GOLD Neonatal Conference 2023
We’re excited to continue our work of bringing you the latest research, trends, new ideas and hot topics in the world of neonatal care. This activity provides evidence-based continuing education that will help bridge the gap between established protocols and practices and the rapid growth of new research. Join us for an amazing program of thought-provoking topics and speakers who will expand your knowledge and skills.
Our conference for 2023 is packed full of important clinical topics such as The Role of Sensation in the NICU: Creating Healing Environments, Demystifying the Car Seat Tolerance Screening, Artificial Airway Management of the Neonate, Unraveling Neonatal Hypoglycemia, Implementing Safe Sleep for Babies in the NICU, and so much more. GOLD Neonatal is a thought-provoking and knowledge expanding event that you won't want to miss!
After raising three children as a stay-at-home mother, Dr. Phillips received a master’s degree in Developmental Psychology with a focus on mother-infant attachment, became NIDCAP certified as a Preterm Infant Developmental Specialist, and then attended medical school at University of California, Davis. She completed her pediatric residency and neonatology fellowship at Loma Linda University Children's Hospital in S. California and is an attending neonatologist in the Level 4 NICU at the same hospital. She is an Associate Professor of Pediatrics/Neonatology at Loma Linda University School of Medicine and is Pediatric Department Chair and Medical Director of Neonatal Services at Loma Linda University Medical Center-Murrieta. Dr. Phillips is an International Board-Certified Lactation Consultant, a Fellow of the Academy of Breastfeeding Medicine, and a past president of the National Perinatal Association (NPA). She is currently President of the Association for Prenatal and Perinatal Psychology and Health (APPPAH), a global non-profit organization with a mission to support healthy infant-parent relationships before and after birth. Her passion is to honor and nurture the earliest connections between babies and their parents.
1.Describe the neuroscience of parent-infant bonding/attachment for term and preterm infants
2. Describe the neurobiology of skin-to-skin contact as a modality for nurturing babies
3. Explain ways to communicate with babies in the NICU and the importance of doing so
Developing secure bonds of attachment is a major developmental task for all human babies, a process that is considered to be foundational for future mental health and even physical wellbeing. The mechanism for doing so is called “nurturing,” and a growing body of evidence supports the impact of nurturing on physiologic stability, co-regulation and growth, as well as brain development and ongoing physical and emotional health. The first bond of attachment is between mother and baby and begins before birth. Separation of mothers and babies always causes stress and interrupts the bonding and attachment process. When temporary separation is necessary in the NICU, there are ways we can support mothers and babies to help minimize the detrimental effects of separation and to promote healing. This presentation will describe the neuroscience behind parent-infant bonding and attachment and the neurobiology of skin-to-skin contact as a modality for nurturing babies. We will describe ways to communicate with NICU babies in a manner that enhances bonding and attachment and promotes the development of trust as well as enhances brain and language development. We will discuss ways to support babies, mothers, families, and staff in promoting bonding and attachment in the NICU.
Emily Hills is co-author and co-founder of Sensory Beginnings Ltd, she is a Clinical Specialist Neonatal Occupational Therapist at Royal Free London NHS Foundation Trust. Emily is a certified neonatal therapist (CNT). She has completed her MSc in Advanced Neonatal Studies at Southampton University. Emily is NIDCAP certified and lectures on The Family and Infant Neurodevelopmental Education (FINE) programme in the UK. Emily has completed Neonatal Touch and massage certification (NTMC) and has completed the advanced course in The Prechtl General Movement Assessment. She is a senior Brazelton trainer and lectures on both the Neonatal Behavioural Assessment Scale (NBAS) and Newborn Behavioural Observation (NBO). She is an Advanced Practitioner in Sensory Integration.
