Publications by authors named "Simmer K"

Background: There is limited evidence regarding the optimal time to commence parenteral nutrition (PN) in term and late preterm infants.

Design: Single-centre, non-blinded, exploratory randomised controlled trial.

Setting: A level-3 neonatal unit in a stand-alone paediatric hospital.

View Article and Find Full Text PDF
Article Synopsis
  • Children born before 29 weeks of gestation may face behavioral difficulties, potentially due to insufficient levels of DHA (docosahexaenoic acid), an important brain fatty acid.
  • The study aimed to see if supplementing DHA in these infants improved their behavioral functioning by following up with parents when their children were 5 years old.
  • The trial involved 731 participants, comparing outcomes between those given DHA and those given a control emulsion; results focused on parent-rated behavior and emotional functioning assessments.
View Article and Find Full Text PDF

Importance: High-dose omega-3 docosahexaenoic acid (DHA) supplementation of children born at less than 29 weeks' gestation has been shown to improve IQ despite increasing the risk of bronchopulmonary dysplasia (BPD). Given that BPD is associated with poorer cognitive outcomes, it is unclear whether the increased risk of BPD with DHA supplementation is associated with decreased benefit to IQ.

Objective: To investigate whether the increased risk of BPD with DHA supplementation was associated with diminished IQ benefit.

View Article and Find Full Text PDF

Background And Aims: Limited studies have described parenteral nutrition (PN) practices and clinical outcomes in term and late preterm infants. The aim of this study was to describe the current practice of PN in term and late preterm infants and their short-term clinical outcomes.

Methods: We conducted a retrospective study in a tertiary NICU between October 2018 and September 2019.

View Article and Find Full Text PDF

This prospective longitudinal study examined changes in milk sodium concentration (Na) and sodium:potassium ratio (Na:K), microbiological culture, milk production, and breast health in relation to mastitis after preterm birth. We studied women who gave birth at 29-34 weeks of gestation in a tertiary obstetric hospital in Perth, Western Australia. Milk samples, 24-hour milk production, and breast health data were collected every second day to day 10 postpartum, then every third day until infant discharge from the neonatal unit.

View Article and Find Full Text PDF

Background: Docosahexaenoic acid (DHA) is a component of neural tissue. Because its accretion into the brain is greatest during the final trimester of pregnancy, infants born before 29 weeks' gestation do not receive the normal supply of DHA. The effect of this deficiency on subsequent cognitive development is not well understood.

View Article and Find Full Text PDF

Background: Despite the wide use of parenteral nutrition (PN) in neonatal intensive care units (NICU), there is limited evidence regarding the optimal time to commence PN in term and late preterm infants. The recommendations from the recently published ESPGHAN/ESPEN/ESPR/CPEN and NICE guidelines are substantially different in this area, and surveys have reported variations in clinical practice. The aim of this randomised controlled trial (RCT) is to evaluate the benefits and risks of early versus late PN in term and late preterm infants.

View Article and Find Full Text PDF

Importance: Maternal milk feeding may have unique long-term neurodevelopmental benefits in very preterm infants.

Objective: To examine the extent to which maternal milk feeding after very preterm birth is associated with cognitive, academic, and behavioral outcomes at school age.

Design, Setting, And Participants: This prospective cohort study assessed 586 infants born at less than 33 weeks' gestation at 5 Australian perinatal centers and enrolled in the Docosahexaenoic Acid for Improvement of Neurodevelopmental Outcomes study (January 1, 2001, to December 31, 2005) who were evaluated at a corrected age of 7 years.

View Article and Find Full Text PDF

Infant allergy is the most common early manifestation of an increasing propensity for inflammation and immune dysregulation in modern environments. Refined low-fibre diets are a major risk for inflammatory diseases through adverse effects on the composition and function of gut microbiota. This has focused attention on the potential of prebiotic dietary fibres to favourably change gut microbiota, for local and systemic anti-inflammatory effects.

View Article and Find Full Text PDF

Our pilot RCT found that probiotic supplementation with the three-strain bifidobacterial product (B. breve M-16V, B. longum subsp.

View Article and Find Full Text PDF

Background: Composition of leukocyte populations in the first month of life remains incompletely characterised, particularly in preterm infants who go on to develop late-onset sepsis (LOS).

Aim: To characterise and compare leukocyte populations in preterm infants with and without LOS during the first month of life.

Study Design: Single-centre prospective observational cohort study.

View Article and Find Full Text PDF
Article Synopsis
  • Scientists studied if giving preterm babies a mix of probiotics (triple-strain) worked better than just one type (single-strain).
  • They found that both types of probiotics helped babies similar ways, especially in their gut bacteria, but it didn’t affect how quickly they were able to eat fully.
  • The study showed that both probiotics could lead to better gut health, though more research is needed to see what the long-term effects are.
View Article and Find Full Text PDF

Objective: To evaluate whether probiotic supplementation attenuates gut-dysbiosis in neonates with congenital gastrointestinal surgical conditions (CGISC).

