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Unit news: St Peter’s goes purple forWorld Prematurity Day Page 8-10

Conference report: NNA celebrates 40 years of caringfor sick newborn infantsPages 12-14

Perinatal nurse receivestop nursing award Forget Me Not Children’s Hospice’s perinatal teamleader Emma Bleasdale has been named ‘Nurse ofthe year’ in the Nursing Times Awards 2017.The award was announced at a ceremony at theGrosvenor House Hotel, London, on 2 November.More than 137 organisations, primarily largehospital trusts, competed for awards across 21categories.

Emma joined Forget Me Not, based inHuddersfield, in 2013 and was the first memberof the nursing team to specialise in perinatal care.

She leads a team of seven perinatal nursing andcare staff, including Europe’s first hospice-basedmidwife, which is in turn part of a broader teamof 50 nurses, therapists and care assistants at thechildren’s hospice.

Nurse of the year Emma Bleasdale (centre).

Staff from the special care baby unit at Glan Clwyd Hospital, including Healthcare Support WorkerJulia Davies (holding iPad) who set up the new group.

A support network to help families of children on neonatal units in North Wales has been

launched by neonatal nurses.

Neomates North Wales is a new group for parents of babies receiving care in one of the

region’s three neonatal units.

The support network, which is open to all parents of children currently receiving care or

who have previously had care on a unit, will initially launch as a Facebook group.

Group meetings will follow in 2018 once the new SuRNICC (Sub Regional Neonatal

Intensive Care Centre) unit opens at Glan Clwyd Hospital, Bodelwyddan.

The group has been inspired by the work of neonatal unit staff at Arrowe Park Hospital

on the Wirral, which set up the original Neomates group in 2013.

The Facebook page will be administered by neonatal staff from Wrexham Maelor, Ysbyty

Gwynedd and Glan Clwyd Hospital, and will offer a private space for parents and families to

share their experiences of a child receiving care on a neonatal unit. It will also contain

information on how to seek medical care if needed.

North Wales neonatal nurses launch newsupport network

Front cover Gr Dec 17 .qxp_cvr ideas iNFANT 13/12/2017 11:37 Page 1

UKI/201/17-0041 (UK) October 2017 This material is intended for Healthcare Professionals only.

Baxter Healthcare Ltd:

Wallingford Road, Compton, Newbury, Berkshire RG20 7QW.

Tel: 0800 0289 881 Fax: 08708 507075 email: servicecs@baxter.comwww.baxterhealthcare.co.uk

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard.

Any adverse events relating to Baxter products can also be reported direct to Baxter Pharmacovigilance

on 01635 206360, or by email to vigilanceuk@baxter.com.

NUMETA G13%E PRETERM

Innovative parenteral nutrition that has them covered

NUMETA G13%E PRETERM is the first and only triple-chamber bag system

designed and licensed specifically for parenteral nutrition in preterm neonates.

It provides a solution that is:1

Supportive1,2 Ready1

Flexible1Secure3-7

NUMETA RANGE PRESCRIBING INFORMATION – UKName and composition: Numeta G13% Preterm, Numeta G16%E , Numeta G19%E.Active Substance: Reconstituted triple chamber bag contains:

Active Ingredients

Numeta G13% Preterm

Numeta G16%

Numeta G19%

Amino Acid ChamberAlanine 0.75g 1.03g 1.83gArginine 0.78g 1.08g 1.92gAspartic acid 0.56g 0.77g 1.37gCysteine 0.18g 0.24g 0.43gGlutamic acid 0.93g 1.29g 2.29gGlycine 0.37g 0.51g 0.91gHistidine 0.35g 0.49g 0.87gIsoleucine 0.62g 0.86g 1.53gLeucine 0.93g 1.29g 2.29gLysine monohydrate (equivalent to Lysine)

1.15g (1.03g)

1.59g (1.42g)

2.82g (2.51g)

Methionine 0.22g 0.31g 0.55gOrnithine hydrochloride (equivalent to ornithine)

0.30g (0.23g)

0.41g (0.32g)

0.73g (0.57g)

Phenylalanine 0.39g 0.54g 0.96gProline 0.28g 0.39g 0.69gSerine 0.37g 0.51g 0.91gTaurine 0.06g 0.08g 0.14gThreonine 0.35g 0.48g 0.85gTryptophan 0.19g 0.26g 0.46gTyrosine 0.07g 0.10g 0.18gValine 0.71g 0.98g 1.74gSodium chloride 0g 0.30g 1.79gPotassium acetate 0.61g 1.12g 3.14gCalcium chloride dihydrate 0.55g 0.46g 0.56gMagnesium acetate tetrahydrate 0.10g 0.33g 0.55gSodium glycerophosphate hydrated 0.98g 0.98g 2.21gGlucose ChamberGlucose Anhydrous (equivalent to glucose monohydrate)

44.00g (40.00g)

85.25g (77.50g)

210.65g (191.50g)