Lindsay Hardy is the Director of Clinical Services at PACE, where she leads a multidisciplinary team of therapists, providing therapy to children from 0- 19 years and support to their families. Lindsay has led the development of the Pace Early Intervention Service for children 0-3 years and their families. Lindsay has designed content and taught post-graduate courses in the field of paediatric occupational therapy, sensory integration, cerebral palsy, early intervention & developmental neurology. Lindsay was involved in the start-up of national organisations Sensory Integration Network UK & Ireland and EISMART. She is co -founder and co-author of Sensory Beginnings Ltd
1. Describe the role of sensation in early human development
2. Explain sensory experiences in the neonatal unit and the impact of stress on the infant, the family and staff.
3. List 3 sensory strategies to promote infant development, staff and family well being.
Human neurobiology is highly sensitive to stressors. Adverse early life experiences create stress that have the possibility to change brain chemistry, anatomy and gene expression. These changes can predispose a baby to impaired emotional regulation, poor cognitive development, and increased risk of cardiovascular, metabolic and immune system dysfunction. In addition, chronic stress can become trauma and have a long term effect. In the neonatal unit the infant, parents and staff are experiencing stress. This presentation will focus on the role of sensation and how we can use sensory experiences to create healing environments, enhance optimal development and minimise stress and trauma.
Dr Mark Johnson is a consultant neonatologist at University Hospital Southampton NHS Foundation Trust and an honorary senior clinical lecturer in neonatal medicine at the University of Southampton. He is also currently the clinical director for neonatal medicine in Southampton. Dr Johnson graduated in medicine (BM) from the University of Southampton in 2004, and undertook an intercalated degree in biomedical science during his medical training. Dr Johnson was awarded a prestigious NIHR doctoral research fellowship to fund his PhD, which he was awarded by the University of Southampton in 2015. Dr Johnson’s PhD focused on change management in neonatal care in the context of nutrition, successfully implementing improved nutritional practices in order to improve the growth of preterm infants. Dr Johnson's research centres around the nutritional care and growth of premature babies, and the implementation of practice change in order to improve care, and has published on these topics widely, including systematic reviews looking at the use of early parenteral nutrition in preterm infants, the impact of enhanced nutrition on the neurodevelopmental outcomes of preterm infants and the effect of preterm birth on body composition and growth. He has also contributed to national and international guidance on nutritional care.
1. Describe current patterns of growth and body composition in preterm infants and how to assess them
2. Explain the optimal patterns of growth in preterm infants
3. Describe recent evidence-based guidance and approaches to neonatal nutritional care and their implementation into clinical practice to achieve optimal growth
Current recommendations for the growth of preterm infants are that they should try and achieve the same pattern of growth they would they were still in-utero. This growth should be both the right quantity, but also the right quality in terms of body composition and the relative proportions of fat and lean tissue. This requires higher amounts of nutrition that can be difficult to deliver, meaning that preterm infants are at risk of poor growth and body composition that favours fat accretion over lean mass. This is important, as nutrition, growth and body composition in early life are associated with neurodevelopmental outcomes and longer-term cardiovascular risk. However, the exact pattern of growth that results in optimal short- and long-term outcomes in these infants is not well defined. This talk will explore current patterns of growth, the evidence for the pattern of growth for optimal clinical outcomes, and what can be achieved in clinical practice. It will then go on to consider different strategies for nutritional care and how these can be implemented in clinical practice for preterm infants in the neonatal unit to achieve optimal growth.
Leslie Parker has a dual position at the College of Nursing and the College of Medicine at the University of Florida where she is a professor. She has been a neonatal nurse practitioner since 1990 and continues to practice as a neonatal nurse practitioner in the NICU at UF Health. She was the tract coordinator of the neonatal nurse practitioner program from 1992-2011. She has been involved in human milk research for nearly two decades and focuses on improving milk production in mothers of critically ill and premature infants. She is funded by the National Institutes of Health for her team’s work regarding neonatal nutrition including the risk of feeding tube contamination, risks and benefits of gastric residual evaluation and optimizing consumption of breast milk for preterm infants.
1. Describe the most recent research regarding the practice of monitoring gastric residuals
2. Explain the potential risks and benefits of monitoring gastric residuals
3. Describe potential practice changes regarding monitoring gastric residuals
Until recently, routine monitoring of gastric residuals has been standard care in most neonatal intensive care units (NICUs). Rationale for this practice includes early recognition of feeding intolerance and necrotizing enterocolitis. However, gastric residuals are often used to direct feeding decisions and thus their use can result in delays and interruptions in feeding resulting in an increased risk of complications. Recent evidence suggests that the routine monitoring of gastric residuals prior to every feeding may not be clinically necessary and other clinical indicators may be sufficient to monitor for feeding intolerance and necrotizing enterocolitis. This presentation will describe practices clinicians are currently using to monitor gastric residuals In addition, an overview of current evidence including the risks and benefits of monitoring gastric residuals, alternatives to monitoring gastric residuals, and how to best change unit practice in order to decrease the routine use of aspirating and evaluating gastric residuals prior to every feeding will be presented.
