Nutrition
Good nutritional practice is at the core of neonatal medicine - feeding, protein, breastmilk, supplements, KMC, FICare, growth, follow up.... Respiratory support had the largest impact on improvements in preterm infant survival in the 1960/70s - CPAP, ventilation, oxygen monitoring and then in the 1980/90s - surfactant, antenatal steroids etc. Nutrition was under-studied and there were few RCTs. The importance of human milk has always been recognised, but key papers in the 1980s and 1990s increased attention on the relationship between human milk and NEC. Donor human milk banks have supported neonatal units since 1909 (Wien) and 1910 (Boston) and continued to grow, but the true impact on NEC is sill uncertain.
Medical training focuses on pathology and treatment of disease, and depending on school and training programme, there is a focus on metabolism, applied physiology, and chronic disease (cardiovascular, obesity, diabetes etc.). The Developmental Origins of Health and Disease (DOHaD) emerged out of the "Barker Hypothesis" that rapidly gained traction in the 1990s and inspired me to become interested. How could maternal nutrition (or even grand-maternal nutrition) impact on outcomes in later life?
Medical training focuses on pathology and treatment of disease, and depending on school and training programme, there is a focus on metabolism, applied physiology, and chronic disease (cardiovascular, obesity, diabetes etc.). The Developmental Origins of Health and Disease (DOHaD) emerged out of the "Barker Hypothesis" that rapidly gained traction in the 1990s and inspired me to become interested. How could maternal nutrition (or even grand-maternal nutrition) impact on outcomes in later life?
