NMH

NMH | 2024 50 Neonatology NEONATOLOGY HEALTH & SOCIAL CARE PROFESSIONALS Speech and Language Therapy (Zelda Greene) 2 024 saw the third full calendar year of the Neonatal SLT service. Zelda Greene is the Clinical Specialist SLT in Neonatology at the NMH and currently provides both inpatient and outpatient clinical services across a full working week. Clinical Service Development is continuing to develop and evolve. The SLT works with all members of the neonatal multidisciplinary team. Zelda also sees families on the postnatal wards if required e.g. diagnosis cleft lip/palate, Down Syndrome. In 2024 SLT recorded involvement for 166 inpatients with 403 recorded contacts. Of the inpatients seen, 99 were premature (<37 weeks) and of those, 72 were high risk infants (<30-32 weeks/<1500g). There were 23 term infants (37+ weeks) seen in the Neonatal Unit. Average time spent per inpatient was 49 minutes ranging from 42-97 minutes. At any one time there are 12-22 babies active on the SLT caseload every month. A total of 50 babies requiring ongoing SLT input were transferred to other acute hospitals including level 1 and 2 neonatal units and Children's Health Ireland and of these, 38 were high risk infants. Many of our Level 1 units have no SLT service provision resulting in limited appropriate SLT follow up for many of these high risk babies and families. Outpatient Service High risk infants (those born at <32 weeks/<1500g or infants post therapeutic hypothermia) who are admitted to the neonatal unit are seen by therapists in the unit. This is called the ACORN programme (Allied Care Of at Risk Newborns). On discharge there is a defined schedule of appointments that are offered to families as part of a follow up developmental surveillance programme. These infants are at risk of developmental delays and internationally surveillance is proven to identify these delays earlier and minimise their effects. SLT is involved in the following parts of this follow up programme: 1. ' Feeding my baby after NICU' – new online parent class offered by SLT/ Dietitians and lactation consultant twice a month 2. In-person appointment at 3 months corrected gestational age – joint assessment with physiotherapy 3. 'Introduction of solids and textures to my baby after the NICU' – online parent class offered by SLT/OT and Dietitians once babies are 4 months corrected gestational age, takes place once a month 4. In-person appointment at 9 months corrected gestational age – joint assessment with physiotherapy 5. In-person appointment at 12 months corrected gestational age – joint assessment with OT However, as the inpatient caseload demands are increasing, the ability to provide a consistent service to this growing clinic is more difficult as is evident from Table 2 below. Education & Research Zelda continues in her role as adjunct Assistant Professor in the School of Clinical Speech and Language Studies at the University of Dublin, Trinity College (TCD) and this year supported Ms Sarah Alsunyadi, who attended for her MSc clinical placement at the NMH. Sarah's thesis focused on parents experiences of feeding their preterm infants and her placement at NMH supported her learning and knowledge in this area. In December 2024, she was accepted for a poster presentation at the Dysphagia Research Society Annual Meeting in Philadelphia in March 2025 with her poster entitled "When I had a preemie, I didn't realize feedings would be so impersonal": Parents' autobiographical accounts of feeding premature infants". Zelda continues to contribute to teaching on the MSc course in TCD on neurodevelopmental assessment of feeding and swallowing and in assessment and management of paediatric tracheostomy. In November 2024, in conjunction with colleagues on the neonatal team and at TCD, Zelda developed a protocol for developing a Core Outcome Set (COS) for oral feeding outcomes in neonatal care called the 'NEOFEED COS' and is seeking funding for this research. Zelda continues to contribute to the development of national standards and guidelines with the Irish Association of Speech and Language Therapists (IASLT) in relation to Feeding and Swallowing Disorders. As part of a working group for the Royal College of Physicians of Ireland she contributed to a Consensus document 'The Assessment and Mangement of Ankyloglossia (Tongue Tie) in babies-A Consensus Statement' due to be released for publication early 2025.

• Cover