Gail A. Bagwell, DNP, APRN, CNS works at Nationwide Children's Hospital as the CNS of Perinatal Outreach and clinical instructor of practice at the Ohio State University College of Nursing. In her role she works with the healthcare providers caring for neonates and provides education to healthcare providers on the well-newborn as well as care of the sick and premature newborn and serves as a resource on neonatal and quality improvement initiatives. Gail is a member of the National Association of Neonatal Nurses (NANN) and currently the Immediate Past President of the organization. She is also a member of the Central Ohio Association of Neonatal Nurses, American Nurses Association, Ohio Nurse’s Association, Association of Women’s Health and Neonatal Nursing, Academy of Neonatal Nursing, National Association of Clinical Nurse Specialists, Sigma Theta Tau and a Fellow in the American Academy of Nursing. Gail's interests are neonatal abstinence syndrome, breastfeeding, safe sleep, newborn resuscitation and stabilization and parent transition. Gail is a published author of book chapters in all six editions of the Kenner’s ""Comprehensive Neonatal Care"" textbook, the Encyclopedia of Child and Adolescent Development, Neonatal Nursing Care Handbook, editor of the NANN Guideline for Newborn Safe Sleep and multiple journal articles.
1. Participants will be able to describe the causes of sleep related deaths and injuries for infants.
2.
Participants will be able to list the top four AAP safe sleep recommendations for infants less than 1 year of age.
3. Participants will be able to apply strategies to implement the AAP recommendations for role modeling safe sleep in the NICU.
Sleep related deaths are the number one cause of infant deaths in the United States, with neonates that have been in a NICU being at a higher risk. In order to combat this problem, the American Academy of Pediatrics (AAP) in the early 1990's began publishing recommendations on how to prevent sleep related deaths in healthy term infants. This effort has led to a decrease in infant sleep related deaths, but confusion remains on when a premature or convalescing neonate be transitioned to a safe sleep environment in the NICU. This presentation will review the different types of sleep related deaths in infants, most current theory of cause of SIDS, review the myths of safe sleep and give guidance to the NICU nurse on how to implement safe sleep in their unit.
Heidi Heflin RN, MN, CPSTI became a Child Passenger Safety (CPS) Technician in 2013, then an instructor with training in transportation of children with disabilities and school bus transportation. A year later, she established the CPS exhibit at the American Academy of Pediatric Conference for >10,000 attendees seen annually since. She instantly saw the need to combine her experiences by advising, educating, and advocating for nurses in CPS, leading to national, then international presentations. In 2018, she relaunched CPS-In-Healthcare Google group to support hospitals without CPS staff. She’s written for NANN E-News for neonatal nurses and CPS Express for CPSTs. In 2021, she joined the Association for the Advancement of Automotive Medicine and is revising their child restraint policy. She was named a Kidz in Motion ‘CPS Hero’ 2019, 2022, and was a recipient of the SafetyBeltSafe U.S.A. 2022 Siegel Child Safety Restraint Award. Her research examining neonatal nurses’ CPS knowledge and practice is pending publication. Heidi ‘s fervor is for working with CPS pioneers in lower- and middle-income countries. Her favorite work is with CPS Malaysia especially when she met with the Director of the Road Safety Council in 2018. When not working, she cycles with friends, hikes with her dog Olive, or ocean-swims with dolphins.
Carrie Rhodes is the Passenger Safety Program Coordinator at Nationwide Children's Hospital in Columbus, Ohio. She is a Child Passenger Safety Technician-Instructor, Certified Health Education Specialist, and instructor for Safe Travel for All Children: Transporting Children with Special Healthcare Needs, and holds a Master of Transportation Safety Administration from Clemson University. In her role as Passenger Safety Program Coordinator, she focuses on facilitating safe transportation at the time of discharge for patients of all ages, from neonates to teens. Her work includes frequent assistance with car seat tolerance screenings across the hospital's neonatal intensive care units, working with families and clinical staff to achieve the correct balance between a neonate's cardiorespiratory safety and their protection in the event of a motor vehicle crash. She is passionate about ensuring NICU staff understand the importance of both neonate positioning and proper car seat use, as well as remaining abreast of the most currently available evidence to inform transportation decisions and practices.
