In Reply

We appreciate the opportunity to respond to the recent letters to the editor in response to our updated meta-analysis of probiotics for preventing necrotizing enterocolitis in preterm neonates.¹  We will address the common and important issues.

Although it has not happened in a proper sequence, probiotics as an intervention have completed a full circle, from basic science^14,15  and cohort studies¹⁶  to conclusive meta-analysis,¹  routine use,¹⁷  and long-term follow-up.¹⁸  It is time to acknowledge the elephant in the room, provide all evidence (for and against) to parents in a clear, honest, and transparent manner, and let them decide. The belief that we know what is best for our patients needs to be discarded.