Guidelines for Nutritional Care in the NICU: Author-Led Cases

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This video and case-based course presents a series of 7 modules that builds on content included in the updated and expanded Nutritional Care of Preterm Infants: Scientific Basis and Practical Guidelines, 2nd Edition, published in 2021. Faculty authors share the latest data and key practice tips from their respective chapters, while highlighting continued research opportunities to advance nutritional care of preterm infants. To facilitate application to practice, each module includes a case study with faculty discussion of clinical decision points. Series editor, Dr. Berthold Koletzko, presents an overview of key nutritional needs, as well as how to approach human milk fortification in preterm infants. Additional topics include preterm nutrition as it affects the brain, strategies to prevent growth faltering, critical periods for nutrition and long-term outcomes, the role of nutrition in neonatal lung function, and energy requirements for preterm infants.

Target Audience:

This activity was developed for neonatologists, nurses, dietitians, advanced practice clinicians, and other healthcare providers with an interest in preterm infants.

Course Credit:

2 AMA PRA Category 1 Credits^TM
2 ANCC Contact hour(s)
2 CA-BRN Contact hour(s)
2 CDR Contact hour(s)

Dates:

Opens: 2022-11-17
Closes: 2024-11-17

This activity is supported by an independent educational grant from Mead Johnson Nutrition.

Complete Continuing Education Details

Francis Bloomfield, MBChB, MRCP(UK), PhD

Francis (Frank) Bloomfield, MBChB, MRCP(UK), PhD, is director of the University of Auckland’s Liggins Institute in New Zealand. Dr. Bloomfield earned his MBChB at the Victoria University of Manchester in England and a PhD in pediatrics at the University of Auckland. He completed fellowships at the University of Toronto and the Hospital for Sick Children in Toronto, Canada.
The Liggins Institute is an internationally recognized facility dedicated to improving life-long health through research into the consequences of early life events. Much of Dr. Bloomfield’s research focuses on the role of nutrition in fetal and neonatal growth and development including the multidisciplinary nature of neonatal care.
Dr. Bloomfield is the principal investigator of the DIAMOND trial investigating the role of nutritional support for moderate-late preterm infants born at 32 to 35 weeks’ gestation. Although survival rates for these infants are excellent, over the past couple of decades, several studies that have followed them into childhood and adulthood indicate that they are at increased risk, later in life, of a variety of adverse long-term health outcomes including obesity, type 2 diabetes, and cardiovascular disease, as well as development issues such as learning and cognitive ability.
One of the factors affecting these long-term health issues may be the care these preterm babies receive after birth. Since there is little evidence guiding optimal feeding practices in neonatal intensive care units, protocols tend to vary widely. The DIAMOND trial will address the role of parenteral nutrition, milk supplementation and exposure of the preterm infant to taste and smell with each feeding during their first few weeks of life. The trial will provide the first direct evidence to inform feeding practices in moderate-late preterm infants to optimize their growth, metabolic and development outcomes.
Dr. Bloomfield is the author of approximately 200 peer reviewed journal articles, abstracts and book chapters and is a frequently invited lecturer on preterm infant nutrition. He serves on a number of boards in Australasia and is an elected member of the United States’ Perinatal Research Society. He is a past president of the Perinatal Society of New Zealand and of the Perinatal Society of Australia and New Zealand.

Francis Bloomfield, MBChB, MRCP(UK), PhD

Director, The Liggins Institute
Professor in Neonatology
University of Auckland
Auckland, New Zealand
Tanis R. Fenton, PhD, MHSc, RD

