Dietitians (NDIG)

Useful information/websites

Neonatal Networks

In 2001 the Department of Health commissioned an expert group to review neonatal services .The resulting 'Strategy for Improvement' proposed the reorganisation of neonatal care into managed clinical networks so that units in each network would provide virtually all the care required by mothers and babies without the need for long-distance transfers. This followed evidence from other countries that networked models of intensive neonatal care produced the best outcomes for babies. Networks would align with maternity/obstetric care. Each network would have a supervisory structure and within each clinical network one clinician would have a co-ordinating advisory role.

For more information visit:
http://www.parliament.uk/deposits/depositedpapers/2008/DEP2008-1441.pdf
where the report of the Neonatal Intensive Care Services Review Group can be viewed. Further details of individual networks is available on the BAPM website: www.bapm.org/networks_info

More recently, the National Audit Office published a report focusing on how well the introduction of networks has helped the service respond to the increasing demand for neonatal care. This report, Caring for Vulnerable Babies: the Reorganisation of Neonatal Services in England, can be downloaded from http://www.nao.org.uk/pn/07-08/0708101.htm

Although a very interesting report there was no mention of therapy services, so on behalf of neonatal dietitians and other professionals Caroline King (Hammersmith and Queen Charlottes) wrote to the National Audit Office, received a positive response and was informed of a Taskforce being set up to look at workforce issues following the report and all AHPs have been involved. Neonatal dietitians have been represented by a number of our members but coordinated by Lynne Radbone from Addenbrookes who has done an excellent job on our behalf.

Neonatal Taskforce

The Neonatal Taskforce was set up early in 2008 jointly between the NHS and DH. The chair is Sir Bruce Keogh, NHS Medical Director and its membership is from a broad cross section of the NHS neonatal community supported by DH colleagues. The Taskforce and its sub-groups have developed a Toolkit that was launched in late 2009.

The Toolkit contains four main elements:

  • A Commissioning Framework
    • A resource for commissioners and providers to plan, deliver and quality assure neonatal services.
  • Principles for high quality neonatal services
    • Eight topics that cover the major areas of activity within the neonatal care pathway supported by evidence, including family centred care, workforce and transfers.
  • Appendices/Resources (including)
    • Sources of data and information
    • Example specifications
    • Neonatal nursing career pathway
  • CD of examples of tools for local adaptation/use, including
    • Patient pathways
    • Service specifications
    • Perinatal clinical dashboard
    • Nursing workforce calculator

The Toolkit for High Quality Neonatal Services is available to download together with the CD documents from: http://www.dh.gov.uk/en/Healthcare/Children/Earlyyears/index.htm

It is also available to order in hard copy from www.orderline.dh.gov.uk
or 0300 123 1002 and quote: 297621/Toolkit for High Quality Neonatal Services.


Neonatology on the Web

This is a website developed and maintained by Ray Duncan MD around his interest in neonatology and contains some very interesting information and useful links. There is some amazing historical information. Can be found at www.neonatology.org or www.neonatology.net or www.neonatology.com and links with NICU-NET.

UNICEF Baby Friendly Initiative website

UNICEF Baby Friendly Initiative – this UK website contains a lot of useful information on all aspects of breastfeeding promotion including the WHO 10 Steps to Successful Breastfeeding. There are many links on the website at: http://www.babyfriendly.org.uk/ though of particular interest to those involved with preterm infants some UNICEF UK BFI best practice standards for establishing and maintaining lactation and breastfeeding in neonatal units:
 http://www.babyfriendly.org.uk/page.asp?page=128

 

ESPGHAN - European Society for Paediatric Gastroenterology, Hepatology and Nutrition

ESPGHAN publishes position papers on numerous topics including many relating to infant and childhood nutrition including the 2010 guidelines for enteral feeding of preterm infants. These are available to download from: : http://www.espghan.med.up.pt in the Professionals section.