1. Describe the rationale behind the Car Seat Tolerance Screening and common misconceptions about the process and results.
2. Describe the steps to set up and conduct a car seat tolerance screening, based on the standard of care in the United States.
3. Explain the scope of practice of the provider, bedside clinician, and Child Passenger Safety technician as it pertains to the car seat tolerance screening.
Healthcare professionals play an important role in promoting the safety of neonates during motor vehicle travel. Properly securing neonates in age- and size- appropriate car seats reduces the risk of serious injury or death from a motor vehicle crash, yet research and field data show most infants and children are incorrectly secured in their car seats. Additionally, screening fragile infants for positioning and tolerance in their car seat reduces the risk of cardiorespiratory compromise. However, research demonstrates that although the American Academy of Pediatrics continues to recommend that at-risk infants be monitored for tolerance in an appropriate car seat or car bed, knowledge, policies, and practices vary widely between healthcare institutions. In light of these concerns, this presentation will review the rationale behind the recommendation to complete a Car Seat Tolerance Screening (CSTS) and discuss common misconceptions about the process and results. Additionally, the steps to set up and conduct a CSTS will be discussed, including a focus on proper harnessing and positioning of the neonate. Finally, the scope of practice of the provider, the bedside nurse, and the hospital’s Child Passenger Safety Technician will be explored.
Cody is a Clinical Nurse II and serves as chair of a pain and palliative care committee in a level 4 NICU at UCSF Benioff Children's Hospital in San Francisco, CA. He switched careers to nursing as a result of experiencing the death of his newborn daughter, Quinn, in the NICU. Cody is an experienced educator reflected by his years teaching Chemistry at the high school level. His graduate degree is in qualitative research, which has supported his efforts in improving neonatal palliative care.
1. Describe the importance of when, how, and why to offer choice to parents making decisions during neonatal death
2. Explain the various roles in end-of-life care
3. List at least 2 ways to promote communication with parents during neonatal loss.
Families whose infants die in the Neonatal Intensive Care Unit (NICU) may be asked about autopsy, organ donation, and research tissue donation. Understanding how parents experience these often difficult but important conversations is crucial information for healthcare teams. This presentation provides the results of research that looked at the perspectives of parents who had experienced neonatal loss. Make a lasting difference to the families in your care by learning more about how to approach the conversation of autopsy, organ donation, and tissue donation for research in a way that is parent centered.
Deborah is Aotearoa/ New Zealand’s first Nurse Practitioner. Deborah’s research interests include the management of babies at risk of neonatal hypoglycaemia and their later development. The impact of her teams research has changed the treatment for millions of babies and families across the developed world. More recently, Deborah has been investigating the prevention and management of neonatal hypoglycaemia within the Pacific Islands.
1. Describe normal metabolic adaptation in healthy babies over the first five days
2. Describe the evidence related to oral treatment interventions for at-risk hypoglycaemic babies
3. Describe the neurosensory outcomes of children who as babies received treatment for neonatal hypoglycemia with oral dextrose gel
Recent evidence has shown healthy term babies have episodes of low blood glucose concentrations, in the first few days after birth, which can last for long periods, similar to those babies identified as being at-risk for neonatal hypoglycemia. Suggesting low blood glucose concentrations may be part of metabolic transition. Neonatal hypoglycemia in at-risk babies is important because it is common and linked with neurosensory impairment and death. Screening is recommended for babies identified as being at-risk, which is routinely performed by heel-prick lances. Half of the babies identified as being at risk, will become hypoglycemic. If hypoglycemia is diagnosed, treatment is recommended. The aim of treatment is to increase the blood glucose concentration, and therefore available glucose for cerebral metabolism. The glucose concentration at which brain injury occurs remains unclear. Therefore, while current treatment thresholds are determined by evidence, expert opinion also contributes to treatment recommendations. Consequently, there are international variations in screening regimes and treatment thresholds. However, feeding and oral dextrose gel are the most common treatments for neonatal hypoglycemia. Learn more about the research and thoughts on best practice for preventing and managing hypoglycemia in neonates.
