Should Very Premature Babies Receive A Placental Transfusion At Birth? A Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$2,875,774.00
Summary
Premature babies under 30 weeks gestation are up to a hundred times more likely than full term babies to die or survive with major disability, often from brain damage due to poor blood flow after birth. This randomised study will find out if giving them more placental blood at birth, by means of a delay in clamping the umbilical cord, then milking it, reduces anemia, blood transfusions, brain damage, infection, death and disability. The results may benefit millions of premature babies worldwide.
Does Bovine Lactoferrin Prevent Death Or Disability In Very Low Birthweight Infants? Childhood Follow Up In The NHMRC LIFT Study
Funder
National Health and Medical Research Council
Funding Amount
$1,474,012.00
Summary
Our international consortium of investigators proposes to undertake follow up in survivors among 1,500 very low birth weight preterm infants enrolled in the NHMRC Lactoferrin Infant Feeding Trial, which is designed to evaluate whether low-cost oral lactoferrin supplementation reduces death and disability in early childhood.
Does Gastrostomy Improve The Lives Of Children With Severe Disability And Their Families?
Funder
National Health and Medical Research Council
Funding Amount
$645,101.00
Summary
Around 750 Australian children are born each year with severe intellectual disability. Problems may include feeding difficulties and frequent hospitalisations. Feeding via a gastrostomy tube into the stomach can be used. We will conduct a data linkage study in NSW and WA, and collect additional data in WA to investigate patterns of gastrostomy use and its safety, effectiveness and costs. Our findings will help the management of poor feeding in intellectual disability.
DHA For The Improvement Of Neurodevelopmental Outcome In Preterm Infants: The DINO Trial
Funder
National Health and Medical Research Council
Funding Amount
$631,875.00
Summary
The incidence of neurological problems that occur in children born prematurely is higher than for those born at term. The earlier that a baby is born, the greater chance it has of having some developmental delay and general inability to cope at school. This has implications for the child, the families and the health system. One of the many dietary factors implicated in the development of neural abilities in premature infants is an omega-3 fatty acid called DHA. This compound is present in breast ....The incidence of neurological problems that occur in children born prematurely is higher than for those born at term. The earlier that a baby is born, the greater chance it has of having some developmental delay and general inability to cope at school. This has implications for the child, the families and the health system. One of the many dietary factors implicated in the development of neural abilities in premature infants is an omega-3 fatty acid called DHA. This compound is present in breast milk and most preterm formulas and is found in high concentrations in the brain and retina. In the last third of pregnancy the developing baby would normally accumulate DHA at a rapid rate. So it seems reasonable to assume that a baby outside the mother, that is born premature, would also need to accumulate DHA at this same rate. The problem is that none of the milks currently given to premature infants have DHA in high enough concentration to supply this amount of DHA to the baby. For example, breast milk and preterm formulas contain only a third of the DHA required. In order to provide this amount for the premature infant, breast milk containing DHA at about 1% of the total fat is required. Fortunately the level of DHA in breast milk can be increased to this level by supplementing the mothers diet with fish or olis like tuna oil. This study hopes to show that premature babies who receive DHA in amounts similar to that supplied in the womb will develop better than babies who receive low amounts of DHA.Read moreRead less
Is There Cytomegalovirus In Mothers Breastmilk And Does It Cause Infection In Very Premature Babies?