Lipid ChamberRefined olive oil (~80%) + refined soya oil (~20%) 7.5g 15.5g 28.1g

If lipids not required, bag design allows activation of peel seals between amino acids/electrolytes and glucose chambers only. Indications: Parenteral Nutrition when oral or enteral nutrition is not possible, insufficient or contraindicated: Numeta: G13%E Preterm – preterm newborn infants, G16%E - term newborn infants and children up to 2years, G19%E – Children older than 2 years and adolescents 16-18 years. Dosage and Route: Dependant on clinical condition and metabolism. Continue for as long as clinically required. Administer via central vein or dilute with sufficient water for injection for peripheral infusion. Adjust administration rate gradually, according to formulation used, dosage, daily volume intake and duration of infusion. Side effects: see Summary of Product Characteristics (SPC) for detail. Common: Hypophosphataemia, Hyperglycaemia, Hypercalcaemia, Hypertriglyceridaemia, and Hyponatraemia. Uncommon: Pulmonary vascular precipitates, cholestasis, Hyperlipidaemia and fat overload syndrome (reversible when lipid infusion stopped). Precautions: Stop infusion immediately if signs or symptoms of allergic reaction develop (fever, sweating, shivering, headache, skin rashes or dyspnoea). Ceftriaxone must not be mixed or administered with intravenous calcium-containing solutions, including Numeta. In patients older than 28 days ceftriaxone and calcium-containing solutions may be administered sequentially. See SPC for further guidance. Pulmonary vascular precipitates causing pulmonary vascular embolism and respiratory distress have been reported in patients receiving parenteral nutrition. Excessive addition of calcium and phosphate increases risk of formation of calcium phosphate precipitates. The solution, infusion set and catheter should periodically be checked for precipitates. If there are signs of respiratory distress stop infusion and initiate medical evaluation. Refeeding syndrome (characterised by shift in intracellular electrolytes), thiamine deficiency and fluid retention may also develop. Correct fluid, electrolyte and metabolic disorders before use. Lipids, vitamins, electrolytes and trace elements should be administered as required. Follow aseptic procedures for catheter placement, maintenance and nutritional formula preparation since patients requiring parenteral nutrition are often predisposed to infectious complications. Check compatibility of additions – risk of occlusion from precipitate formation. With additions the final osmolarity must be measured before administration via peripheral vein to avoid vein irritation. Routinely monitor water and electrolyte balance (particularly magnesium, as signs of hypermagnesaemia may not be detected), serum osmolarity, triglycerides, acid/base balance, blood glucose, hepatic and renal function, blood count and coagulation parameters throughout treatment. Adjust administration to meet clinical needs in unstable conditions (e.g. following severe post-traumatic conditions). Caution in pulmonary oedema, heart failure, hepatic insufficiency, renal insufficiency and severe blood coagulation disorders. Monitor for endocrine and metabolic complications. Fat overload syndrome may develop. Contraindications: As activated 2 chamber bag - hypersensitivity to egg, soy or peanut proteins, or any active substances, excipients, or components of the container; congenital abnormality of amino acid metabolism; Pathologically elevated plasma concentrations of sodium, potassium, magnesium, calcium and/or phosphorus; severe hyperglycaemia. As above for the activated 3 chamber bag (with lipids) also, severe hyperlipidaemia or severe disorders of lipid metabolism characterized by hypertriglyceridemia. G13%E and G16%E:

concomitant treatment with ceftriaxone in preterm newborn and in term newborn infants (≤28 days of age), even if separate infusion lines are used (risk of fatal ceftriaxone calcium salt precipitation in the neonate´s bloodstream). Interactions: Do not administer simultaneously with blood through same infusion tubing due to risk of pseudoagglutination. Do not mix or co-administer with ceftriaxone, take special care with coumarins & their derivatives, potassium sparing diruretics, ACE Inhibitors, angiotensin II receptor antagonists, tacrolimus and cyclosporine. Lipids may interfere with certain laboratory tests if the sample is taken before they have cleared. Overdose: In the event of incorrect administration, overdose and/or infusion rate higher than recommended, signs of hypervolaemia and acidosis, hyperglycaemia, glycosuria and a hyperosmolar syndrome may occur. Nausea, vomiting, shivering and electrolyte disturbances may develop. Reduced /limited ability to metabolize lipids may result in fat overload syndrome. Stop infusion immediately. Emergency procedures should be general supportive measures, particular attention to respiratory and cardiovascular systems. Legal Category: POM Marketing Authorisation Holder: Baxter Healthcare Limited, Caxton Way, Thetford, Norfolk IP24 3SE

Product NameMarketing Authorisation Code

Basic NHS Price

Numeta G13%E Preterm

PL 00116/0659 FDB9601 £62.08

Numeta G16%E PL 00116/0648 FDB9612 £71.70

Numeta G19%E PL 00116/0649 FDB9623 £107.55

Date of preparation: July 2017

References: 1. NUMETA G13E PRETERM Summary of Product Characteristics. July 2016. 2. British Association of Perinatal Medicine. The Provision of Parenteral Nutrition within Neonatal Services – A Framework for Practice. April 2016. 3. Crill CM, et al. Am J Health Syst Pharm 2010;67:914–918. 4. Ybarra JV, et al. JPEN J Parenter Enteral Nutr 2011;35:391–394. 5. Zingg W, et al. Nutrients 2012;4:1490–1503. 6. Rigo J, et al. J Pediatr Gastroenterol Nutr 2012;54:210–217. 7. Simmer K, et al. Nutrients 2013;5:1058–1070.

16982 - 10443 NUMETA A4 AD AW.indd 1 06/12/2017 12:27

DECEMBER 2017 3

IN THE NEWS

infant grapevine

Season’s Greetings!

This issue is not only the last issue of 2017,

it is also the last printed issue of Infant

Grapevine to be produced. The new year

will see a new look for us as we upgrade to

an online format. You can sign up for our

new, free email newsletter on our website, if

you haven’t already!

On behalf of the whole team here at

Infant, I would like to extend warm wishes

to all of our readers this festive season and

wish you all the very best for a happy 2018.

Katherine Robinson,

Assistant Editor

December 2017

© Stansted News Ltd 2017

All rights reserved. No part of this publication may bereproduced or transmitted in any form, by any means,electronic or mechanical, including photocopying, recording orany information storage or retrieval system, without permissionin writing from the publisher.