Karen Lasby leads a specialized nursing team in post-discharge follow-up of extremely premature infants and their families in Alberta, Canada. She has presented locally, nationally, and internationally on the topics of premature babies, neonatal oral feeding, and NICU-to-home transition, including the 2019 and 2022 GOLD Neonatal Conferences. She has been the co-investigator in several research studies examining outcomes for very low birth weight infants and has published articles on maternal work in the NICU, neonatal transition, and gastroesophageal reflux. An educator for nearly thirty years, Karen has taught, written instructional material, and produced online neonatal nursing courses. Formerly the president of the Canadian Association of Neonatal Nurses, she served on this national board for twelve years, and on the board of the Council for International Neonatal Nurses for three years. Karen’s work has been recognized by the Canadian Institute of Child Health and College and Association of Registered Nurses of Alberta. Karen is the co-author for the parent book, "Preemie Care: A guide to navigate the first year with your premature baby".
Noriko Woods is a member of a specialized nursing team in post-discharge follow-up of extremely premature infants and their families in Alberta, Canada. She started her Level 4 NICU RN career in Kanagawa, Japan, trained and worked for 5 years before moving to Canada. She worked 5 years as a Level 4 NICU RN in Calgary Alberta before she started her current position at Postpartum Community Health Services, as a public health nurse. She became passionate about breastfeeding with her own experience with her first child in 2009 and obtained the IBCLC in 2011. She has been working with early postpartum mothers and babies to reach their breastfeeding goals as a Lactation Consultant in her community. She is passionate about supporting families to achieve positive feeding experience with a bottle and at breasts. She has been participating with various committees such as Calgary NICU LC group to revise the breastfeeding guidebook for NICU parents, Calgary Breastfeeding Matters Group annual conference committee, GOLD Neonatal Professional Advisory Committee.
1. Describe common breastfeeding patterns experienced by very preterm newborns and their families.
2. List barriers and facilitators for breastfeeding, as described by our four mothers.
3. Create a plan of action to support fragile feeders and family breastfeeding goals.
Long NICU stays, invasive oral procedures, chronic lung disease, and gastrointestinal complications can contribute to a complex oral feeding journey for premature infants. Frequently, the NICU journey prioritizes bottle feeding over breast feeding. Breastmilk supply and transfer are challenging for mothers and infants born very premature. At the time of NICU discharge, most very premature infants remain fragile oral feeders with weak breast-feeding and bottle-feeding skills, and some require tube feeding support. Community-based breastfeeding support is often lacking, and breastmilk intake and direct breastfeeding diminish beyond discharge. The authors will highlight four remarkable case studies of very premature newborns who were discharged home on nasogastric tube feeding. All four babies had a complex oral feeding journey in the NICU with minimal opportunity to develop breastfeeding skills. Parent comments will be shared, including barriers and facilitators for breastfeeding. Take away messages will focus on helpful strategies to support families taking home a fragile feeder and progressing toward positive, enjoyable oral feedings and more importantly, weaning from tube support and advancing breastfeeding.
Prof EL-Khuffash is a Consultant Neonatologist and Paediatrician. He is a qualified International Board Certified Lactation Consultant. His two primary clinical and research areas of expertise are heart function in neonates and the promotion of breast feeding, and breast feeding support, to new mothers. He also has extensive expertise in general feeding issues encountered by babies over the first few months.
Prof EL-Khuffash sees families for prenatal breast feeding and fetal anomaly consultations and postnatal infant assessment, 2 and 6 week checks, and breastfeeding/general support including early irritability and reflux in his consultation rooms in the Rotunda Private Clinic.
Prof EL-Khuffash has considerable knowledge of breast feeding medicine and experience in providing antenatal and postnatal breast feeding advice and support to new mothers. This includes identifying and addressing challenges to breastfeeding in both the mother and the baby. He also specialises in general feeding difficulties and early feeding issues encountered by babies.
Prof EL-Khuffash graduated from Trinity College, Dublin in 2002 and enrolled in the Royal College of Physicians of Ireland paediatric specialist training scheme in 2005. He completed a Doctor of Medicine (MD) degree in University College, Dublin in 2008 and his neonatal specialty training in Toronto, Canada (2009-2011). Following this, he was appointed as a consultant Neonatologist and Assistant Professor of Paediatrics at the University of Toronto in January of 2011. He obtained a diploma in clinical epidemiology during his time in Toronto. He is the recipient of several national and international research awards, with international peer reviewed publications and keynote presentations and the lead for cardiovascular research, supervising several post graduate PhD candidates.
