Tag Archives: Systematic Reviews

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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Dexamethasone ENT doses

Although we have a great group of ENT surgeons at my hospital, we do have one bone of contention; at least, there is just one bone left since they have agreed that you cannot diagnose reflux by performing a laryngoscopy! … 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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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

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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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Outcomes of infants born at 22 weeks gestation; attitudes are the best predictor of survival

Among the most immature infants, mortality and morbidity are common even if they receive active neonatal intensive care, a new systematic review has attempted to find out how common. Backes CH, et al. Proactive Neonatal Treatment at 22 Weeks of … Continue reading

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Why are so many mothers hypothyroid, and what should pediatricians do about it?

I don’t know if, like me, you are surprised by how often when admitting a baby, or doing an antenatal consult, mothers are taking thyroxine. It seems that there is an epidemic of hypothyroidism during pregnancy, and I am not … Continue reading

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What to do about early postnatal steroids?

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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Erythropoietin for brain protection in the very preterm? Not worth Penuts.

That isn’t a mis-spelling, just a bad attempt to play with the acronym for a good trial; the PENUT trial, just published in the (FP)NEJM. (Juul SE, et al. A Randomized Trial of Erythropoietin for Neuroprotection in Preterm Infants. N … Continue reading

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Progesterone doesn’t prevent prematurity?

Progesterone analogues, including 17-OH progesterone caproate have been investigated over the last several years for prevention of prematurity. In the pivotal trial from 2003 17OHPC intramuscularly once per week was shown to reduce prematurity at less than 37 weeks, less … Continue reading

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