Topics & Abstracts

Intraventricular hemorrhage (IVH) is a devastating and debilitating diagnosis commonly seen in premature neonates. Statistics indicate that 45% of extremely premature infants with very low birth weight develop IVH within the first week of life. IVH is associated with numerous acute and long-term neurologic and psychiatric complications. Additionally, it has led to a progressive increase in hospital costs and length of hospitalization.

IVH is multifactorial, but it is primarily attributed to the intrinsic fragility of the germinal matrix vasculature from prematurity and disturbances in the cerebral blood flow (CBF) from commonly seen complications in premature neonates. Seminal research studies support neurodevelopmental positioning (NDP) of high-risk preterm infants as a postnatal preventive approach to reduce the risk for IVH. Hospitals with low IVH rates utilize NDP.

Live Presentation Schedule Jun 7, 2022

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07-06-2022 15:00 07-06-2022 16:00 35 A Neuroprotective Approach to Reduce the Risk for Intraventricular Hemorrhage (IVH) In ELBW Neonates Intraventricular hemorrhage (IVH) is a devastating and debilitating diagnosis commonly seen in premature neonates. Statistics indicate that 45% of extremely premature infants with very low birth weight develop IVH within the first week of life. IVH is associated with numerous acute and long-term neurologic and psychiatric complications. Additionally, it has led to a progressive increase in hospital costs and length of hospitalization. IVH is multifactorial, but it is primarily attributed to the intrinsic fragility of the germinal matrix vasculature from prematurity and disturbances in the cerebral blood flow (CBF) from commonly seen complications in premature neonates. Seminal research studies support neurodevelopmental positioning (NDP) of high-risk preterm infants as a postnatal preventive approach to reduce the risk for IVH. Hospitals with low IVH rates utilize NDP. GOLD Neonatal Online Conference false DD/MM/YYYY

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We think of the fetus as living in an impenetrable environment, protected from the outside elements. While most bacteria are too large to cross the placental barrier or infiltrate the amniotic membranes, some bacteria, viruses and parasites are capable of reaching the fetus and causing intrauterine infections. Over the years, the list of organisms responsible for these infections has grown with the addition of pathogens such HIV and West Nile Virus. Most recently, a resurgence of congenital syphilis has been identified in newborns born to women with an active infection in pregnancy. This session will review pathogens responsible for intrauterine infection with particular attention to congenital syphilis. A review of the effects of these infections will be accompanied by a discussion of the diagnosis, management and prognosis of intrauterine infections.

Live Presentation Schedule Jun 13, 2022

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13-06-2022 19:00 13-06-2022 20:00 35 Congenital Infections: What’s Old Is Back Again We think of the fetus as living in an impenetrable environment, protected from the outside elements. While most bacteria are too large to cross the placental barrier or infiltrate the amniotic membranes, some bacteria, viruses and parasites are capable of reaching the fetus and causing intrauterine infections. Over the years, the list of organisms responsible for these infections has grown with the addition of pathogens such HIV and West Nile Virus. Most recently, a resurgence of congenital syphilis has been identified in newborns born to women with an active infection in pregnancy. This session will review pathogens responsible for intrauterine infection with particular attention to congenital syphilis. A review of the effects of these infections will be accompanied by a discussion of the diagnosis, management and prognosis of intrauterine infections. GOLD Neonatal Online Conference false DD/MM/YYYY

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Neonatal Diabetes Mellitus (NDM) is defined as persistent hyperglycemia (>200 mg/dL) that requires insulin treatment and occurs before six months of age (Habeb et al., 2020). While the incidence of neonatal diabetes is merely 1 in 90,000 to 160,000 live births, the rarity of this disease can make diagnosis challenging and potentially result in delayed treatment (Letourneau et al., 2017). Uniquely set apart from type I diabetes by its strictly genetic etiology, NDM can be associated with developmental delay and epilepsy (DEND). Insulin is a growth factor that is critical for optimal growth. Insulin dependence can be permanent or transient. Management of NDM includes insulin followed by stabilization using oral sulfonylureas (Hattersley et al., 2018). Positive outcomes are contingent upon early diagnosis, euglycemia, early interventions including multidisciplinary involvement, rehab services and parental support with regard to hypo/hyperglycemia management and insulin administration. The purpose of this presentation shall be to describe the etiology, pathophysiology and clinical presentation of NDM, discuss clinical management strategies, and recognize the importance of a multi-faceted, inter-disciplinary approach to caring for an infant with NDM.