Topic: Mother's Own Milk Versus Donor Human Milk in the NICU: Practical Recommendations for Individualized Care - [View Abstract]
2. Describe the implications associated with both options, and to be able to select the best choice for a premature infant based on individual circumstances.
3. Explain practical recommendations for families and healthcare providers on how to ensure that premature infants receive the best possible nutrition, including the importance of collaboration and ongoing research.
Dr. Ankur Bio Update - Dr. Kumar Ankur, MD, DNB is working as an Associate Director & Head of the Department of Neonatology at BLK MAX Super Speciality Hospital Delhi, India. He has been working in the field of neonatology with private and non-goverment organisations for improving neonatal healthcare in the country. He is the national faculty and trainer for FBNC (Facility based neonatal care), Neonatal Resuscitation, Kangarroo Mother Care (KMC) and the national assessor for Neonatology Fellowship accreditation programme of India. He has been invited as an expert speaker, faculty, chairpersons for various national and state level conferences and workshops. He has many publications in national & international journal and authored many chapters, guidelines published by Indian Academy of Pediatrics & National Neonatology of Forum Delhi & India. He is also the co-editor of Handbook of Neonatal Clinical Practices. He is also running training program in neonatal Fellowship for postgraduate students & neonatal nurses. Currently he is also the Secretary of prestigious National Neonatology Forum, Delhi. National Neonatology Forum (NNF) is a strong and large body of more than 8000 neonatologists across India and abroad. NNF has been actively involved in advocacy, policy making, research and ensuring quality health care to newborn for the last 4 decades. He had been past Secretary (2014) & President (2018) of Indian Academy of Pediatrics (IAP), Central Delhi Branch.
Topic: Tongue-Tie and the NICU: A Neonatologist Perspective - [View Abstract]
Objective 1: Explain what the Golden Hour is and why it's important
Objective 2: Describe resuscitation preparation & care during the golden hour including delayed cord clamping
Objective 3: Describe the importance of and best approach to antenatal counseling of parents and team communication
Prematurity is the leading cause of death across the globe, mainly in low resource settings. Infants born at less than 32 weeks gestation, are prone to developing hypothermia, hypoglycemia, and hospital acquired infections after birth. For them, the initial 60 minutes of holistic approach is crucial for long-term outcomes. The “Golden Hour” of neonatal life is defined as the first hour of post-natal life in both preterm and term neonates. This concept includes practicing particular evidence based interventions in the initial sixty minutes of postnatal life for better long-term outcomes like marked reduction in hypothermia, hypoglycemia, intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), and retinopathy of prematurity (ROP). This presentation will provide a look at the various components of neonatal care that are included in the “Golden hour” of preterm and term neonatal care. Healthcare professionals attending the birth of high risk infants like VLBW (very low birth weight, less than 1500 grams) or high-risk term neonates should be well trained in attending such deliveries and should be able to implement all the management protocols during the golden first 60 minutes of life.
Amanda is a children's nurse, having worked on pediatric wards and in the community supporting children with complex health needs, although over ten years of her nursing career have been in neonatal care, where she is further qualified in specialty (QiS). She trained and volunteered in breastfeeding peer support two years into her nursing career, ultimately sitting the exam to become an IBCLC to ensure that the families within neonatal care had access to an infant feeding specialist familiar with their journey. Amanda has since further specialized in Neonatal Homecare, is a Nurse Practitioner in restrictive lingual frenulum, and has worked as an Infant Feeding Lead for a regional surgical NICU and SCBU, as well as a regional Infant Feeding Advisor to ten neonatal units across a regional network. She has recently been appointed to the Board of Trustees for the Lactation Consultants of Great Britain (LCGB), where she is the Neonatal Lead.
