The Necrotizing Enterocolitis (NEC) Society has released a toolkit that provides structure to clinicians in neonatal intensive care units (NICUs) as they consider the complex process and decision of whether to implement probiotics to help prevent NEC.  


The Toolkit is not a recommendation for or against the routine use of probiotics in the NICU, nor for or against the use of any product or preparation method, the society says.

NICUs and clinicians are encouraged to use the Toolkit to foster thoughtful, intentional dialogue and inclusive conversations amongst key stakeholders in the NICU, including the need for patient-families to understand the risks and benefits relevant to their child’s health.

NICU-level decisions on whether to adopt probiotic therapy should involve the multidisciplinary team, including NICU family advisors. Regardless of whether centres use probiotics to help prevent NEC, clinicians should share information with NICU families. In the NICU, parents are the most important members of their child’s care team and need access to information to contribute and participate.

Strategies to reduce rates

Jennifer Canvasser, founder/executive director of the NEC Society, says: ”While we cannot eliminate the risks of NEC at this time, there are strategies we can implement now to help meaningfully reduce NEC rates. Just as hastily changing care practices can result in unexpected poor outcomes, stalling can carry its own risk. Even slight variations in a unit’s NEC rate profoundly affect families.

”Modest variations in NEC mean the difference between a child developing a devastating, life-altering, too often fatal disease and a child thriving at home with their family. As we question the risks and benefits of probiotics, it is fair to ask and address the risks of inertia.”

NEC is a devastating intestinal disease that affects medically fragile infants in their first weeks and months of life. The NEC Society is a 501(c)(3) nonprofit organization dedicated to building a world without this disease by advancing NEC research, education, and advocacy.