Renowned epidemiologist and dietitian Tanis R. Fenton, PhD, MHSc, RD, is nutrition research lead for Alberta Health Services at Foothills Medical Centre in Calgary, Canada, a professor in the Department of Community Health Sciences at the University of Calgary and a professor in the Division of Medical Sciences at Northern Ontario School of Medicine. She is also an adjunct professor at the University of Calgary, where she earned her PhD in epidemiology. She received her master of health science degree from the University of Toronto and her credentials as a registered dietitian from the College of Dietitians of Alberta.
Dr. Fenton is an internationally recognized researcher in pediatric nutrition. She is the developer of the Fenton Preterm Growth Charts that resulted from her work as a dietitian in the neonatal intensive care unit. The charts, which are gender-specific, include the weight, length, and head circumference of preterm infants from 22 to 50 weeks gestational age, recorded in weekly increments. They are based on the birth criteria of over 4 million infants with confirmed gestational ages in several developed countries. The charts are used around the world, have been incorporated into electronic medical records and clinical tools, and included in more than 40 textbooks.
Dr. Fenton’s ongoing research interests include nutrition, premature infant growth, and knowledge translation. In addition to her other roles and responsibilities, she is an evidence analyst for PEN: Practice-based Evidence in Nutrition, a global, dynamic knowledge translation tool that provides practitioners with timely and authoritative guidance on food, nutrition and services on hundreds of topics. PEN was developed by Dietitians of Canada and is managed through a collaborative partnership with the British Dietetic Association and Dietitians Australia.
Dr. Fenton serves on several international and national committees including those of the (US) National Institutes of Health and Academy of Nutrition and Dietetics, and the Canadian Paediatric Society. A sought-after speaker, she has addressed audiences of healthcare professionals in countries around the world. She is also frequently interviewed by print and electronic media about topics of interest to lay audiences. Dr. Fenton is the author of numerous books, chapters, journal articles, abstracts and other peer-reviewed material.

Tanis R. Fenton, PhD, MHSc, RD

Adjunct Professor
Epidemiologist, Registered Dietitian
Children’s Hospital Research Institute
University of Calgary
Calgary, Alberta, Canada
Katie Huff, MD, MS

Katie Huff, MD, MSc, is an assistant professor of pediatrics at Indiana University School of Medicine and an attending neonatologist at Riley Hospital for Children in Indianapolis. She received her medical degree from the University of Cincinnati College of Medicine and completed her pediatric internship and residency at Washington University School of Medicine in St. Louis, Missouri. During her fellowship in neonatal-perinatal medicine at Indiana University School of Medicine, she obtained a master of science degree in clinical research. Dr. Huff is board certified in pediatrics with subspecialty certification in neonatal-perinatal medicine.
Riley Hospital for Children is a nationally ranked pediatric acute care hospital providing specialized care for infants with advanced medical or surgical needs, including premature infants and those with heart, liver or lung disease. It is one of the top ten sites in the United States for pediatric research, attracting significant funding for biomedical research annually.
Dr. Huff’s current research interests include neonatal nutrition, in particular parenteral lipids and the prevention of cholestasis. Her research was recognized by the American Society for Parenteral and Enteral Nutrition (ASPEN) which presented her with the Harry M. Vars Award at the ASPEN 2022 Nutrition Science and Practice Conference. The award honors an early career investigator who submits a top-scoring original abstract and demonstrates excellence via a manuscript and oral presentation. Dr. Huff’s presentation featured her research on a randomized trial of alternate lipid therapies for the prevention of parenteral nutrition associated liver disease in surgical neonates.
Dr. Huff has published a number of journal articles, abstracts and book chapters and is a member of several professional organizations including the American Academy of Pediatrics, the American Society for Parenteral and Enteral Nutrition, and the Society for Pediatric Research.

Katie Huff, MD, MS

Assistant Professor of Clinical Pediatrics
Indiana University School of Medicine
Indianapolis, Indiana
Berthold Koletzko, MD, PhD

Berthold V. Koletzko, MD, PhD, is the Else Kröner-Seniorprofessor of Paediatrics at Dr. von Hauner Children's Hospital, Ludwig-Maximilians University in Munich, Germany. He received his medical degree from the University of Munster in Germany, continued his pediatric education in South Africa, Germany and Tanzania, and completed a fellowship in clinical nutrition and metabolism at the Hospital for Sick Children at the University of Toronto in Canada.
Funded by numerous public and private organizations, Dr. Koletzko’s research focuses on metabolic and nutritional modulators of child health and disease prevention. He is rated a “World Expert” by Expertscape, ranking in the top 0.01% of researchers worldwide over the past decade. Expertscape provides an objective ranking of healthcare professionals and institutions based on knowledge demonstrated by the publication of material that has undergone the rigorous review process that characterizes scientific publications. The categories in which Dr. Koletzko was rated the world’s top researcher included “infant nutritional physiological phenomena,” “child nutritional physiological phenomena” and “child nutrition science.”
Dr. Koletzko is president of the International Society for Research in Human Milk and Lactation, a strategic advisor on nutrition to the International Pediatric Association, a member of the executive committee of the European Academy of Paediatrics, and a member of several other German and international organizations. He is the author of more than 1000 scientific journal articles, numerous books, book chapters, and monographs. Dr. Koletzko is editor in chief of Annals of Nutrition and Metabolism and World Review of Nutrition and Dietetics, and associate editor of Current Opinion in Clinical Nutrition and Metabolic Care.
Dr. Koletzko is a scientific advisor to the German Federal Government, the European Commission, the World Health Organization, and other national and international governmental organizations. He is a past president of the Federation of International Societies of Pediatric Gastroenterology, Hepatology and Nutrition (FISPGHAN), a not-for-profit umbrella organization composed of pediatric societies in Europe, North America, Latin America and Asia, and a past president of ESPGHAN, its European counterpart.

