How should we pasteurize donor breast milk?
Neonatal Research
by Keith Barrington
5d ago
The standard method of pasteurization of donor breast milk, and I believe the only method approved by HMBANA (the human milk banking association of north america), is similar to what Louis Pasteur himself came up with a couple of centuries ..read more
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Oxygen is toxic in older kids too!
Neonatal Research
by Keith Barrington
2M ago
A new large RCT from PICUs in the UK randomly compared 2 saturation target ranges, 88-92 and >94%. Children <16 years of age being ventilated with supplemental oxygen were randomized within 6 hours of admission. The intervention stopped when the ..read more
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Donor human milk, not toxic after all!
Neonatal Research
by Keith Barrington
3M ago
It was fairly recently that I deconstructed a truly terrible database analysis which claimed that neonatal mortality was dramatically increased among very preterm infants who received mother’s own milk (MoM) and donor human milk (DHM), without any formula or fortifier ..read more
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Is there any indication to close the PDA?
Neonatal Research
by Keith Barrington
3M ago
Yet another trial of PDA treatment and attempted closure with a null result. Baby-OSCAR was a UK multi-center masked RCT of ibuprofen treatment of 23 to <29 week infants who were screened with echocardiogram within the first 72 hours of ..read more
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Time to open the DOOR
Neonatal Research
by Keith Barrington
3M ago
I have written many times about the problems with classical composite outcomes in neonatal research. “Death or BPD”, “death or NDI”, or sometimes “death or NEC or Sepsis or BPD or severe IVH” have been used as a way of ..read more
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Early routine surfactant, method and outcomes
Neonatal Research
by Keith Barrington
4M ago
Two important new studies of the use of very early routine surfactant, compared to later selective surfactant if necessary. The first I will discuss is the one that didn’t seem to improve any important clinical outcomes (Murphy MC, et al ..read more
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Umbilical cord management at birth for preterm infants
Neonatal Research
by Keith Barrington
5M ago
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 the IPD which made 3 comparisons Delayed compared to immediate clamping, and each approach compared ..read more
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Which Probiotic is Preferable?
Neonatal Research
by Keith Barrington
5M ago
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 ..read more
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Do probiotics only work in bigger babies? What is the risk-benefit of routine probiotics in the extremely preterm?
Neonatal Research
by Keith Barrington
5M ago
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 ..read more
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More thoughts about the “toxicity” of donor milk, a case of Reverse Causation
Neonatal Research
by Keith Barrington
6M ago
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 ..read more
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