Background and Aims Evidence based knowledge in neonatal care has substantially increased during the last years. We tried to evaluate how well guidelines and evidence from studies have been implemented into clinical practice during the last 15 years.

Methods Detailed questionnaires were sent 15 years apart to all neonatal units potentially treating VLBW infants in Germany (1995) and all German speaking countries (2010).

Results The response rate was 66% both times. Whereas in 1995 ²/₃ of the units used 100% oxygen and ¼ 50% to start respiratory support in the delivery room, in 2010 only 3% and 5% of the units used 100% and 50% oxygen, respectively. Caffeine and Theophylline were used to treat apnoea of prematurity by 50% and 87% of the units in 1995 compared to 96% and 10% in 2010, respectively. Pasteurization of breast milk was done in 24% of the units in 1995 compared to 53% in 2010. In 1995, 37% of the units routinely used erythropoietin in ELBW infants compared to 27% in 2010.

Conclusions Treatment of VLBW infants changed significantly within the last 15 years and some of the existing guidelines and evidence seem to be transferred into clinical practice in most units.