Table 1

Results of survey of NEC prevention practices and unit-level linked outcome analyses

Units in network, N2830526576124168
Units participating in survey, n (%)27 (96)29 (97)5 (100)26 (100)47 (82)6 (100)9 (75)4 (100)153 (91)
Results of unit level survey
Probiotics Probiotic provision, n (%)25 (93)16 (52)5 (100)0 (0)10 (21)0 (0)7 (78)3 (75)66 (43)
Start of probiotics*, dayNo preference†0–10‡1–302–3No preference†
Probiotic species*L/BLLL/BL/BL‡L/B
Stop at sepsis*NoNo preference†No‡No preference†YesNo‡No
Enteral feeding <26 weeks GA*
Start (day)00–10‡*0–10‡0‡*0–1
Daily rate of advancement, ml/kg/day15–2010–2015–2520–2510–2015201010–20
26–28 weeks GA*
Start (day)000‡0–100‡0‡00–1
Daily rate of advancement, ml/kg/day15–20202520–2520–2510–25202020–25
≤28 weeks GA*
Enteral feed vol. where infants commonly receive milk fortifier*, ml/kg/day≥120100–129100–129No preference†80–10970–89≥12080–89No preference†
Donor milk Available, n (%)10 (37%)25 (81%)5 (100%)0 (0%)20 (42%)6 (100%)5 (56%)4 (100%)74 (48%)
Initiation criteria*No preference†No preference†No GA/BW criteria<32 weeks/<1500 g<34 w<32 weeks/<1500 g<32 weeks/<1500 gNo preference†
Stopping criteria*No preference†No preference†No preference†No preference†No preference†No preference†1800 gNo preference†
Results of unit-level analyses: effect of probiotics, feeding start on day 0 and donor milk availability on outcome of NEC surgery
Units providing probiotics versus not providing probiotics§, OR (95% CI)NA¶0.77
(0.48 to 1.24)
(0.14 to 0.93)
(0.61 to 1.16)††
Units starting to feed on day 0§ versus those starting after day 0 (95% CI) for<26 weeks’ GA1.13
(0.70 to 1.85)
(0.86 to 3.06)
(0.02 to 1.02)
(0.83 to 1.63)††
Units starting to feed on day 0§ versus those starting after day 0 (95% CI) for 26–28 weeks’ GA1.78
(0.76 to 4.15)
(0.69 to 2.48)
(0.03 to 0.52)
(0.74 to 1.75)††
Units providing donor milk§ versus units not providing donor milk OR (95% CI)0.78
(0.37 to 1.66)
(0.21 to 1.41)
(0.62 to 1.20)††
  • *Response of ≥50% of units.

  • †Units responses were distributed over entire possible range (see online supplement 2 for detailed responses).

  • ‡Unanimous response of 100% of units.

  • §NEC surgery OR (95% CI) are given for networks with variability in provision of probiotics, feeding start and/or donor milk availability. Adjustment was made for GA, male sex, multiple birth and birth-weight z-score.

  • ¶OR could not be calculated for AZNN and SEN1500 as permission for linking survey and patient data was not available.

  • **OR for probiotics could not be calculated for TuscanNN as all patients were from the three units providing probiotics.

  • ††OR for “All” includes all units in countries allowing linkage between unit survey and cohort study, that is, also those countries where all neonates either received or did not receive intervention.

  • ANZNN, Australian and New Zealand Neonatal Network; B, Bifidobacterium; BW, birth weight; CNN, Canadian Neonatal Network; FinMBR, Finnish Medical BirthRegister; GA, gestational age; INN, Israel Neonatal Network; L, Lactobacillus; N, total number in group; n, number in subgroup; NA, not available; NEC, necrotising enterocolitis; SEN1500, Spanish Neonatal Network; SNQ, Swedish Neonatal Quality Register; SwissNeoNet, Swiss Neonatal Network; TuscanNN, Tuscan Neonatal Network.