Collaborative networks are playing an increasing role in improving neonatal care. An editorial by Shah and Lehtonen 1 praise Kiechl-Kohlendorfer et al. 2 for developing a robust, national cohort study of preterm infants born at 23–31 weeks in Austria. The overall survival of the cohort, who were born from 2011 to 2016, was 91.6% and 78.2% survived without major neonatal morbidities. Not surprisingly, lower gestational age, lower birth weight, male sex and multiple pregnancies were associated with adverse outcomes. Shah and Lehtonen also comment on the Swedish Neonatal Quality Register, which is described by Norman et al. 3 in this issue. Its completeness and agreement with other registers, especially for preterm infants, was judged to be excellent. Ear tube placements are the most common paediatric surgical procedure in high-income countries. Eythorsson et al. report that the incidence of ear tube insertions increased in Iceland after the introduction of the pneumococcal vaccine into the paediatric vaccination programme in 2011 4. The reasons for these findings are speculative. However, children in the 2011–2015 birth cohorts were less likely to be diagnosed with otitis media or receive antimicrobials before the placement procedure than children in the 2005-2010 cohorts. Administering paediatric drugs remains a challenge, due to the lack of age-appropriate formulations. A study from the Netherlands by van der Vossen et al. found that nurses and parents frequently manipulated oral medication and that 45% of these changes were not in line with the summary of product characteristics or patient information leaflets 5. The results showed that there is a need for age-appropriate medicines that can deliver correct dosages. A cohort study from Gothenburg, Sweden, showed that boys born at term with metabolic acidosis had worse perinatal symptoms and less favourable neurodevelopmental outcomes at 6.5 years of age than girls 6. The findings were seen in those who appeared healthy during the neonatal period. Readers may also be interested in the Evidence-Based Neonatology commentary by Lohmann and Wright, which asks Does permissive hypercapnia carry increased risk for neurodevelopmental sequelae? 7. Medical advances mean that critically ill neonates who eventually die are surviving longer. This has raised concerns that neonatal intensive care units are overtreating patients and unnecessarily subjecting them to expensive and burdensome treatment. Prentice et al. have developed a neonatal intervention score to measure how clinicians treat neonates during their admission, in contrast to other tools that only focus on the time around delivery 8. A validation study on preterm babies born at less than 28 weeks indicated that the score was useful and reliable and may facilitate rigorous empirical ethics research and optimise communication between providers and parents. Figures 1, 3–5: istockphoto.com, 2: Alamy.com