Methods: Sixty-one neonates (≥35 weeks gestation) with CGISC were randomised to receive daily supplementation with a triple-strain bifidobacterial probiotic (n = 30) or placebo (n = 31) until discharge. Stool microbiota was analysed using 16S ribosomal RNA gene sequencing on samples collected before (T1), 1 week (T2), and 2 weeks (T3) after supplementation and before discharge (T4).

View Article and Find Full Text PDF

Importance: The currently recommended method for screening for retinopathy of prematurity (ROP) is binocular indirect ophthalmoscopy, which requires frequent eye examinations entailing a heavy clinical workload. Weight gain-based algorithms have the potential to minimize the need for binocular indirect ophthalmoscopy and have been evaluated in different setups with variable results to predict type 1 or severe ROP.

Objective: To synthesize evidence regarding the ability of postnatal weight gain-based algorithms to predict type 1 or severe ROP.

View Article and Find Full Text PDF

Background: Preterm infants have shorter breastfeeding duration than that of term infants. Details of postdischarge feeding methods and difficulties are needed to inform the care of preterm breastfeeding dyads.

Purpose: To describe postdischarge breastfeeding characteristics of mother-preterm infant dyads up to 12 weeks corrected gestational age (CGA).

View Article and Find Full Text PDF

Background: A previous systematic review showed that intramuscular vitamin A supplementation reduced the risk of bronchopulmonary dysplasia (BPD) in very-low-birth-weight (VLBW) infants. However, more recent studies have questioned this finding.

Objectives: Our objective was to synthesize current evidence on vitamin A supplementation in very-preterm (<32 wk gestational age) or VLBW infants and investigate the factors that may modify its efficacy.

View Article and Find Full Text PDF

Background: Vitamin A has anti-inflammatory and immune-modulating properties. We aimed to assess whether enteral water-soluble vitamin A supplementation in extremely preterm infants decreases fecal calprotectin, a marker of intestinal inflammation.

Methods: This was a prospective observational study nested in a randomized, double-blind, placebo-controlled clinical trial investigating enteral vitamin A (5,000 IU/day) for reducing the severity of bronchopulmonary dysplasia (BPD) in extremely preterm infants.

View Article and Find Full Text PDF

There is limited information regarding the use of parenteral nutrition (PN) in term and late preterm infants. We conducted a survey to study the current clinical practices within Australia and New Zealand (ANZ). A fifteen-question online survey was distributed to 232 neonatologists and fifty-five paediatric intensivists across ANZ between September and November 2019.

View Article and Find Full Text PDF

Preterm infants are particularly susceptible to bacterial late-onset sepsis (LOS). Diagnosis by blood culture and inflammatory markers have sub-optimal sensitivity and specificity and prolonged reporting times. There is an urgent need for more rapid, accurate adjunctive diagnostics in LOS to improve management and minimise antibiotic exposure.

View Article and Find Full Text PDF

Introduction: During the last trimester of pregnancy, the fetal brain undergoes a rapid growth spurt and accumulates essential nutrients including docosahexaenoic acid (DHA). This takes place ex-utero for infants born <29 weeks' gestation, without the in-utero provisions of DHA. Infants born <29 weeks' are more likely to experience behavioural and emotional difficulties than their term-born counterparts.

View Article and Find Full Text PDF

Introduction: Docosahexaenoic acid (DHA) is an omega-3 (n-3) fatty acid that accumulates into neural tissue during the last trimester of pregnancy, as the fetal brain is undergoing a growth spurt. Infants born <29 weeks' gestation are deprived the normal in utero supply of DHA during this period of rapid brain development. Insufficient dietary DHA postnatally may contribute to the cognitive impairments common among this population.

View Article and Find Full Text PDF

Background And Objectives: Evidence suggests that intramuscular vitamin A reduces the risk of bronchopulmonary dysplasia (BPD) in preterm infants. Our objective was to compare enteral water-soluble vitamin A with placebo supplementation to reduce the severity of BPD in extremely preterm infants.

Methods: We conducted a double-blind randomized controlled trial in infants <28 weeks' gestation who were to receive either enteral water-soluble vitamin A (5000 IU per day) or a placebo.

View Article and Find Full Text PDF

Background: Adequate human milk nutrition is critical for infant growth and neurodevelopment; however, low milk transfer volumes are common when establishing preterm breastfeeding. Despite clinical assessments of milk transfer volumes at the breast being inaccurate, measurement of feed volume via test weighing is rarely carried out either routinely or in cases where infant weight gain is inadequate.

Purpose: To assess the accuracy of the Preterm Breastfeeding Assessment Tool (PBAT) in determining transfer volumes and examine factors associated with PBAT accuracy.

View Article and Find Full Text PDF

Background: Preterm infants are at a high risk of developing late-onset sepsis (LOS). Lactoferrin is one of the most abundant endogenous antimicrobial proteins expressed in breast milk, stools, and blood, and a candidate for preventive intervention. Large clinical trials have recently investigated whether enteral supplementation with bovine lactoferrin reduces LOS.

View Article and Find Full Text PDF