Redesigning Postdischarge Nutrition in the NICU

Preterm birth affects 1 of every 10 infants in the United States. Improper nutrition in the NICU can result in impaired neurodevelopment, delayed cognitive development, retarded growth, and an increased risk for type 1 diabetes and cardiovascular disease later in life. It is essential that the intake of protein, macronutrients, and micronutrients be provided at the right nutritional levels during their first hours, days, and weeks of life while in the NICU, followed by an individual feeding strategy at discharge.

Dr. Tara Bastek and Dr. Ian Griffin provide detailed information to underscore the significance of proper nutritional intake in the NICU. They review the latest nutrient intake recommendations, and define optimal growth as an infant transitions from parenteral to enteral nutrition during the course of acute, convalescent, and discharge phases, with specific feeding strategies during each. Individualized formula fortification strategies are also discussed to help parents and providers follow prescribed feeding plans to optimize long-term outcomes.

• Profile

  Tara K. Bastek, MD, MPH

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  Tara K. Bastek, MD, MPH, is a board-certified pediatrician and neonatologist with WakeMed Physician Practices, a division of the WakeMed Health and Hospital network in Raleigh, North Carolina. She is an attending neonatologist at the Raleigh, Cary, and North campuses and medical director of the Raleigh neonatal intensive care unit. Prior to joining WakeMed, Dr. Bastek was an assistant professor of pediatrics at the University of North Carolina at Chapel Hill.

  Dr. Bastek received her medical degree from Eastern Virginia Medical School in Norfolk, Virginia, completed an internship and residency at the University of North Carolina Hospitals, and a fellowship in newborn medicine/neonatology at Boston Children’s Hospital through Harvard Medical School. Dr. Bastek earned her master's degree in public health at the Harvard School of Public Health and completed a fellowship in medical ethics at Harvard Medical School.

  Dr. Bastek has been the principal investigator on research projects involving studies of both regional and international prenatal consultations for extremely premature infants. Her published work includes a chapter on decision-making and ethical dilemmas in the Manual of Neonatal Care, as well as articles in the Journal of Perinatology and Pediatrics. Dr. Bastek serves as chair or in a leadership capacity for numerous WakeMed committees. Her national affiliations include membership in the American Academy of Pediatrics and the American Society for Bioethics and Humanities.

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  Tara K. Bastek, MD, MPH

  Neonatologist
  Chair, Ethics Committee
  WakeMed Health and Hospitals
  Raleigh, North Carolina

• Profile

  Ian J. Griffin, MD

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  Ian J. Griffin, MD, is director of clinical and translational research at MidAtlantic Neonatal Associates (MANA) in Morristown, New Jersey. Dr. Griffin received his medical degree from Leeds University in England. He completed an internship at Chapel Allerton Hospital in Leeds, and residencies in Scotland at Royal Hospital for Sick Children, the Queen Mother’s Hospital, and Southern General Hospital. He was awarded fellowships by Baylor College of Medicine, Houston, and Royal Victoria Infirmary in England. Prior to joining MidAtlantic Neonatal Associates, Dr. Griffin had a distinguished clinical and research career at Baylor College of Medicine/Texas Children's Hospital and the University of California at Davis.

  At MANA, Dr. Griffin directs a multidisciplinary program, ranging from laboratory research to quality improvement initiatives in the NICU and postgraduate medical education. The overall goal of Dr. Griffin and his team is to improve survival rates of extremely premature infants.

  Dr. Griffin contributions to the field of neonatal education include pioneering work in the development of neonatal growth charts and expanding the understanding of many of the nutrients that contribute to the growth of preterm babies. He was responsible for the development of a curriculum consisting of a series of lectures to teach the basics of statistical analysis to neonatal fellows.

  Dr. Griffin is the author or coauthor of numerous peer-reviewed journal articles, book chapters, and abstracts. He is a member of the editorial board of the Journal of Nutrition and is an invited reviewer for a number of other medical journals. Dr. Griffin serves on several national committees on neonatal nutrition and is recognized internationally for his research efforts.

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  Ian J. Griffin, MD

  Director, Clinical and Translational Research
  Mid-Atlantic Neonatal Associates
  Biomedical Research Institute of New Jersey
  Morristown, New Jersey