ContactsEditor

Lisa Leonard01279 714508

lisa@infantjournal.co.uk

Assistant EditorKatherine Robinson

01279 714514katherine@infantjournal.co.uk

Display and recruitment advertising Bradley Wright01279 714521

brad@infantjournal.co.uk

DesignerKate Woods

ProductionIan Christmas

Printed bySterling, Kettering

Publishing DirectorDavid Wright

Published byStansted News Ltd, 134 South StreetBishop’s Stortford, Herts CM23 3BQ

Tel: +44 (0)1279 714511Fax: +44 (0)1279 714519info@infantjournal.co.uk

Infant Grapevine believes that whenever possible, breast-feeding is always best for babies, but that mothers are entitledto choice together with information and support regardingalternative methods of feeding.

Medela UK’s second National Breastfeeding Symposium took place in Manchester in

October and the team was out in force to make this a special educational opportunity.

Delegates heard from four world-class speakers – Paula Meier (USA), Kathy Dewhurst (UK),

Annie Aloysius (UK) and Donna Geddes (Australia) – who provided insightful and thought-

provoking presentations of their current research, ranging from the value of human milk in

the NICU to the dynamicity of human milk composition and what this means to the infant.

The event was an ideal platform for those with a common interest in breastfeeding and

lactation to meet and share thoughts and experiences to stimulate new ideas and future

research activities.

There will be a full write-up of the event in the January 2018 issue of Infant journal.

Medela breastfeeding symposium providesinsight into research

The Infant team is sad to report that this will be the last printed Grapevine that we will be

producing, but delighted to announce that the title has made way for a faster and expanded

news service – still available free of charge – by email in 2018.

This upgrade to a digital format will enable us to report news and events in real-time via our

new-look website and social media channels, in addition to sending a free monthly newsletter to

all subscribers.

Please do continue to send us your news as we love to hear from you. Be sure to subscribe for

the free email newsletter on our website www.infantjournal.co.uk and follow us on Facebook at

www.facebook.com/infantjournal.

Infant Grapevine has been published bi-monthly since 2005 and we look forward to welcoming

you to our email newsletter in the new year. Infant journal will remain unaffected by these

changes.

We are bringing you faster news in 2018

The government has announced a maternity

strategy to reduce the number of stillbirths

as part of plans to make the NHS the safest

place in the world to give birth.

Families who suffer stillbirth or life-

changing injuries to their babies will be

offered an independent investigation to find

out what went wrong and why, and full-

term stillbirths will be investigated by

coroners.

Under the plans, hundreds of stillbirth,

early neonatal death and severe brain injury

cases each year will be referred to the

Healthcare Safety Investigation Branch, the

new NHS safety investigator led by experts.

This will standardise investigations of cases

so that the NHS learns as quickly as possible

from what went wrong and shares the

learning to prevent future tragedies.

The government is also bringing forward

from 2030 to 2025 the ambition to halve

rates of stillbirths, neonatal and maternal

deaths, and brain injuries occurring during or

soon after birth.

New maternity strategy aims to reduce thenumber of stillbirths

Perfect hosts: the Medela UK team.

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4 DECEMBER 2017

IN THE NEWS

infant grapevine

CYRIL provides information on babies’ brainfunction at the cotside A research team at University College London called MetaboLight and led by Dr Ilias Tachtsidis

has designed CYRIL, a compact broadband near-infrared spectroscopy system, to monitor brain

tissue physiology non-invasively in newborn babies.

A portable system small enough for use in the NICU and A&E rooms, CYRIL is currently being

used in preclinical studies looking for future neuroprotective therapies and in clinical studies in

the neonatal unit in University College London Hospital.

During birth, disruptions in blood and oxygen supply to baby’s brain can stop it from working

properly. This can lead to an acute injury to the developing brain and could potentially lead to

significant disability or death.

CYRIL offers a safe, non-invasive way of shining light through the brain tissue of a newborn

baby and detecting its function with a sensitive digital camera. This reveals detailed information

about oxygen and metabolism levels, providing vital and potentially life-saving information for

doctors.

Bliss offers research funding Bliss has launched a fund for UKneonatal research focused on the mosteffective ways of judging whether apremature or sick baby is feeling pain,the impact of developmental caresupport on neurodevelopmentaloutcomes, and emotional or otherpractical support to improve attachmentand bonding of premature or sick babiesand their families.

Bliss has worked closely with a panelof parents, health professionals and anadult who was born prematurely, as wellas experts in the field, to identify thesekey research questions.

For more information, visitbliss.org.uk/research-funding

Atain e-learning programmesets out ways to reduceavoidable harmAn e-learning programme has beenlaunched by the Atain (avoiding termadmissions into neonatal units) initiativeto help healthcare professionals improveoutcomes for babies, mothers andfamilies. Atain aims to reduce avoidablecauses of harm that can lead to infantsborn at term (ie ≥37 weeks’ gestation)being admitted to a neonatal unit. The learning modules, developed by e-Learning for Healthcare, NHSImprovement and a range of experts,focus on four clinical areas: respiratoryconditions, hypoglycaemia, jaundice andasphyxia (perinatal hypoxia-ischaemia).An additional module raises awarenessof the importance of keeping motherand baby together. For information visit www.e-lfh.org.uk/programmes/avoiding-term-admissions-into-neonatal-units

PATH urges equal access tobreast milk in policy briefInternational health organisation PATHhas launched the policy brief Ensuringequitable access to human milk for allinfants – a comprehensive approach tonewborn care in partnership with theGlobal Breastfeeding Collective.

It highlights the need to increaseawareness, establish policies and takeaction to ensure equitable access tohuman milk for those sick andvulnerable newborns at greatest risk ofillness and death.

The document can be accessed at www.healthynewbornnetwork.org/hnn-content/uploads/EquitableAccesstoHumanMilk_PolicyBrief_16Nov17-1.pdf

In the NICU, medical engineers Isabel de Roever and Dr Gemma Bale work with neonatologist Dr Subha Mitra (right) to monitor a baby with the optical instrument CYRIL.