Berthold Koletzko, MD, PhD

Else Kröner Senior Professor of Pediatrics
Department of Pediatrics
Dr. von Hauner Children’s Hospital
Munich, Germany
Fernando R. Moya, MD

Fernando R. Moya, MD, is director of the Division of Wilmington Pediatric Subspecialties in the Department of Pediatrics, and professor of pediatrics at the University of North Carolina School of Medicine, in Chapel Hill, North Carolina. Board certified in pediatrics and neonatal-perinatal medicine, Dr. Moya is also medical director of the Pediatric Subspecialty Clinic at Novant Health—New Hanover Regional Medical Center in Wilmington, North Carolina.
Dr. Moya has been involved in clinical and translational research throughout his career. As a principal or coinvestigator on more than a dozen clinical trials, Dr. Moya’s research focused on preterm infant nutrition and respiratory care, among other topics. Dr. Moya has disseminated his research and expertise in more than 80 peer-reviewed publications and 200 articles, presentations, and book chapters.
He has lectured on the topic of preterm infant health in more than 25 countries throughout the world. He is a reviewer for numerous prestigious medical journals, including the American Journal of Obstetrics and Gynecology, European Journal of Pediatrics, The Journal of Maternal-Fetal Medicine, Pediatric Research, Genetics in Medicine, and Journal of Perinatology.

Fernando R. Moya, MD

Professor of Pediatrics
University of North Carolina School of Medicine
Director, Division of Wilmington Pediatric Subspecialties
Wilmington, North Carolina
Sara Ramel, MD

Sara E. Ramel, MD, is an associate professor in neonatology and a member of the faculty of the Center for Neurobehavioral Development/Masonic Institute of the Developing Brain at the University of Minnesota in Minneapolis. She received her medical degree from the University of Minnesota School of Medicine where she completed her residency in pediatrics and a fellowship in neonatal/perinatal medicine. Dr. Ramel is board certified in pediatrics and neonatal-perinatal medicine.
Dr. Ramel’s research focuses on the impact of neonatal nutrition, illness and growth on long-term neurodevelopment and body composition. She has been the principal investigator on a number of growth studies sponsored by the University of Minnesota, the National Institutes of Health, as well as the March of Dimes and the Minnesota Obesity Center. Dr. Ramel and her research team have uniquely shown that optimizing linear growth in the first year of life is as important as adequate weight gain in improving long-term neurodevelopment amongst preterm infants. Additionally, the team found that increased fat-free mass gains, rather than fat-mass gains, are associated with improved speed of processing and cognitive and motor scores later in life. Dr. Ramel and her colleagues worked on the development of growth curves for preterm infants in fat mass and fat-free mass, as well as examining factors, both nutritional and non-nutritional, associated with improved linear growth and fat-free mass gains. In addition, the team examined the difficult balance between optimizing neurodevelopment and minimizing later metabolic risk amongst preterm infants.
Dr. Ramel is the co-author of numerous peer-reviewed publications, manuscripts and book chapters. She is also a sought-after speaker at national and international conferences and serves as an ad hoc review for several prestigious medical journals.

Sara Ramel, MD

Associate Professor
Division of Neonatology
Department of Pediatrics
University of Minnesota
Minneapolis, Minnesota

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Learning Objectives

Assess updates to the preterm infant nutritional guidelines
Identify areas of your clinical practice impacted by these updates
Modify clinical practice impacted by these guideline updates in collaboration with members of the preterm infant care team
Implement preterm infant nutrition strategies aligned to the updated guidelines