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Delay in adopting effective treatment has serious consequences. 1 Hundreds of thousands more infants could have lived had antenatal corticosteroids been introduced sooner after evidence to support their use was published in 1972. 2, 3 A systematic review, published in this issue of Pediatrics, by Deshpande et al4 of 11 randomized, controlled trials (RCTs) in 2176 infants of 34 weeks’ gestation revealed that oral probiotics reduced all-cause mortality and necrotizing enterocolitis (NEC) by more than half (P. 00001). These results suggest that current probiotics could prevent tens of thousands of deaths annually. The unusually large effect implies that most deaths or cases of NEC in eligible infants who are not given probiotics may, on balance of probability, be ascribed to that omission. Few infants receive probiotics outside RCTs. Should this practice change? After birth at term, the gut is colonized with probiotic …