Pictured here on the left, CYRIL is an important addition atUCLH that allows doctors to directly measure changes inbrain activity in a simple, non-invasive way.

Medical physicist Dr Paola Pintiengages with the public on theMetaboLight stand at NorwichScience Festival.

We want your newsHave you got news to share? Contact Katherine Robinson,

Assistant Editor. Email katherine@infantjournal.co.uk or call 01279 714514

Masthead and News Dec 2017.qxp_layout 13/12/2017 11:41 Page 4

DECEMBER 2017 5

IN THE NEWS

infant grapevine

According to the newly-published third Perinatal Confidential Enquiry report issued by the

MBRRACE-UK collaboration, stillbirth and neonatal deaths have more than halved in the UK

from 0.62 to 0.28 per 1,000 total births since 1993, representing a fall of around 220

intrapartum deaths per year.

Led by the National Perinatal Epidemiology Unit at the University of Oxford, the report

looked at the quality of care for stillbirths and neonatal

deaths of babies born at term, who were alive at the onset of

labour and who were not affected by a major congenital

anomaly.

The analysis aimed to identify potentially avoidable

failures of care during labour, birth and any resuscitation,

which may have led to the death.

A key finding was that in over a quarter of the cases

capacity issues were a problem. The majority of staffing and

capacity problems were related to the delivery suite with

the remaining issues relating to neonatal care provision.

Heavy workload contributed to delays in induction in one

third of women being induced.

In 80% of the stillbirths and neonatal deaths analysed,

improvements in care were identified that may have made a difference to the outcome

of the baby.

Another finding was that overall the quality of bereavement care was variable, with a lack of

joint midwifery, obstetric and neonatal input.

The full report is available at www.npeu.ox.ac.uk/mbrrace-uk/reports

MBRRACE-UK publishes perinatal report

Articles comingup in the

January 2018issue of Infant

journal

Don’t miss out!

Subscribe online atwww.infantjournal.co.uk

■ SIGNEC UK FifthInternational Conferenceon Necrotising Enterocolitis

■ Neonatal and infant organdonation

■ Developmentally accuratenewborn body posture

■ Blood warming devices forneonatal exchangetransfusion

■ A neonatal surgicaloutreach service

■ Congenital laryngotrachealstenosis

■ Simulation and self-efficacy in neonatalnursing

Baxter partnered with leading charity Bliss to raise awareness of World Prematurity Day

(WPD), which was held on Friday 17 November. WPD is a global movement and was

established to raise awareness of premature birth, the needs of babies who are born early or

born needing specialist care and the impact this can have on families.

To recognise the day, Baxter’s employees across three of its UK and Ireland sites including

the head office in Compton, Newbury, undertook many different activities to raise £1,000 for

Bliss and increase awareness of premature birth. Fun activities included a baby themed Bake

Off style competition and a guess the baby competition. The events culminated in a “Little

Lights Walk” through the village where the office is based, attended by employees, family

members and local residents.

Baxter Healthcare helped raise awareness ofWorld Prematurity Day

Baxter employees taking part in the Bliss Little Lights Walk.

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6 DECEMBER 2017

IN THE NEWS

infant grapevine

Armstrong Medical hosts neonatal eventArmstrong Medical hosted a two-day event focused on neonates at its facilities in Coleraine,

Northern Ireland on 29-30 November. Sixteen hospitals from across the UK and Ireland were

represented, along with doctors and nursing staff from Norway and Romania.

The NeoFlow Workshop gave neonatal healthcare professionals the opportunity to meet the

Armstrong Medical team, tour the facilities and share feedback on products and best practices.

Day one, entitled ‘Understanding respiratory care challenges’, provided the Armstrong Medical

team with the opportunity to better understand the needs and challenges healthcare

professionals face in delivering neonatal care.

Day two was dedicated to the delivery of advanced communication skills training: an

interactive skills workshop focused on supporting professionals to develop communication

strategies for the effective delivery of difficult and emotional information in stressful situations.

The training was facilitated by Dr Lisa Kauffman, Consultant Community Paediatrician with a

special interest in palliative care, along with Nicola Fitzmaurice, Deputy Head of Nursing,

Corporate Nursing at Birmingham Women and Children’s Hospital, and actor Hayley Fairclough.

Hospitals represented at the event included Liverpool Women’s Hospital, QMC Nottingham

University Hospital, The Coombe Women and Infants University Hospital, Altnagelvin Hospital

and Royal Stoke University Hospital.

Draft EU regulation coversproduction of infant formulaFrom February 2017 the maximumpermitted contaminant levels of carcino-genic and genotoxic levels of glycidylfatty esters found in refined vegetableoils used in infant formula manufacturewill be reduced to <75μg/kg until 30June 2019, thereafter it will be furtherreduced to <50μg/kg. Draft regulationcan be found at www.ec.europa.eu/info/law/better-regulation/initiatives/ares-2017-4129615_en

Best Beginnings’ film isnominated for awardBest Beginnings’ maternal mental healthfilm My Mental Health Matters has beennominated for a prestigious CharityMedia Awards. The charity hopes to winthe award to help shine a spotlight onmaternal mental health.

In the film, new mums talk aboutfeeling low in pregnancy or afterwards,and how they got help. Midwife Sheenaand mental health doctor Alain explainhow to look after yourself and howimportant it is to get help if you’re notfeeling right.

The film is endorsed by the RoyalCollege of Midwives and was launchedby the Duchess of Cambridge earlier thisyear. The film can be viewed atweb.bestbeginnings.org.uk/web/video/my-mental-health-matters-10421

Bliss Scotland calls ongovernment to tackle cost ofhaving a baby in NICUBliss Scotland has called upon Holyroodto honour its pledge to urgently reviewits approach to expenses for families ofbabies in neonatal care in order to tacklethe hefty price tag that Scottish parentsare paying every week while their child isin hospital.

