened intestinal barrier and immune dysfunction. Consequently, there is a decrease in the diversity of gut bacteria and the development of dysbiosis. The quantitative balance of individual bacterial strains and gastrointestinal motility is disrupted. There is a noticeable increased risk of infection due to pathogens’ easier access to the intestinal epithelium. The process of normal gut colonization is altered, and the development of the microbiome is delayed. Currently, carefully selected strains of probiotic bacteria are used to support the maturation of the gastrointestinal tract during parenteral nutrition therapy. This helps reduce adverse effects while ensuring optimal therapy.

Keywords: parenteral nutrition, gut microbiota, breastfeeding, neonatal patients, probiotics.

© Farm Pol, 2025, 81(11): 679–688