We introduced probiotics in Walsall Manor Hospital, a local neonatal unit (LNU) in West Midlands, in February 2022. During the pre-implementation phase, we struggled to find out the extent of use of probiotics in the region. Some units were already using it, some in the process of implementation, some wanted to wait for more evidence. There was no consensus or uniformity on the probiotic strains for use. There was considerable price disparity among the different brands and implementation in some was influenced by the cost of the product.1 2 We decided to follow the European Society for Paediatric Gastroenterology Hepatology and Nutrition recommendations3 for the probiotic strain and introduced ProPrems.

Following our implementation, we conducted a national survey on the current …