Research published by Bliss Scotlandrevealed that the average weekly cost ofhaving a baby in neonatal care is £218across Scotland. While the health servicein Scotland has minimum requirementsfor units to provide support withaccommodation, food and drink, thesestandards are still not being met, and are well below those seen across the restof the UK.

Bliss Scotland is calling for theimplementation of urgent, immediatesolutions, as well as the delivery oflonger-term recommendations made bythe government’s The Best Start reviewand Bliss Scotland Baby Report.

vCreate introduces festiveeffects to help specialmoments last foreverThis Christmas on the neonatal unit, vCreate has added special festive effects to videos captured using its technology. For existing vCreate users, it is easy toadd a festive touch by choosing the effect from thebackground list when adding text to the video. Nurses can choose from a snow effect and a Christmas stocking effect.

See an example of a video made using the festive effects feature at www.whyvcreate.com/wb3p9t23ra.

Alternative neonatal pacifiers areavailable from Delta MedicalFollowing global reports of a supply issue with some brands of pacifier

products, Delta Medical International is promoting an alternative product.

The JollyPop pacifier was designed by the creator of the GumDrop and Soothie

pacifiers, using new materials and manufacturing techniques.

The JollyPop is available in three sizes, preterm, newborn and three months plus.

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DECEMBER 2017 7

IN THE NEWS

infant grapevine

Bliss donates Christmasparcels to every baby inneonatal care in WalesBliss, the UK’s leading premature andsick baby charity, has donated Christmasparcels to every neonatal unit in Walesto make sure that babies and theirparents know that they are not alone thisfestive season.

The parcels, which also include giftsfor parents, contain a Bliss teddy bear,dungarees, photo frame, children’s book,snacks and toiletries. They also includeadditional information about thesupport parents can receive from Bliss.The majority of these gifts have beendonated by Bliss’ corporate partners.

vCreate wins technologyawardvCreate has been announced the HealthTech News ‘Winner of the Year 2017’ forits secure video messaging technology.

Editor Sean White says: “I amdelighted to announce vCreate is ourwinner for the significant impact thetechnology makes to the parents andfamilies of premature babies.”

BAPM welcomes newpresidentSeptember marked the end of Dr AlanFenton’s tenure as President of theBritish Association of Perinatal Medicine(BAPM). After 14 years on BAPM’sExecutive Committee, Alan is steppingdown and handing over the reins toDr Gopi Menon.

Unicef issues updated childmortality report The 2017 UnicefChild Mortality reportpresents the latestestimates of under-five, infant andneonatal mortality upto 2016, and assessesprogress at the country,regional and global levels. For the firsttime, the report also provides mortalityestimates for children aged 5 to 14.

The full report can be accessed atwww.unicef.org/publications/files/Child_Mortality_Report_2017.pdf

Necrotising enterocolitis conference is a huge successThe fifth SIGNEC (Special Interest Group in Necrotising Enterocolitis) International Conference was

held in London on 16-17 October. A wide spectrum of topics related to NEC was discussed including,

for the first time, a focus on genetic aspects and a poster session. Representatives of NEC advocacy

and support organisations also attended the meeting, including the NEC Society in the USA,

members of NEC UK and the Instituto PGG in Brazil. To coincide with the meeting, SIGNEC founder

Professor Minesh Khashu and parent Joanne Ferguson set up a website for the group. The aim of

signec.org is to provide professionals and parents with information on NEC and to share some of the

research that has been presented at SIGNEC conferences.

Inspiration Healthcare introduces Inspire rPAPInspiration Healthcare has announced the release of the Inspire rPAP,

a non-invasive device for the initial stabilisation and resuscitation of

infants. It is said to be the first system of its kind to introduce low

imposed work of breathing into a resuscitation device.

The two-part system consists of a generator and a driver, which

were developed by a dedicated in-house team and received CE marks

in March 2016 and October 2017 respectively.

The Inspire rPAP’s design works in harmony with the infants’ own

respiratory efforts to ensure they do not tire so quickly and preserve

valuable energy. It can enable clinicians to quickly and seamlessly transition the infant onto nCPAP

which, partnered with the additional capability to add supplementary inflation breaths, means more

infants can be successfully maintained on nCPAP therapy and avoid intubation.

Speakers and delegates at the SIGNEC meeting held at Chelsea Football Club, London.

Children’s Wales AirAmbulance touchesdown in CardiffThe Wales Air Ambulance Charity has

permanently relocated its paediatric and

neonatal operation to a new base in the Welsh

capital. Children’s Wales Air Ambulance is a

specialist division of Wales Air Ambulance,

which is dedicated to the specialist care needed

to transfer vulnerable paediatric and neonatal

patients to hospitals across Wales and further

afield. It had been based at Wales Air

Ambulance’s headquarters in Dafen, Llanelli,

while the crews prepared a new, permanent

base at Cardiff City Heliport.

The helicopter charity launched a seven-day

transfer service with its fourth aircraft earlier

this year, making it the largest air ambulance

operation in the UK. The new operation is

claimed to be the most advanced air

ambulance service for paediatric and neonatal

transfers in the UK, with a pioneering flight

incubator system and Britain’s only dedicated

helicopter transfer practitioners (HTPs).

HTPs Steffan Simpson and Jeremy James withPilots James Grenfell and Jay Curtis alongsidethe Children’s Wales Air Ambulance helicopter

Inspire rPAPTM Generator.

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UNIT NEWS

infant grapevine8 DECEMBER 2017

£2.1m Lincoln neonatal unit opensA newly-refurbished neonatal unit at LincolnCounty Hospital is open following a £2.1 million refurbishment. It provides oneintensive care, two high dependency and 12special care cots. Two further cots areavailable for babies requiring isolation.

