Tag Archives: Systematic Reviews

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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More thoughts about the “toxicity” of donor milk, a case of Reverse Causation

Posted on 6 November 2023 by Keith Barrington

After my recent post, about the study which suggested that donor milk was killing babies, I have been taking a deeper dive into the article, as I prepare a letter to the editor. Only 2 small subsets of the infants … 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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Probiotics. What now?

Posted on 6 October 2023 by Keith Barrington

Many of you will have seen or heard of the FDA warning about probiotics in preterm infants. In a letter (I am not in the USA, so I am not sure exactly who this letter was sent to, or the … Continue reading →

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Reducing pain from retinopathy screening

Posted on 3 October 2022 by Keith Barrington

Retinopathy screening is undoubtedly painful for preterm babies, formal evaluation with PIPP scores routinely exceed 10 during screening, and may exceed 14, meaning moderate to severe pain. As a planned procedure there is always opportunity for pre-emptive analgesia prior to … Continue reading →

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The list of shame, and the continued shame of the Journal “Pain”

Posted on 9 June 2022 by Keith Barrington

Randomized controlled trials of pain control measures prior to planned painful procedures that have an untreated control group are unethical. I would have thought in 2022 that statement was about as uncontroversial as a statement about ethics could be, nevertheless … Continue reading →

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