Tag Archives: Necrotising Enterocolitis

Intestinal perforation in the very preterm, what causes it, and what to do about it.

There are 2 main causes of intestinal perforation in the very preterm, Necrotising Enterocolitis and Spontaneous Perforation. NEC, as I have previously discussed, may be a convenient name for a few different conditions which present in a similar fashion. In … Continue reading

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Opioid infusions for ventilated preterm babies

Many practices in neonatology are variable between NICUs, and many vary from year to year; without any good scientific data practices become fashionable or routine or ingrained without necessarily having an evidence base to support them. One such practice is … Continue reading

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More about Prebiotics

I don’t know if there is an “official” definition of prebiotics, but I think of them as molecules present in the diet that promote the growth of probiotic organisms. I believe that originally the term was applied only to molecules … Continue reading

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Probiotics and NEC, the latest answer?

The updated Cochrane review of probiotics for prevention of NEC, sepsis and mortality has been published. Meta-analysis showed that probiotics may reduce the risk of NEC: RR 0.54, 95% CI 0.45 to 0.65 (54 trials, 10,604 infants; I2 = 17%); … Continue reading

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Breast milk fortifiers, a new systematic review

A systematic review has just been published which compares the outcomes of milk fortification with bovine-milk derived fortifier and human-milk derived fortifier. (Grace E, et al. Safety and efficacy of human milk-based fortifier in enterally fed preterm and/or low birthweight … Continue reading

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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

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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

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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

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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

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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

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