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Meta-analyses indicate that giving probiotics to preterm neonates significantly decreases risk of necrotising enterocolitis (NEC) or death.1–3 Multiple randomised controlled trials including >5000 very low birthweight (VLBW) infants have not shown any adverse effects associated with probiotic use,3 and no disadvantages to growth or neurodevelopment are apparent.4 Routine probiotic supplementation has been offered in Bradford since September 2011 and in Norwich and Newcastle since January 2013 via Probiotics in Neonates Collaboration (PINC-UK). We treat all infants born <32 weeks’ gestation and all VLBW preterm infants using Infloran, a probiotic produced to assured drug quality standards using Good Manufacturing Practices (Desma Healthcare, Switzerland). This provides a daily dose of 1 billion each of live Lactobacillus acidophilus and Bifidobacterium bifidum at a cost of ∼£1 per day. Parents either receive a written information sheet (see …
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