Tag Archives: Randomized Controlled Trials

Lactoferrin: Does it decrease late-onset sepsis?

Posted on 24 August 2020 by Keith Barrington

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 →

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When should we start Parenteral Nutrition?

Posted on 21 August 2020 by Keith Barrington

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 →

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How much Intravenous lipid should we start with?

Posted on 20 August 2020 by Keith Barrington

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 →

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How much should we feed babies?

Posted on 19 August 2020 by Keith Barrington

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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ELVIS is alive!

Posted on 17 August 2020 by Keith Barrington

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 →

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Does erythropoietin prophylaxis prevent NEC? Unreliable data.

Posted on 14 August 2020 by Keith Barrington

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?

Posted on 13 August 2020 by Keith Barrington

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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Omega-3 fatty acids, hype, and hope, and disappointment.

Posted on 7 August 2020 by Keith Barrington

Omega-3 fatty acids seem to be important for many functions, and currently many babies, especially preterm babies appear to be deficient compared to babies born at term. There has been much research into these dietary components, and they certainly are … Continue reading →

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Treating seizures in the newborn: phenobarbitone unexpectedly not so bad!

Posted on 28 May 2020 by Keith Barrington

Or perhaps “probably better than the current fashionable alternative” might be a better title. Phenobarbitone (or phenobarbital, I will call it PHE) is one of the oldest anticonvulsants out there, and because of little good data, remains the drug of … Continue reading →

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What to do about early postnatal steroids?

Posted on 3 March 2020 by Keith Barrington

Steroid metabolism in the very immature infant is… immature. Adrenal function is still developing in the fetus between 20 and 26 weeks, and a source of precursors from the placenta is important, but obviously disappears at delivery. Very preterm babies … Continue reading →

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