The unit provides a more comfortable andmodern space for parents to use during theirbaby’s stay, with three parent bedrooms (twoen suite), a kitchen, sitting room and babychanging facilities and a play area for siblings.

On 2 November, the unit was blessed byReverend Alison Amelia and babies werewelcomed onto the new unit two days later.

Cathy Franklin, matron for neonatalservices, says: “This is a really exciting timefor women’s and children’s services, and afantastic investment in maternity for familiesin Lincolnshire. These improvements willprovide an up-to-date environment in whichour staff can deliver better quality care tothose babies who need it.”

Poole Hospital consultantdevelops resource for dads ofbabies on neonatal unitsA consultant at Poole Hospital has developeda new information pack specifically forfathers of babies admitted to neonatal units.

DadPad Neonatal was conceived byconsultant neonatologist Professor MineshKhashu and complements the existingDadPad guide for new dads. It’s thought to bethe first resource of its kind aimed at fathersof babies on neonatal units.

The pack of laminated cards containspractical information including what dadscan do to support themselves and theirpartners, the range of feelings and emotionsthey may experience and how to find support,as well as more practical advice on holdingand handling a premature baby.

Fathers of babies on the neonatal unit atPoole Hospital will be the first in the countryto benefit from the resource, developed withthe makers of the original DadPad, InspireCornwall Community Interest Company. It will be free initially, thanks to charitablefunding.

“DadPad is such a good idea for new dads,bringing together a range of information in ahandy and convenient pack,” says ProfessorKhashu. Visit www.thedadpad.co.uk/neonatal

This regular feature gives unitsacross the UK the chance to sharenews and events. Send yoursubmissions to Katherine Robinson,katherine@infantjournal.co.uk

One hundred families have benefited fromvideo messaging at RHC GlasgowThe neonatal unit at the Royal Hospital for Children, Glasgow, invited parents of premature

babies to join nursing staff at a special event to celebrate the 100th family using Secure

Video Messaging application vCreate. Parents of babies being cared for in the NICU, who

are currently registered to receive video updates recorded by nurses on the unit, or have

previously benefited from the service, attended the celebration event.

Consultant Neonatologist and event organiser Dr Neil Patel explains why the unit felt it

was important to mark this

milestone: “Today is a

momentous day because 100

families are now benefiting from

the service. Parents tell us that

they love receiving videos of their

baby when they are not able to be

in the unit. And to have 100

families register in six months is

more than we could have ever

hoped for.”

November was the first ever maternity

support worker month, launched by the

Royal College of Midwives (RCM) to

celebrate all those people who help

support midwives as well as mothers and

families across the UK.

Southend University Hospital has been

celebrating those who help make a real

difference to everyone in the maternity

unit and SCBU at the trust, whether they

are on the front line or working in the

background.

The trust welcomed Jacque Gerrard,

RCM Director for England, to help in the

celebration of coffee, cake and a chat,

something that Southend midwives have

dubbed ‘the 3Cs’.

Jacque was impressed by the

camaraderie she witnessed at the hospital.

She says: “I think ‘the 3Cs’ is a brilliant idea

of packaging the thanks we all want to give

to those dedicated people who help us day

in and day out. Midwives couldn’t do what

they do without such a fantastic support

system behind them and it was great to

join in the celebrations and speak to

midwives and maternity support workers

in Southend.”

RCM director delivers thanks tomaternity support workers

Jacque Gerrard (third back on the left) with midwives and maternity support workers.

Unit news Dec.qxp_layout 13/12/2017 11:54 Page 8

DECEMBER 2017 9

UNIT NEWS

infant grapevine

The NICU team at St Peter’s Hospital was out

in force on 17 November to raise awareness of

prematurity and money for their Little Roo

Neonatal Fund on World Prematurity Day.

It is estimated that one in every 13 babies is

born before 37 weeks in the UK and last Friday

staff, babies, parents and even the building at

St Peter’s went purple as a striking reminder of

the impact it has on families when babies are

born too soon.

Joining the team on the day was Mayor of

Runnymede, Cllr Iftikhar Chaudhri, who has

personal connections to Ashford and St Peter’s

Hospitals and is a great supporter of the NICU

and the Little Roo Neonatal Fund. He spent

time chatting to staff before moving to NICU

to meet some of the babies and parents on

the unit.

St Peter’s goes purple forWorld Prematurity Day

Top right: Representative from charity BLISSMegan, Staff Nurses Emily Davies and EmmaBlack, baby Marshall Thorp-Lee held by Mayorof Runnymede Cllr Iftikhar Chaudhri and JoThorp-Lee.

Right: Abbey Wing, which houses maternityservices and NICU at St Peter’s Hospital, lit inbright purple.

Conference attendees were encouraged to inspire, innovate and imagine.

Nurses and midwives from across Essex and aspiring health and

social care students from Anglia Ruskin University (ARU) were

brought together at the first Nursing and Midwifery Conference.

Jointly organised by the Mid and South Essex Sustainability and

Transformation Partnership (STP) and ARU, the event was hosted in

the lecture theatre of the Michael Salmon building at the university.

The aim of the event was to inspire nurses and midwives to be

leaders and to share the vision for the three hospitals (Mid Essex,

Southend and Basildon) that make up the Mid and South Essex STP.

Guest speakers included Jane Cummings, Chief Nursing Officer,

NHS England; Ruth May, Executive Director of Nursing, NHS

Improvement; Clare Panniker, CEO, Mid and South Essex Hospitals;

and Professor Ruth Taylor, Pro Vice Chancellor and Dean of the

Faculty of Health, Social Care and Education at ARU.