1. Describe how to develop a discharge pathway for a home NGT feeding programme.
2. Explain the criteria for an ideal home NGT feeding candidate.
3. Describe how home NGT feeding can be protective of breastfeeding goals, before and after discharge from NICU.
While approximately 80% of UK mothers initiate breastfeeding, by 3-4 months, just 15% of infants receive any breastmilk. Despite the low rates of breastfeeding nationally, in 2021-22, 64% of the NICU graduates in our unit were discharged receiving breastmilk. One possible reason for the higher rates of breastfeeding in this population may be our innovative home NGT feeding programme. In order to hasten discharge from NICU, many mothers feel under pressure to introduce bottles to meet “full oral feeding” criteria. The home nasogastric tube (NGT) feeding programme focusses on the infant’s and family’s needs, without rushing the infant towards full oral feeding, which some are not yet ready for. In this way, all oral feeds can be at the breast, with NGT feeds as required for supplementation. We aim to reduce unnecessary days in hospital, reduce readmissions post-discharge, keep families close to their infants, and embrace the integration of families as essential members of the neonatal care team. This presentation will discuss the practicalities of designing a discharge pathway that optimises parental confidence and ensures competence with home administration of NGT feeds. It will also discuss how to predict which infants are ideal candidates for short-term home NGT feeding, and how to transition to direct breastfeeding. Finally, the presentation will present a case for home NGT feeding as an intervention to protect the mother’s breastfeeding goals, optimise clinical outcomes for infants, and improve the experience of neonatal care for families.
Michelle has been a respiratory therapist for 23 years. Working in the neonatal population for approximately 22 of those years, she was the Neonatal Respiratory Care Specialist for a large organization, where she enjoyed bringing evidenced based practice to the bedside.
1. Describe the correct steps of routine neonatal endotracheal tube management
2. Describe the correct steps of routine tracheostomy care
3. Explain the process for securing artificial airways.
Appropriate care of artificial airways is an important part of clinical care in the NICU. This presentation will demonstrate how to provide ongoing care to newborns with an endotracheal tube or a tracheostomy tube. Indications, and contraindications of endotracheal tube management. A variety of securing methods will be reviewed for endotracheal tubes. A review of a variety of chronic conditions that may warrant a tracheostomy tube. The procedure for securing a tracheostomy tube will be reviewed. Cleaning and maintaining a tracheostomy will be discussed. Education with the staff caring for newborns with an artificial airway will be reviewed along with parent education.
Amber Valentine is a Speech-Language Pathologist who graduated from the University of Kentucky with her MS in Communication Disorders. She is a Board Certified Specialist in Swallowing and Swallowing Disorders and an International Board Certified Lactation Consultant, as well as a Certified Neonatal Therapist (CNT). She worked for Baptist Health Systems, Inc for 8 years before moving to Florida where she worked for Wolfsons Children’s Hospital and Mayo Florida. She is now back in Kentucky working for Baptist Health Lexington. She has experience in adults and pediatrics with feeding and swallowing difficulties including: bedside swallow evaluations, Modified Barium Swallow studies, FEES, and pediatric feeding evaluations including NICU. She has experience with head and neck cancer patient including evaluation and treatment of swallowing difficulties, PMV use, and voice after total laryngectomy including TEP. She has provided guest lectures for the University of Kentucky, Eastern Kentucky University, and the University of Louisville on feeding and swallowing topics. She has presented at the hospital, local, state, national, and international levels on pediatric feeding/swallowing and breastfeeding.
Topic: Breastfeeding Medically Complex Infants in the Neonatal ICU - [View Abstract]
Topic: Building a Successful Breastfeeding Program in the NICU: Challenges and Practical Solutions - [View Abstract]
1. List at least 2 challenges related to protocols for implementing breastfeeding and breastmilk provision in the NICU.
2. Describe at least 3 differences in breastmilk production for term vs. preterm infants (or sick babies in NICU).
3. Describe strategies for implementing a successful breastfeeding regime in the NICU
Dr. Jennifer Barnes is the Neonatal Intensive Care Clinical Pharmacy Specialist at Levine Children’s Hospital in Charlotte, NC. She has over 10 years of experience within the field. Dr. Barnes received her bachelor’s degree at Virginia Tech and her Doctor of Pharmacy at Virginia Commonwealth University’s Medical College of Virginia. She completed her pharmacy practice residency at Alamance Regional Medical Center- Cone Health. Dr. Barnes is board certified in pediatric pharmacotherapy. She is also an active member of the Pediatric Pharmacy Association (PPA) and is currently serving as the neonatology committee chair. Dr. Barnes serves as a clinical assistant professor for pharmacy advanced practice rotations for University of North Carolina, University of South Carolina, Wingate University and High Point University. Her current research areas of interest include the role of diuretics in bronchopulmonary dysplasia treatment and antibiotic stewardship for late-onset sepsis amongst other topics.
