Researching best care for the smallest of patients

Justin Gregory finds out about a study investigating how pre-term babies are fed during their first few weeks, and whether there is a better way.

Busy and happy, Isla Rothwell is a confident toddler with a great giggle. She loves an adventure.

'Oblivious to danger is the current mode,' says mum Olivia. '" What are you doing on the table and how did you even get up there?"'

But 21-month-old Isla isn't your everyday toddler. She was born seven weeks early, giving her family a big shock.

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Isla was healthy and a good weight, so the morning after she was born, her parents were approached by a researcher from the Liggins Institute, part of the University of Auckland's School of Medical and Health Sciences. Isla and her family were being asked to play a part in a unique investigation into the care of pre-term babies, called the DIAMOND Study.

DIAMOND stands for Different Approaches to Moderate & late preterm Nutrition: Determinants of feed tolerance, body composition and development. The study, which began in 2017 with 528 babies across four different hospitals, is believed to be the largest of its kind in the world, and is run by Professor Frank Bloomfield, a neonatologist and the director of the Liggins.

Each year, around 5000 New Zealand babies are born prematurely (before 37 weeks gestation); 85% of them between 32 and 37 weeks. They usually need to stay in a neo-natal intensive care unit, or NICU, until close to their original due date.

"They look like term babies, they behave in many ways like term babies, and we think their outcomes are like term babies', explains Frank.

But that may not be the whole story, he says.

'These babies are at increased risk of a variety of issues that affect their health in later life. Obesity, Type-2 diabetes, cardiovascular disease and also developmental issues.'

Large scale studies over the last 20 years have followed pre-term babies into adulthood and have uncovered these worrying findings. A variety of factors are involved, but one of them may be the care these pre-term babies receive after birth.

The DIAMOND study is investigating how pre-term babies are fed during their first few weeks and whether there is a better way. And all the babies in the study really have to do is to have a good kai…

Go to this episode on rnz.co.nz for more details