Speaker Type: Preterm Lecture Pack 2014, GOLD Neonatal 2017, Advancing Human Milk & Breastfeeding Practices in the NICU Lecture Pack 2022
Country: USA
Biography:
After 37 years as an attending neonatologist and 18 years as medical director of lactation services, Nancy retired from clinical practice 2019. She graduated from medical school and did her training in pediatrics at the University of North Carolina, Chapel Hill. She did her fellowships in Neonatal-Perinatal Medicine and ECMO at UCSD Medical Center in San Diego. She has been a board-certified lactation consultant since 1988.
Nancy co-founded the San Diego County Breastfeeding Coalition in 1994. She was the Breastfeeding Coordinator for AAP CA Chapter 3 from 1992 until 2020, Board Member of HMBANA 2015-2019 and established the first Donor Milk Depot in San Diego over 25 years ago. Nancy is a past president of the Academy of Breastfeeding Medicine. She wrote, and continues to update, the very first ABM Protocol on Hypoglycemia and Breastfeeding.
In 2014 Nancy was awarded the Golden Wave Award by the California Breastfeeding Coalition for her efforts to reduce obstacles to breastfeeding in California, and the WIC Breastfeeding Champion Award in 2017. She received AAP Special Achievement Awards in 1997 and 2021 for her breastfeeding education and promotion efforts.
On a personal note, she is the mother of a (formerly breastfed) archaeology student and lives in San Diego, CA, with her significant other, their dog, Darwin, and a beautiful view of the ocean.
The benefits of human milk for term infants are well recognized. Human milk is species-specific and has been adapted through evolution to meet the needs of the human infant, supporting growth, development, and survival. It has only been in the very recent past that significantly preterm infants have survived and that attention has been paid to the crucial role of nutrition in the long-term outcomes for these infants. Human milk is a complex fluid that simultaneously provides nutrients and bioactive components that facilitate the adaptive, functional changes required for the optimal transition from intrauterine to extrauterine life. Preterm infants suffer not only from gastrointestinal immaturity, but also from functional immaturity of all organs and physiologic systems, as well as specific illnesses and complications, which further confound their transition from fetus to newborn. We will discuss the goals and methods of providing appropriate nutrition for NICU infants to promote optimal short and long term outcomes.
The preferred feeding for all NICU infants is human milk, preferably started on day 1. If mother’s own milk is not immediately available, the clinician should consider the use of heat-treated donor human milk (DHM), which has most of the properties of fresh human milk (immunoglobulins, growth and developmental hormones, enzymes, anti-inflammatory factors, etc.), is sterile, and reduces NEC while improving feeding tolerance. The use of human milk and human milk-derived products has been steadily increasing in world-wide NICUs. In many areas of the USA, it is the standard of care. We will explore the benefits and risks of various donor human milk products, as well as the cost-effectiveness, and challenges for NICUs in using these products.
In the neonatal period, low birth weight, preterm, and ill infants, regardless of gestational age, have greater nutritional needs than at any other time in their lives. Without the last trimester, the preterm infant faces the most demanding growth period with a nutritional deficit. For any NICU infant, the stress of medical conditions may contribute to increased nutrient needs. Human milk is a complex fluid that simultaneously provides nutrients and bioactive components that facilitate the adaptive, functional changes required for the optimal transition from intrauterine to extrauterine life. We will discuss the goals and methods of providing appropriate nutrition for NICU infants to promote optimal short- and long-term outcomes.
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