Topic: Get the LOW Down on Neonatal Hypotension - [View Abstract]
Topic: Starbucks for Babies? Caffeine Use in Neonates - [View Abstract]
1. Describe the routine immunization schedule for infants in the first six months of life
2. Describe tolerability of immunizations and monitoring parameters
3. Analyze new vaccines in the pipeline that are relevant to the neonatal intensive care population
Many premature infants spend months within neonatal intensive care units (NICUs). During their NICU admission, typical preventive care ideally should also be addressed. The Centers for Disease Control and Prevention (CDC) recommends that infants and children be vaccinated at the recommended schedule regardless of premature birth. In this presentation, we will review the different immunizations given in the first six months of life that are most relevant to patients in the NICU. Additionally, we will compare distinctive immunogenic and tolerability aspects for the term and preterm population. There is also tremendous growth in new vaccines and viral prophylaxis options coming to market soon. This presentation will also address these new agents and how they are pertinent to the NICU population. So don’t miss your shot to further your immunization knowledge.
Accreditation
CERPs - Continuing Education Recognition Points
Applicable to IBCLC Lactation Consultants, Certified Lactation Consultants (CLCs), CBEs, CLE, Doulas & Birth Educators. GOLD Conferences has been designated as a Long Term Provider of CERPs by IBLCE--Approval #CLT114-07. This program is approved for 15.5 CERPs (11.5 R-CERPs)(4 L-CERPs).
CMEs - Continuing Medical Education Credits for Physicians & Nurses
The AAFP has reviewed the activity and deemed it acceptable for AAFP credit. Term of approval is from May 30, 2023 to May 30, 2024. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This activity is approved for 15.5 AAFP Prescribed CME credits.
CME credits are valid until 05/30/2024.
Nurse Contact Hours
This nursing continuing professional development activity was approved by the American Nurses Association Massachusetts, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation for 15.5 Nursing Contact Hours.
Nurse Contact Hours are valid until 05/30/2025.
- View this presentation in its entirety, under your individual GOLD login info
- Successfully complete a post-test (3 out of 3 questions correctly answered)
- Fill out the Evaluation Survey
If you have already participated in this program, you are not eligible to receive additional credits for viewing it again. Please send us an email to [email protected] if you have any questions.
Additional Details
Viewing Access Time: 8 Weeks
Tags / Categories
(IBCLC) Clinical Skills, (IBCLC) Development and Nutrition, (IBCLC) Pathology, (IBCLC) Physiology and Endocrinology, (IBCLC) Psychology, Sociology, and Anthropology, (IBCLC) Techniques, Breastfeeding Strategies for the Preterm Infant, Discharging From NICU, Donor Human Milk for Preterm Infants, Evidence Based Care in Nicu, Family-Centered Care, Hypoglycemia in the NICU, Necrotizing Enterocolitis, Neonatal Loss, Neonatal Screening, Neonatology Ethics, NICU Nutrition & Feeding, Pharmacology in the NICU, Respiratory Concerns/Problems, Stress in the Neonate
How much time do I have to view the presentations?
- The viewing time will be specified for each product. When you purchase multiple items in your cart, the viewing time becomes CUMULATIVE. Ex. Lecture 1= 2 weeks and Lecture Pack 2 = 4 Weeks, you will have a total of 6 weeks viewing time for ALL the presentations made in that purchase.
- Time for viewing the talks begins once you purchase the product. For Live Webinars & Symposiums, the viewing period begins from when the live event takes place. Presentations can be accessed 24/7 and can be viewed as many times as you like during the viewing period.
What are bundled lectures?
- Presentations may be available individually or via a bundled package. Bundled lectures are a set of lectures that have been put together based on a specific category or topic. Some lectures will be available in both individual and lecture form, whereas others will be available only via a bundled lecture pack.
Will there be Handouts?
- YES! Each lecture comes with a PDF handout provided by the Speaker.
Some lectures include a Q&A, what does that mean?
- During our online conferences, presentations that occur live are also followed by a short 15 minute Question & Answer Session. The Speaker addresses questions that were posted by Delegates during the presentation. We include the recording of these Q&A Sessions as a bonus for you.
How can I receive a Certificate?
- If this presentation offers a certificate, once you are done viewing the lecture or the lectures within a bundle, submit your attendance record in order to be able to download your certificate. You'll be able to see which credits are offered for the lecture by hovering over the "Credits Available" link within the "Speakers & Topics" tab.
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