Our article describing the results of introducing routine probiotic prophylaxis in our NICU has just become available on-line.
Janvier A, Malo J, Barrington KJ: Cohort Study of Probiotics in a North American Neonatal Intensive Care Unit. The Journal of pediatrics 2014. We had about 300 babies in each of the 2 cohorts, all the babies less than 32 weeks who were admitted during the last 17 months before probiotics, and the first 17 months after introducing routine probiotics (the slightly unusual times were because we had 2 months during which the stuff was being introduced where several babies had probiotics started later in their life, such as after an episode of feeding intolerance, we excluded those 2 months). Our unit, that already had the only other evidence-based practices for reducing NEC already in place, that is we had a feeding protocol and we were actively, and successfully, promoting breast feeding (over 90% of the mothers producing breast milk up to one month of age).
We show that after we introduced routine probiotic prophylaxis into our NICU the incidence of NEC decreased by about 50%. There was a very small and non-significant reduction in nosocomial sepsis, no cases of sepsis with probiotic organisms, and a small and non-significant decrease in mortality. I tried to correct for potential differences in risk profile using logistic regression, which confirmed the results.
The preparation we used is readily available in Canada; it is also available in the USA but I have heard that the components are slightly different in the US, as it contains a prebiotic, please confirm this before you consider using it outside of Canada.
Very nice work Annie, Josiane and Keith. I applaud your persistence despite the long way to get the non objection letter from Canada health. These results will encourage other North American NICUs.
Congratulations Dr Barrington. very nice work