Tag Archives: Necrotising Enterocolitis

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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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

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Do Probiotics work in the UK?

Seems like a dumb question I know, if they work in one country, surely they should work everywhere? It is sometimes difficult, however, to institute change based on studies that are done elsewhere, usually because there is an idea, or … Continue reading

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Donor human milk for congenital heart disease?

Newborns with serious Congenital Heart Disease are at risk of intestinal injury which may present in a similar fashion to Necrotising Enterocolitis (NEC). Our local guidelines for eligibility for donor milk from our provincial milk bank include infants with significant … Continue reading

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How fast to feed?

One of the recurring themes in this blog is that good, large enough, prospective RCTs do not necessarily reproduce the results of prior smaller trials, and often do not reproduce the findings of observational studies. Specifically, I have mentioned previously … Continue reading

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