Funder
National Health and Medical Research Council
Funding Amount
$235,970.00
Summary
The hypothesis behind this study is that some very premature infants become infected with cytomegalovirus (CMV) from their mother's breast milk. This proposal is for a study of 200 CMV antibody positive mothers who are expressing breast milk for their very premature infants. We believe this is likely to be about 50% of all mothers. It has been well established that some full term infants are infected with CMV from their mother's breastmilk. The question now is do very premature infants with poor ....The hypothesis behind this study is that some very premature infants become infected with cytomegalovirus (CMV) from their mother's breast milk. This proposal is for a study of 200 CMV antibody positive mothers who are expressing breast milk for their very premature infants. We believe this is likely to be about 50% of all mothers. It has been well established that some full term infants are infected with CMV from their mother's breastmilk. The question now is do very premature infants with poor immunity develop serious infections from cytomegalovirus. This project has the overall aim of determining what proportion of very premature infants become ill with CMV excreted in their mother's breast milk, and then determining the nature and severity of those illnesses. It will also define how many mothers of premature infants are excreting CMV in their breast milk, the time this starts after birth, the viral load transmitted to the infant, the age after birth when the infants first become infected, the proportion who become ill with the infection, the details of the diseases and whether freezing breast milk kills the CMV.Read moreRead less
Nasal CPAP For Very Preterm Infants At Birth: Does It Improve Outcome? A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$460,604.00
Summary
Neonatal respiratory distress syndrome (RDS) is the major cause of morbidity and mortality in preterm infants. Many of these infants need ventilatory support to keep them alive. In 1996 and 1997, 10,471 infants in Australia and New Zealand needed ventilatory support for a total of 72,544 days. This treatment is a great physical burden for the infants and an enormous emotional stress for their parents. Each day of treatment costs about A$2000 so their hospital treatment costs about $72 million a ....Neonatal respiratory distress syndrome (RDS) is the major cause of morbidity and mortality in preterm infants. Many of these infants need ventilatory support to keep them alive. In 1996 and 1997, 10,471 infants in Australia and New Zealand needed ventilatory support for a total of 72,544 days. This treatment is a great physical burden for the infants and an enormous emotional stress for their parents. Each day of treatment costs about A$2000 so their hospital treatment costs about $72 million a year. Of infants born less than 29 weeks' gestational age, about 40% of the survivors subsequently developed chronic lung disease (CLD). This condition is defined as prolonged dependence on supplementary oxygen therapy. CLD is associated with further costs and increased lung problems and readmissions to hospital in the first year of life. Thus, CLD is an expensive and time-consuming condition that has a high social cost. This project will determine whether treating these very premature babies from birth simply by applying oxygen under a low continuous positive pressure (CPAP) into their nose rather than the present treatment of placing a tube in the windpipe (known as intubation) and ventilation will reduce the incidence and severity of neonatal respiratory distress syndrome and subsequent chronic lung disease. The project will involve 600 babies from different, high quality neonatal intensive care units. Babies who are born at less than 29 weeks' gestation and who show signs of breathing at birth will be randomly allocated to be treated with either nasal CPAP or intubation and ventilation. This project will determine whether CPAP treatment at birth improves survival and reduces the severity of the RDS and subsequent CLD, or has no long term beneficial effect. If the trial is successful, this will be one of the most useful new treatments in neonatal medicine because it is simple to use, easier for the babies, and cheaper than ventilation.Read moreRead less
Previous research has shown that SIDS victims have a number of subtle abnormalities that set them apart from the normal population. These include the occurrence of upper airway obstruction in sleep, a reduced ability to awaken from sleep and abnormalities of the automatic control of heart rate and blood pressure in sleep. These body functions are controlled by a component of the brain called the autonomic nervous system which controls the heart and other internal functions by means of nerves cal ....Previous research has shown that SIDS victims have a number of subtle abnormalities that set them apart from the normal population. These include the occurrence of upper airway obstruction in sleep, a reduced ability to awaken from sleep and abnormalities of the automatic control of heart rate and blood pressure in sleep. These body functions are controlled by a component of the brain called the autonomic nervous system which controls the heart and other internal functions by means of nerves called the parasymmpathetic and sympathetic systems. The purpose of this project is to undertake studies of the autonomic system in normal infants and in those infants who are considered to be at risk for SIDS. As SIDS occurs almost exclusively in sleep it is important to study the infant?s heart rate and blood pressure responses to various challenges whilst asleep. All infants (both controls and subjects) enrolled in the protocol will therefore undergo overnight sleep studies during which their automatic responses to a variety of stimuli will be measured. Once we have established the normal response to these stimuli we can then compare them to the results of the at risk group. If, as we anticipate, there is a difference between our at risk group and the normal controls in automatic function then we will measure some of the stress hormones in the body which reflect the function of the autonomic nervous system. If there is a difference in the levels of these hormones between the normal and the at risk groups which correlates with the expected subtle abnormalities in function we may be able to devise an accessible and quantifiable measure for those infants at risk of SIDSRead moreRead less