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

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

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

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.

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

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The preterm GI tract is not sterile

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

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.

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

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?

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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Artificial Formulae and NEC. It is not necessarily the protein source!

As mentioned several times recently, artificial formula seems to lead to an increase in Necrotising Enterocolitis, compared to donor milk. Of note, the trials in the Cochrane Systematic Review include both those with the entire diet being formula or donor … Continue reading

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Preventing NEC. Does erythropoietin have a role? Unreliable data.

I wrote a similarly titled post 3 years ago, which lamented the poor research practices of a group in Zhengzhou, who seem to perform large RCTs, then register them after completion, and sometimes register them with different primary outcomes to … Continue reading

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