Category Archives: Neonatal Research

Probiotics: are they cost effective?

Like almost any intervention in the NICU (even maternal breast milk requires pumps and equipment, and kangaroo care requires chairs) there is some cost associated with routine probiotic administration. A new publication attempts to calculate the cost-effectiveness relationship. (Craighead AF, … Continue reading

Posted in Neonatal Research | Tagged , , | Leave a comment

Probiotics, can’t get enough…

All probiotics are not equal. I think it is clear, for example, that the probiotic fungi (Saccharomyces) studied in 2 small trials had no impact on NEC. In addition one of the largest and best trials (PiPS) from the UK … Continue reading

Posted in Neonatal Research | Tagged , , | Leave a comment

Probiotics save the lives of preterm infants. Find a reliable source.

The American Gastroenterological Association has recently published its guidance about probiotics for various conditions. They found little evidence of benefit for most indications with the probable exception of preventing antibiotic-associated diarrhoea. The 8th indication that they reviewed was the prevention … Continue reading

Posted in Neonatal Research | Tagged , , | 3 Comments

Lactoferrin: Does it decrease late-onset sepsis?

The first multicentre trial of bovine lactoferrin supplementation in preterm infants showed a dramatic reduction in late-onset sepsis of about 70%. I was very excited when I first saw Paolo Manzoni’s trial and rushed to set up a pilot in … Continue reading

Posted in Neonatal Research | Tagged , , , | Leave a comment

When should we start Parenteral Nutrition?

Following on from the previous post: This all brings me to a larger and very thorny issue, which is whether we should even be routinely starting parenteral nutrition (PN) immediately after birth at all! I hate to discuss this, as … Continue reading

Posted in Neonatal Research | Tagged , , , | 1 Comment

How much Intravenous lipid should we start with?

Since I started neonatology (just a little over 5 years ago…) we have given intravenous lipid emulsions starting at low doses and progressively increasing. As a reminder to everyone, when intralipid (as I will call it to refer to all … Continue reading

Posted in Neonatal Research | Tagged , , | Leave a comment

How much should we feed babies?

Surely after 60 years of neonatal intensive care, we have figured out what volume of milk to give to small preterm babies? Our local feeding protocol uses a standard of 160 mL/kg/d, which we will increase to 170 mL/kg/d if … Continue reading

Posted in Neonatal Research | Tagged , , | 4 Comments

ELVIS is alive!

I was searching through the lyrics of ELVIS songs for a quote that might be more apt for this new blog post than “It’s now or ever”, which I have used previously, when I realized that I am a loser, … Continue reading

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

Does erythropoietin prophylaxis prevent NEC? Unreliable data.

Routine erythropoietin administration from early life in very preterm babies has been postulated to be neuro-protective. Unfortunately, despite some early promising results, 2 large well-performed RCTs showed no benefit, including the largest with 750 babies under 28 weeks, which showed … Continue reading

Posted in Neonatal Research | Tagged , , , | Leave a comment

When should we transfuse preterm babies, and why?

I was one of the investigators in the PINT trial (Kirpalani H, et al. The Premature Infants in Need of Transfusion (PINT) study: a randomized, controlled trial of a restrictive (low) versus liberal (high) transfusion threshold for extremely low birth … Continue reading

Posted in Neonatal Research | Tagged , , , , | 3 Comments