National Perinatal Epidemiology Unit (NPEU)

NPEU is a multidisciplinary research team dedicated to improving the care provided to women and their families during pregnancy, childbirth and the postpartum period, as well as the care provided to the newborn.
An Extended Neonatal Network is being established across England to ensure the continued successful conduct and completion of large-scale neonatal studies, predominantly randomised controlled trials which address important questions in the provision of neonatal care. Funding for the establishment of the network is provided by the Medicines for Children Research Network. Further information is available at: at http://www.npeu.ox.ac.uk/neonatalnetwork

Zetoc alerts

Zetoc provides access to the British Libraries Electronic Table of Contents of around 20,000 current journals and 16,000 conference proceedings published per year. It is free to members of the NHS in England and Scotland. It includes an email alerting service so that users can receive notification of relevant new data. It is available at zetoc.mimas.ac.uk. It gives reference titles and has a link to abstracts and sometimes the full article via an Athens username and appropriate subscription.

Gaining and Growing

Gaining and Growing is a website designed to promote discharge growth and development of preterm infants, especially those born weighing <1500g, by providing easy access to up-to-date nutrition and feeding information for community health care professionals in the Pacific North West of America in the hope that assuring adequate nutritional status will improve outcomes and family life for these children. A summary is available at:
http://depts.washington.edu/growing/Brochure.pdf with links to the full website at:
http://depts.washington.edu/growing/


Although it has a lot of useful information, it is American so may differ from UK practice. It was last reviewed in 2007.

California Perinatal Quality Care Collaborative

This was an initiative proposed by the California Association of Neonatalologists. CPQCC advocates not only superior patient care but also efficiency in resource allocation and utilisation. Quality improvement activities are aimed at identifying desired outcomes and promoting best practice. Health care providers and academic researchers benefit from the database.

An excellent nutrition toolkit updated in December 2008 is available to download at:
http://www.cpqcc.org/quality_improvement/qi_toolkits/nutritional_support_of_the_vlbw_
infant_rev_december_2008
This replaces the previous version which was presented as two documents and includes a wealth of information in the following sections:

1. General Principles
2. Parenteral Nutrition
3. Establishing Enteral Nutrition
4. Human Milk/Breastfeeding
5. Transition to Oral Feedings
6. Discharge Planning and Post-Discharge Nutrition
7. Special/Controversial Issues

There is also a separate download of Appendices too numerous to mention covering 140 pages. An amazing resource!

Sharp Mary Birch Hospital

This is a women’s hospital in San Diego with a website providing information about their NICU,
including a section on Breastfeeding the High Risk Newborn. This can be found at:
http://www.sharp.com/healthinfo/content.cfm?pageid=P02343

Paediatric Academic Societies (PAS)

PAS holds an annual conference in the US linking the American Pediatric Society, Society for Pediatric Research, Academic Pediatric Association and American Academy of Pediatrics. Abstracts of these conferences are available from past conferences at :
http://www.abstracts2view.com/pasall/index.php and just prior to the latest conference at:
http://www.abstracts2view.com/pas/index.php

You can search by author, title or category but be prepared to spend some time as there are hundreds of abstracts and you can get very carried away!

Infant & Toddler Forum

The Infant & Toddler Forum brings together a multi-disciplinary team of experts and practitioners from paediatrics, neonatology, health visiting, dietetics and child psychology to share new ideas and to debate the latest thinking in infant and toddler nutrition - http://www.infantandtoddlerforum.org

The aim is to identify gaps in current knowledge and areas where information is lacking and to fill these gaps by providing reliable, evidence-based nutritional information and practical educational tools that are relevant to HCPs' day to day practice. Where appropriate, they also engage with professional bodies, policy makers and industry to bring about positive changes to nutritional policy and practice.

The Forum focuses primarily on nutrition from birth to three years of age including issues relating to the healthy infant and toddler with particular nutritional needs, such as the premature infant or the atopic child. Discussion extends beyond nutritional science, to social and practical issues involved in achieving optimal diet and feeding practices. Achievements include the publication of factsheets, study days, published reports and articles and a growing national profile on infant and toddler nutrition and health.

The Forum is supported by an educational grant from the Infant Nutrition division of Nutricia Ltd. The views and outputs of the group, however, remain independent of Nutricia and its commercial interests.

Last updated April 2010