Making Preterm Babies Grow: Here And Worldwide
One of the great challenges of modern neonatology is making very premature babies grow and doing so safely while we provide for their many other health needs. We have been particularly interested in determining how to increase the number of babies who are less than about 3 pounds at birth who gain weight adequately so that they don't "drop" percentiles on the growth curves from when they were born. Furthermore, we'd like to see how we can apply the lessons we've learned at Texas Children's Hospital (TCH) about monitoring and supporting growth in tiny premature infants to countries that have fewer neonatal intensive care resources than we do at TCH.
Recently we have embarked on parallel studies of preterm infant growth at TCH and at the Instituto Nacional Materno Perinatal (INMP) in Lima, Peru, a very large and historic public maternity hospital in Peru's capital. We are conducting research measuring how infants who are born at less than about 3 pounds grow at both TCH and INMP. We've provided accurate scales and support to the Peruvian hospital to help them collect data on babies they are caring for who are this small.
Our goal is to identify the best ways to safely help very premature babies grow and avoid any unneeded risks of bowel damage that can occur with feeding. We strongly support the use of human milk in all settings, but human milk, for all its tremendous benefits for infants, needs to be fortified with extra protein, calories and minerals in order for very premature babies to grow. How best to do this in different settings remains a challenge and a topic for further research.
Our work in Peru carries forward over 10 years of collaboration with INMP and other hospitals in Peru in neonatal training and education. Currently, we are doing this research in Peru along with other educational programs as part of our World Health Organization Collaborating Center. It is also done in partnership with the Pan American Health Organization and an important nutritional research center in Peru called the Instituto de Investigacion Nurticional. We have been working with the Beyond Traditional Borders (BTB) Program at Rice University as well as having students from BTB helping us with the project on-site in Peru and in Houston.
These types of multi-center collaborations provide benefits in allowing those of us in the United States to share our expertise with our colleagues in developing countries while learning about how to best support the needs of hospitals in other countries. It is successful because both institutions gain from the exchange of ideas and personnel and work together in a collaborative process to enhance pediatric care. We hope to expand to several other countries in the next year and evaluate how the data we are collecting can be used to further develop globally applicable guidelines for nutrition for premature infants.
Photo Credits: Photos taken by Rice University Beyond Traditional Borders students Lila Kerr and Ana El-Behadli.