Tag Archives: Randomized Controlled Trials

Umbilical cord management at birth for preterm infants

Posted on 24 November 2023 by Keith Barrington

The Lancet just published back-to-back articles from the iCOMP collaborative reporting the results of the Individual Patient Data Meta-analysis of trials of differing cord management techniques in preterm infants. There were 48 trials with a total of 7000 patients in … Continue reading →

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Which Probiotic is Preferable?

Posted on 21 November 2023 by Keith Barrington

The word “probiotic” is defined rather vaguely as a micro-organism which has beneficial health impacts. I think it is obvious that there is a huge difference between fungi that are found in the intestinal microbiome of adults, and the lactic … Continue reading →

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Do probiotics only work in bigger babies? What is the risk-benefit of routine probiotics in the extremely preterm?

Posted on 13 November 2023 by Keith Barrington

The recent statement from the AAP and a recent review article both state that probiotics only appear to be effective in babies over 1000g birthweight. This would be remarkable if it were true. I am trying to think of another … Continue reading →

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Manipulating the Microbiome

Posted on 2 November 2023 by Keith Barrington

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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How to express negative results… or positive ones

Posted on 25 October 2023 by Keith Barrington

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.

Posted on 24 October 2023 by Keith Barrington

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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Closing the PDA… or leaving it alone?

Posted on 20 October 2023 by Keith Barrington

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!

Posted on 18 October 2023 by Keith Barrington

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.

Posted on 16 October 2023 by Keith Barrington

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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The myth of the “exclusive human milk diet”; fortification options for breast milk.

Posted on 12 October 2023 by Keith Barrington

The Exclusive Human Milk Diet sounds superficially immediately convincing: “We should only give milk products derived from human milk to human babies”. But, is it more than just a catchy phrase? The major company which is responsible for producing a … Continue reading →

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