Professor Cummings spoke about the importance of nurses being

willing to lead and share ideas. Clare and a range of speakers covered

topics from innovation in healthcare to resilience and leadership.

Recent graduates from Anglia Ruskin shared their experience of

practice and spoke about their own innovative projects covering

students as leaders; behaviours and values in children’s nursing; and

enhanced sepsis screening.

Conference embraces partnershipworking and inspires nurses andmidwives to lead and innovate

Alongside staff from the hospitals, spoken word artist, writer and

registered nurse Molly Case gave her unique insight into the

profession, while sepsis survivor Tom Ray and his wife Nicola gave an

emotional account of their experience of the NHS, life-threatening

illness and simply surviving.

Unit news Dec.qxp_layout 13/12/2017 11:54 Page 9

UNIT NEWS

infant grapevine10 DECEMBER 2017

An intimate photography exhibition showing the lives of

premature babies and their parents on a neonatal unit was

developed with help from staff at Kingston University and St

George’s, University of London.

The exhibition, held to commemorate World Prematurity Day,

gave a window onto the world of parents and

staff at the neonatal unit at St George’s Hospital

in Tooting and was put together in partnership

with First Touch – the hospital’s neonatal baby

charity. It showed images that captured very

personal moments between parents and their

newborns. The aim was to increase parental

involvement in discussions about family-

centred care and highlight the challenging

environment in which support is delivered.

Mr Mandeep Singh, Fetal Maternal MedicineConsultant.

NathalyaKennedy fromSands, JakeHildred withbaby Leila-Mai,Keira Pooler,ANNP FranWootton andAndrea Genner,sister in theNeonatalBereavementTeam.

The mum of a stillborn baby has donated a special CuddleCot to a Birmingham hospital

to help other grieving parents. Kiera Pooler of Brierley Hill, Dudley, raised enough cash to

pay for the £1,600 device, which she kindly handed over to the neonatal department at

City Hospital.

The CuddleCot is a portable device that circulates cold air around babies who are stillborn

or die before they have a chance to go home, to allow parents precious time to be with their

baby before leaving the hospital.

Kiera was 27 weeks pregnant, when she found out her son, who she named Rogan-Lee,

had died. Both Kiera and her partner Jake Hildred, aged 22, got to spend time with their

baby after he was born at Russells Hall Hospital, in Dudley, because it had a CuddleCot.

Keira says: “Jake and I were able to have that extra time with Rogan-Lee after he was born

and it meant so much to us. However, at the time, there was only one device there and

there were five other parents who had babies that were born sleeping that day. It meant

that they didn’t have that special time with their baby like we did. So I decided to fundraise

for a CuddleCot.”

Since the tragedy, which happened more than two years ago, Kiera has carried out

various activities to raise the money and sold badges and tops with Rogan-Lee’s Charity

on them.

She adds: “Once I had raised enough money I found out that Russells Hall didn’t need a

CuddleCot, so Sands (Stillbirth and neonatal death charity) found out which hospitals were

in need of the cot. City Hospital came forward and so I was delighted to make the donation

to them.”

Caring couple donate CuddleCot toBirmingham hospital neonatal unit

Southend Hospital has played a leading role in

a new study into the effectiveness of aspirin

in reducing the chances of pregnant women

developing pre-eclampsia.

Results, published in the New England

Journal of Medicine, revealed a daily 150mg

aspirin dose reduces the pre-eclampsia risk by

82% in deliveries before 34 weeks’ gestation.

Pre-eclampsia occurs in nearly one in 10

pregnancies in the UK and it can lead to

significant harm to mothers and babies. There

is no treatment so the main aim is to manage

blood pressure and deliver babies at the right

time.

Fetal Maternal Medicine Consultant Mr

Mandeep Singh said: “Southend Hospital was

one of the few centres in UK that participated

in the study. We screened almost 91% of the

pregnancy population in Southend, which was

the highest in any centre taking part in the

study across the world.”

Southend Hospital playskey role in pre-eclampsiastudy

The early lives of premature babies are capturedin poignant photography exhibition

Unit news Dec.qxp_layout 13/12/2017 11:59 Page 10

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12 DECEMBER 2017

CONFERENCE REPORT

infant grapevine

Above: At the exhibition Susannah Cooper, Jo Crossley and SumayaTicknerand of BD with the Alaris IV System.

Below: Question time: Speakers Gaynor McGuiness, Claire Campbell,Patrick Turton and Sarah Stephenson discuss exchange transfusion,perinatal loss and neonatal transport.

This year’s Neonatal Nurses Association (NNA) annualconference, which celebrated 40 years of the NNA, took place on17 November, coinciding with World Prematurity Day.

Delegates were treated to a variety of presentations along thetheme of ‘My world, my journey – tales of the unexpected’. Topicsincluded an update on Atain (avoiding term admissions intoneonatal units), hypoxic-ischaemic encephalopathy, hypoplasticleft heart syndrome, gut problems in newborn infants,hyperbilirubinaemia exchange transfusion, the Butterfly Project(improving support for parents who have lost a baby in amultiple pregnancy) and neonatal transport. There was a posterdisplay with prizes for the best posters, an exhibition and thehighly regarded Neonatal Nurse of the Year award.

The NNA has brought together nurses working in neonatologysince it was founded in 1977 and its overall aims have remainedlargely unchanged; a national organisation representingneonatal nurses, steered by neonatal nurses to promote neonatalnursing for the benefit of sick newborn infants and their families.

NNA celebrates 40 years of caring forsick newborn infants and their families

Top: The National Perinatal Epidemiology Unit (NPEU) Clinical Trials Unit: Elfin Trial LeadResearch Nurse Paula Jenkins and Baby Oscar Trial Coordinator Marketa Laube.

