Our research is targeted at benefitting health in childhood and beyond. We lead studies of fetomaternal interactions, of fetal, neonatal and child development, of therapies and innovations using basic science, clinical translation, detailed imaging (such as magnetic resonance imaging and infrared thermography) and through new technologies.
What we are doing about...
1. Establishing life long health
Substantial research from around the world has shown that the nutrition of the mother and her infant can both lead to susceptibility to a range of non-communicable diseases including diabetes, hypertension and obesity.
We have developed detailed experimental investigations to identify critical periods in early life when changes in nutrition can result in permanent consequences to the developing individual. These studies include the effects of a suboptimal maternal diet and the influences of infant feeding and of exposure to an obesogenic environment.
Our studies, led by Professors Michael Symonds and Helen Budge, have highlighted the significant impact that changes in maternal nutrition, at defined stages of development, have on the placenta and fetus. Adipose tissue, cardiovascular function and appetite regulation are all particularly affected. Our research focusses on how these critical pathways can be used in the development of sustainable interventions aimed at preventing later disease.
2. Health and wellbeing of newborn infants
Our studies in newborn infants are targeted at answering important clinical questions in neonatal care to optimise the health of infants born both before and at full gestation through clinically relevant interventions and innovations. Our research includes feeding, nutrition and perinatal interventions which offer the potential to improve long term outcomes including in survival, health, neurodevelopment and metabolic status.
Current studies include:
- A pilot trial of deferred cord clamping in preterm infants (CORD: Clinical Lead – Dr Jon Dorling). Whilst deferred cord clamping in term infants is gaining popularity, the feasibility of this in infants born preterm and their longer term outcomes remain to be established and are the focus of the CORD study.
- The NIHR funded ‘SIFT’ trial examining how to increase milk feeds for premature babies born less that 32 weeks of gestation or who are born weighing less than 1500 grams. This study, led by Dr Jon Dorling, of 2500 infants will assess the effects of aiming to reach ‘full’ milk feeds over 5 compared with 9 days on infection and disability free survival.
We are also undertaking studies of developments in neonatal care including in optimising postnatal nutrition for very preterm infants, use of a multimedia parenting intervention to assist the development of preterm infants once they leave hospital and in the outcomes of those born preterm at school age. (Lead: Professor Helen Budge)
3. Delivering improvements in neonatal and paediatric clinical care through innovative technological advancements
Technological and diagnostic clinical advances have, in the main, been developed for, and in, adults. Adapting these technologies for newborn babies and children has proven problematic due to the significant anatomical, physiological and disease state differences in these patients. There is an urgent need to address this with carefully designed, developed and studied devices and diagnostics aimed at this population.
The use of invasive monitoring is both technically difficult and can be painful for babies and children. The development of useful, non-invasive devices specifically for neonatal and paediatric clinical care is vital if outcomes are to improve. In collaboration with engineers at the University of Nottingham, we are developing novel diagnostic and monitoring technologies to reduce the impact of paediatric conditions including prematurity, cardiovascular compromise and neurological injury.
10% of all newborn babies require some form of resuscitation. The first few minutes of life, termed the ‘golden minutes’, can have a significant impact on short and longterm outcomes. In the developing world, simple interventions can have a major impact on newborn mortality. We are developing technologies and interventions that have the potential to bring about improved outcomes in both developed and developing countries. To achieve this, the interventions must be tailored to the resource capabilities of each setting.
These research studies, led by Dr Don Sharkey, are designed to deliver improvements in neonatal and paediatric clinical care through innovative, child friendly technologies and diagnostics that will make a significant positive impact on the outcomes of sick babies and children. These studies are currently focussing on newborn resuscitation (HeartLight Project), improved neonatal transport (PremiTranS) and novel methods for identifying the child at risk of cardiovascular compromise and clinical deterioration (PaedCEW).
4. Brown fat, overweight and obesity in childhood
Obesity is of immense global significance and non-communicable diseases (such as obesity and diabetes) not only have substantial impacts on daily life but, worldwide, are responsible for around two thirds of all deaths. Body fatness, overweight and obesity in childhood present unprecedented challenges for life long health.
Brown adipose tissue (BAT) is a primary target tissue in the prevention of obesity, especially in children. BAT is primarily located within the supraclavicular region and is uniquely able to rapidly generate substantial amounts of heat.
We have pioneered a range of in vivo techniques aimed at quantifying the control of BAT during development. These include the use of thermal imaging of children and adolescents under basal and stimulated conditions. These studies, led by Professors Helen Budge and Michael Symonds, are being complemented by detailed experimental investigations designed to elucidate the developmental control of brown adipose tissue and promote BAT function in early life. Ultimately, these studies could enable sustainable strategies to prevent excess adiposity in children and adolescents.
Our current studies in healthy volunteers and patients include:
- The GestATion Study which aims to develop a postnatal gestational age assessment software App for developing countries funded by the Gates Foundation (Lead: Sharkey)
- The HeartLight Project of newborn resuscitation (Lead: Sharkey)
- The aPAC and ATIC studies of adipose tissue in newborns and children (Lead: Budge/ Ojha)
- The CORD study of delayed cord clamping in preterm infants (Lead: Dorling)
- The SIFT (Speed of Increasing Feeds Trial) study in preterm infants (Lead: Dorling)
- The BRAID-T Study of brown fat in children and young people with common childhood illnesses (Leads: Budge/ Symonds/ Law)
- The PremiTranS study to improve neonatal transport (Lead: Sharkey)
- The PaedCEW studies to develop novel methods for identifying the child at risk of cardiovascular compromise and clinical deterioration (Lead: Sharkey)
- The TOBIAS Study of brown fat in adults and young people (Leads: Symonds/ Budge/ Elvidge)
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