Neonatal medicine

Congenital anomalies requiring major neonatal surgery are rare but account for a significant proportion of NICU admissions, where feeding challenges necessitate early parenteral nutrition. Emerging evidence suggests delaying amino acid provision during critical illness may improve outcomes, including shorter ICU stays and reduced ventilation time. This multicentre randomised controlled trial will test whether delayed amino acid delivery improves recovery in surgical newborns.

High-grade germinal matrix haemorrhage-intraventricular haemorrhage (GMH-IVH) is a major cause of death and long-term disability in preterm infants, with no effective treatments to prevent progression to complications such as posthaemorrhagic ventricular dilatation (PHVD). Emerging evidence suggests that intranasal maternal breast milk - rich in stem cells with neuroprotective properties – may offer a novel therapeutic approach. This multicentre randomised controlled trial will test whether adding intranasal maternal breast milk to standard care reduces PHVD and improves brain and developmental outcomes in preterm infants with GMH-IVH.

Infants born preterm are at high risk of developing cognitive, behavioural and emotional deficits later in life. One in three infants born before 32 weeks of pregnancy exhibits a language delay, with communication difficulties persisting into adulthood. While advances in neonatal medicine have resulted in decreased mortality for preterm infants, neurodevelopmental problems in survivors have remained unchanged. The study will evaluate the impact of listening to recorded maternal and paternal or other parent’s voice on later speech development in very preterm newborns.