Above: The NNA executive board are (from left) Sara Harris, Pamela Boyd, Denise Evans,Róisín McKeon-Carter, Claire O'Mara, Julia Petty, Liz Crathern, Cath Holder and PatrickTurton.

Right: Denise Evans with Claire O'Mara: Denise is stepping down as NNA Chairman andwill be replaced by Claire.

NNA conference report .qxp_layout 13/12/2017 12:00 Page 12

DECEMBER 2017 13

CONFERENCE REPORT

infant grapevine

Above: Sophie Pantry and Anna Ioannou of Nutricia.

Left: Owen Wainwright of Inspiration Healthcare.

Below left: Luke Bourdillion of Dräger demonstrates the BabyleoIncuwarmer.

Below: Jeremy Billet and Robert Stone of SLE.

Above left: In her presentation, Michele Upton of NHS Improvement spoke about the Atainprogramme, which aims to provide safer neonatal care and reduce the number of full-term babiesadmitted to neonatal units.

Above centre: Celebrating 40 years: the Neonatal Nurses Association 1977-2017.

Above right: Erica Everett explained why hypoxic-ischaemic encephalopathy is an important cause ofperinatal mortality and morbidity, and how multidisciplinary teams can work together to improveoutcomes for babies.

Left: Gillian Weaver of Hearts Milk Bank, the UK’s newest milk bank, which aims to offer equity ofaccess to safe and assured supplies of donor human milk across London and the southeast of England.

NNA conference report .qxp_layout 13/12/2017 12:52 Page 13

14 DECEMBER 2017

CONFERENCE REPORT

infant grapevine

Left: The winner of the Neonatal Nurseof the Year award: NNA Chair DeniseEvans presents Colm Darby with hisprize.

Right: Melanie Mears at the NeoSavestand – the neonatal stabilisation, airand land transport, ventilation andemergency care course.

Below left: Katie Bradly-Russell andHelen Shelley presented an interestingcase of a baby born with hypoplastic leftheart syndrome: ‘When the unexpectedbecomes the unexpected’.

Below right: Richard Rhodes of WaltersMedical.

Keep up-to-date withadvances in neonatal care

Sign up for our free email newsletter at infantjournal.co.uk

Follow us on Facebook and Twitter

facebook.com/infantjournal

twitter.com/InfantJournal

infant

NNA conference report .qxp_layout 13/12/2017 12:01 Page 14

The importance of two-year follow-up assessments in neonatal trials: overcoming the challenges ofobtaining dataKaren Willoughby, Beatriz Lopez Santamaria

Two-year follow-up assessments are important but locating and

obtaining the information is rarely easy. This article considers the

experiences gained during a randomised controlled trial and offers tips

on how to enhance the availability and quality of follow-up data.

Helping Babies Breathe in Madagascar: neonatalresuscitation training in the era of sustainabledevelopment goalsAlison Leaf, Emily Clark, Vik Mohan

This article describes the approach taken by two British paediatricians

who benefited from the infrastructure and communication networks

built up by a well-established conservation organisation to improve

awareness and resuscitation capacity for babies born in remote rural

areas of Madagascar.

Rainbow Trust neonatal care: caring for families whohave a child with a life threatening or terminal illnessAnne Harris, Joanne Dunckley

Anne Harris, Director of Care at Rainbow Trust Children’s Charity,

discusses how Rainbow Trust can help families while Joanne Dunckley

describes her role as a neonatal support worker.

BAPM annual conference: excellence in perinatalpracticeThe British Association of Perinatal Medicine’s (BAPM) annual scientific

meeting included lively debates, workshops and presentations from

internationally renowned speakers.

Infusing TPN in babies too rapidly poses risk of severeharm and deathMichele Upton

A Patient Safety Alert was issued warning of the risk of severe harm

and death from infusing total parenteral nutrition (TPN) too rapidly in

babies. This article discusses the background to the alert and the

required actions.

Shared data may lead to better neonatal practice butvariation in key measures shows improvement isstill needed Sam Oddie

A review of the tenth annual National Neonatal Audit Programme

(NNAP) report that was published in September.

Each Baby Counts: lessons learned from babiesborn in 2015 Each Baby Counts Project Team

Each Baby Counts aims to halve the number of babies who die or are

left severely disabled as a result of preventable incidents during term

labour. A detailed analysis has identified key clinical actions needed to

improve the quality of care and prevent future cases.

Improving the early detection of cleft palate in the UKHelen McElroy, Alex Habel, Mervi Jokinen, Cathy Marsh,

Giselle Murphy, Wendy Tuohy

The new eLearning module, Cleft Palate: Examination in the Newborn,

aims to improve early identification of cleft palate. This article

highlights the importance of a proper examination to visualise the

entire length of the palate using a torch and tongue depressor.

The use of ECMO to treat infection in paediatricpatientsOtilia Osmulikevici, Donna Kelly, Judit Llevadias

The use of extracorporeal membrane oxygenation (ECMO) in term

babies with severe but potentially reversible respiratory failure results

in significantly improved survival without increased risk of severe

disability. This article describes a case series of children referred for

ECMO treatment for sepsis.

Congenital hepatic arteriovenous malformationwith persistent pulmonary hypertension: anunusual presentation Yogen Singh, Hannah Shore

Congenital hepatic arteriovenous malformations (HAVMs) are rare

anomalies, which typically present in infancy with congestive heart

failure, anaemia and hepatomegaly. This case study reports a

unique premature infant who developed persistent pulmonary

hypertension of the newborn soon after birth and was diagnosed with

congenital HAVM.

S U B S C R I B E N O W A T W W W . I N F A N T J O U R N A L . C O . U K

Don’t miss the November 2017 issue of Infant journal,

available now and featuring the following articles:

infant SUBSCRIBETODAY!

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