Author Archives: Keith Barrington

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About Keith Barrington

I am a neonatologist and clinical researcher at Sainte Justine University Health Center in Montréal

Which Probiotic is Preferable?

Posted on 21 November 2023 by Keith Barrington

The word “probiotic” is defined rather vaguely as a micro-organism which has beneficial health impacts. I think it is obvious that there is a huge difference between fungi that are found in the intestinal microbiome of adults, and the lactic … Continue reading →

Posted in Neonatal Research | Tagged , , , , | 2 Comments

Do probiotics only work in bigger babies? What is the risk-benefit of routine probiotics in the extremely preterm?

Posted on 13 November 2023 by Keith Barrington

The recent statement from the AAP and a recent review article both state that probiotics only appear to be effective in babies over 1000g birthweight. This would be remarkable if it were true. I am trying to think of another … Continue reading →

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More thoughts about the “toxicity” of donor milk, a case of Reverse Causation

Posted on 6 November 2023 by Keith Barrington

After my recent post, about the study which suggested that donor milk was killing babies, I have been taking a deeper dive into the article, as I prepare a letter to the editor. Only 2 small subsets of the infants … Continue reading →

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Manipulating the Microbiome

Posted on 2 November 2023 by Keith Barrington

Not with human milk based fortifier, but with probiotics. This post is a sort of intersection between some of my recent posts, human-milk based fortifier does not appear to have a positive effect on the intestinal microbiome. But exogenous probiotics … Continue reading →

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Interesting study, impossible results. Donor breast milk is not toxic.

Posted on 29 October 2023 by Keith Barrington

Is it possible that giving artificial formula to babies will prevent 90% of the deaths of very preterm babies, compared to using donor human milk? (Chehrazi M, et al. Outcomes in very preterm infants receiving an exclusive human milk diet, … Continue reading →

Posted in Neonatal Research | Tagged , , , | 6 Comments

The preterm GI tract is not sterile

Posted on 27 October 2023 by Keith Barrington

The FDA are at it again, they seem to be on a mission to go after suppliers of probiotics for preterm babies, and have now attacked Abbott. They appear to have demanded that they stop marketing their probiotic product, as … Continue reading →

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How to express negative results… or positive ones

Posted on 25 October 2023 by Keith Barrington

After any trial result, there is always a possibility that the true effect of an intervention is different to that shown in the sample who were studied. That is the whole rationale behind using statistics, a trial on a small … Continue reading →

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On which Planet? Reducing platelet transfusions in the newborn.

Posted on 24 October 2023 by Keith Barrington

Recent publications about platelet transfusions in the newborn. Hopefully, everyone has integrated the findings of Planet-2 into their protocols and guidelines. Curley A, et al. Randomized Trial of Platelet-Transfusion Thresholds in Neonates. N Engl J Med. 2019;380(3):242-51. This trial, in … Continue reading →

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Addressing Prognostic Uncertainty

Posted on 23 October 2023 by Keith Barrington

I recently gave a presentation to the Pediatrix consortium which was based on our review article about the approach to take after diagnosis of a serious intracranial haemorrhage (ICH) in the very preterm infant. (Chevallier M, et al. Decision-making for … Continue reading →

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Closing the PDA… or leaving it alone?

Posted on 20 October 2023 by Keith Barrington

Two new publications, in the Journal of Pediatrics, report trends in definitive closure of the PDA. This is a subject that I haven’t written about much on the blog, I wrote about the Beneductus trial last year, which was an … Continue reading →

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