This project will establish a core network of 6 neonatal units (4 Nigeria/2 Kenya) to improve gut health and early nutrition in low birthweight (LBW) infants. Immature gut structure and function in preterm and growth-retarded infants compromises nutrition, facilitates sepsis and risks necrotising enterocolitis (NEC). Nutritional interventions used in richer countries, such as probiotics and lactoferrin, may be practical, safe and affordable in low-resource settings. Improved gut health would likely improve nutrition, brain, lung and other organ development and prevent NEC and sepsis.
Our network will
- evaluate current evidence and document variation in feeding practices for LBW infants
- develop core outcome sets for common diseases such as sepsis and NEC
- share anonymised clinical data as a basis for future research
We will also pilot test volumetric absorptive microsampling technology combined with QPlex Array for measuring micronutrients in small blood samples and high resolution melt based qPCR to describe acquisition of anti-microbial resistance genes in faecal flora. We will engage other low-resource NNUs and develop processes that can be rolled-out to expand the network as a resource for multicentre clinical trials.
Paediatric inflammatory bowel disease (pIBD) research at Alder Hey
Funded through the NIHR Research for Patent Benefit programme, we are undertaking two projects. The “VOCs in pIBD” study, in collaboration with Prof Chris Probert, Liverpool University, will evaluate faecal volatile organic compounds in the diagnosis of pIBD in an inception cohort of children presenting to gastroenterology clinics in Liverpool, Birmingham and Bristol. An add-on study, joint funded by CORE and BSPGHAN, will investigate the role of gut fungi in pIBD.
Secondly, the “First milk” in paediatric Crohn’s disease study, is a feasibility study to evaluate whether children tolerate a daily supplement of bovine colostrum presented as a flavoured milk shake and how this may affect intestinal mucosal healing and quality of life. We will also undertake qualitative research on nutritional therapy collaborating with Prof Bernie Carter and colleagues from Edge Hill University.