NMH

181 NMH | 2024 181 Health and Social Care Professionals works within the neonatal multidisciplinary team and enjoys close collaboration with our neonatal therapy colleagues. Following the success of our online parent class on the topic of 'Introducing solid foods and textures for babies post discharge from the neonatal unit' which started in 2023, we introduced a second multidisciplinary class on 'Feeding your baby post discharge from the neonatal unit' in June. This is a joint collaboration with our Speech and Language Therapy colleague, Zelda Greene, and Neonatal Lactation Clinical Midwife Manager 2, Ramita Dangol. The class is offered fortnightly online. Over the first 7 months there were 11 classes and 24 parents attended. While the feedback has been positive, attendance has been low (29% of invited parents) and attention is focusing on improving this through a quality improvement model incorporating Plan Do Study Act (PDSA) cycles that will include a parent survey and promotional campaign. Our PRIME (PReterm Infants need Milk Early) and PRIME-B (-Breastfeeding) multi- disciplinary initiatives supporting maternal milk provision and breastfeeding continued, with attention extended to the post discharge period. Data captured in 2024 for the cohort of babies born ≤31 weeks' gestation or ≤1.5 kg birthweight, showed that the rate of any breastfeeding post-discharge home increased from 33% in 2018 to 66% in 2023; while the rate of breast milk feeding post discharge to home increased from 59% in 2018 to 68% in 2023. In our audit of nutrition and growth amongst babies born very preterm or VLBW (n=120 in 2024), for the cohort of inborn babies (n=102) who received feeds (n=98), the number who received maternal milk remained high at 99% (n=97); and for those who received oral feeds (n=72), the number who breastfed during their time in the NICU was 71% (n=51). This was a decrease from 74% in 2023, but compares well with the breastfeeding rate reported for the hospital as a whole and reflects the huge effort by all involved. The use of parenteral nutrition (PN) reduced, with 621 orders through the year (15% reduction from 2023). Individualised PN (IPN) as a proportion of all PN ordered, also reduced to 2% (5% in 2023), with Standardised PN (SPN) accounting for the remaining 98%. Thank you to our Pharmacy colleagues for this data. We expect this continued reduction reflects improvements in enteral feeding also associated with better maternal milk provision, and a considerable cost saving to the Hospital. We piloted a screening program to ensure the appropriate and timely referral to dietetics for babies in the neonatal unit, and in particular to ensure that babies who meet established criteria for referral are not missed. This was carried out by our Dietitian Assistant, Sarah Browne, over 6 weeks, and concluded that our current referral system together with attendance on daily ward rounds is working efficiently and so this additional screening was discontinued. We continued to contribute to the therapy- led multidisciplinary ACoRN (Allied Care of at Risk Newborn) program focusing on activities to optimise the development of babies in the NICU and post-discharge, details of which are published in the Neonatology chapter. Further details on nutrition and growth amongst babies in the NICU are available from the Department of Clinical Nutrition and Dietetics. Other Activities • Education: BSc Midwifery (UCD), MSc Nutrition & Dietetics (UCD), Public Health Nurse training (NMH). Caring for Women with Obesity – a multidisciplinary symposium in conjunction with ICPO and ASOI March 2024. NMH Neonatal Study Day for Public Health Nurse and Community Partners on 1 March, the Health and Social Care Professionals in Neonatal Care in Ireland Study Day on 17 May (hosted at NMH). • Professional Groups: Diabetes Interest Group (INDI), Neonatal Dietitians Ireland Group, Maternity Dietitians Ireland, Irish Nutrition and Dietetic Institute. • National Groups: HSE Neonatal and Paediatric Parenteral Nutrition Advisory Group (RMC), HSE Infant Feeding Oversight Group (RMC), HSE Neonatal and Paediatric Parenteral Nutrition Operational Oversight Group (RMC), HSE Clinical Guidelines Expert Advisory Group (SC), HSE Neonatal Expert Advisory Group (RMC), HSE Model of Care for Neonatal Services in Ireland Review Group (RMC). • Hospital Committees: Healthy Ireland Group (SC, HMC, SB), Strategy Group (SC), Infant Feeding Steering Committee (RMC), Infant Feeding Committee (RMC), Nutrition and Hydration Committee (SC, RMC, LH, CC), Partnership Committee (SC) • National Reports and Resources: HSE booklet 'Breastfeeding and expressing for your premature or sick baby' 2024 update (RMC). • National and International Events: Health and Social Care Professionals (HSCP) Day 17 Apr; International Kangaroo Care Day on May 15th; British Dietetic Association PENG 40th Anniversary Conference invited presentation 'Nutrition Support in Pregnancy' (SC) 26-27 Sept; National Breastfeeding Week 1-7th Oct. Sinéad Curran, Manager (Maternity), Head of Department 2024. Roberta McCarthy, Manager (Neonatology).

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