TY - JOUR T1 - Is it time for routine probiotic use in UK neonatal units? JF - Archives of Disease in Childhood - Fetal and Neonatal Edition JO - Arch Dis Child Fetal Neonatal Ed SP - 344 LP - 345 DO - 10.1136/archdischild-2021-323091 VL - 107 IS - 4 AU - Paul Fleming Y1 - 2022/07/01 UR - http://fn.bmj.com/content/107/4/344.abstract N2 - Probiotics have been evaluated extensively in preterm babies for more than 30 years. Early studies in the 1990s sought to ascertain whether or not these live micro-organisms could colonise the preterm intestinal tract, while others evaluated their potential to improve nutritional outcomes. From the late 1990s, a series of small studies (including randomised controlled trials (RCTs)) reported outcomes of reduced necrotising enterocolitis (NEC) in babies receiving probiotics and interest in their use as a preventative strategy for NEC accelerated from the early 2000s.1 In 2010, a meta-analysis concluded that probiotics were effective at reducing stage II NEC and all-cause mortality and recommended no more placebo controlled trials if a suitable product was available.2 Some neonatal centres in the UK were pioneers in the early adoption of probiotic use. Granger and colleagues report the findings from a pre-implementation and post-implementation study of probiotic use at a large tertiary neonatal unit in the north of England.3 A total of 1061 infants born <32 weeks’ gestation were included; 509 in the pre-probiotic period and 552 in the post-probiotic period. Two different probiotic products were used during the implementation period including one containing Lactobacillus acidophilus and Bifidobacterium bifidum and the other containing L. acidophilus, B. bifidum and B. longum spp infantis. Between the two periods (pre-implementation and post-implementation), the overall unadjusted risk of NEC was 9.2% vs 10.6% (p=0.48), late-onset sepsis 16.3% vs 14.1% … ER -