Live Presentation Schedule Jun 6, 2022

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06-06-2022 21:00 06-06-2022 22:00 35 Current Trends in Identifying and Managing Neonatal Diabetes Mellitus Neonatal Diabetes Mellitus (NDM) is defined as persistent hyperglycemia (>200 mg/dL) that requires insulin treatment and occurs before six months of age (Habeb et al., 2020). While the incidence of neonatal diabetes is merely 1 in 90,000 to 160,000 live births, the rarity of this disease can make diagnosis challenging and potentially result in delayed treatment (Letourneau et al., 2017). Uniquely set apart from type I diabetes by its strictly genetic etiology, NDM can be associated with developmental delay and epilepsy (DEND). Insulin is a growth factor that is critical for optimal growth. Insulin dependence can be permanent or transient. Management of NDM includes insulin followed by stabilization using oral sulfonylureas (Hattersley et al., 2018). Positive outcomes are contingent upon early diagnosis, euglycemia, early interventions including multidisciplinary involvement, rehab services and parental support with regard to hypo/hyperglycemia management and insulin administration. The purpose of this presentation shall be to describe the etiology, pathophysiology and clinical presentation of NDM, discuss clinical management strategies, and recognize the importance of a multi-faceted, inter-disciplinary approach to caring for an infant with NDM. GOLD Neonatal Online Conference false DD/MM/YYYY

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Premature infants have impaired cardiovascular function that persists into adulthood. Preterm infants exhibit impaired systolic and diastolic dysfunction that is intolerant of the adverse loading conditions experienced during the early neonatal period. Young adults born premature demonstrate a unique cardiac phenotype characterized by reduced biventricular volume, relatively lower systolic and diastolic function, and a disproportionate increase in muscle mass. This may clinically manifest by an increased risk of cardiovascular incidents, hypertension, and reduced exercise tolerance. Those consequences appear to result from early postnatal cardiac remodelling due to premature birth and associated comorbidities. Recent evidence suggests that early exposure to breast milk slows down or even arrests those pathophysiological changes, thereby mitigating the long-term adverse effects of premature birth on cardiovascular health. In this presentation, I aim to demonstrate the vital role of early breast milk exposure in preventing cardiovascular disease in preterm infants. We will explore the emerging evidence and examine the possible mechanistic pathways mediating this phenomenon.

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07-06-2022 13:00 07-06-2022 14:00 35 Early Breastmilk Exposure and Later Cardiovascular Health in Premature Infants Premature infants have impaired cardiovascular function that persists into adulthood. Preterm infants exhibit impaired systolic and diastolic dysfunction that is intolerant of the adverse loading conditions experienced during the early neonatal period. Young adults born premature demonstrate a unique cardiac phenotype characterized by reduced biventricular volume, relatively lower systolic and diastolic function, and a disproportionate increase in muscle mass. This may clinically manifest by an increased risk of cardiovascular incidents, hypertension, and reduced exercise tolerance. Those consequences appear to result from early postnatal cardiac remodelling due to premature birth and associated comorbidities. Recent evidence suggests that early exposure to breast milk slows down or even arrests those pathophysiological changes, thereby mitigating the long-term adverse effects of premature birth on cardiovascular health. In this presentation, I aim to demonstrate the vital role of early breast milk exposure in preventing cardiovascular disease in preterm infants. We will explore the emerging evidence and examine the possible mechanistic pathways mediating this phenomenon. GOLD Neonatal Online Conference false DD/MM/YYYY

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Join your colleagues for a whirlwind journey of the past 20 years of neonatal care. Together we will reflect on key lessons from the past, identify opportunities to improve care in the present and reimagine how we might provide care to create a preferred future that fosters better health and outcomes for every baby, every time, and everywhere.

Live Presentation Schedule Jun 21, 2022

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21-06-2022 16:00 21-06-2022 17:15 35 Fast Forward to the Future: Reimagining Care in the NICU Join your colleagues for a whirlwind journey of the past 20 years of neonatal care. Together we will reflect on key lessons from the past, identify opportunities to improve care in the present and reimagine how we might provide care to create a preferred future that fosters better health and outcomes for every baby, every time, and everywhere. GOLD Neonatal Online Conference false DD/MM/YYYY

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At no other time does the hemodynamic status so drastically and rapidly change as the transition from fetal to extrauterine life. Neonates may experience hypotension due to delayed transition, factors of prematurity such as immature myocardium or secondary to a variety of comorbid states including but not limited to chorioamnionitis, perinatal asphyxia, hypovolemia, patent ductus arteriosus, necrotizing enterocolitis, and sepsis. The definition of hypotension and decision to treat are two of the most controversial topics within neonatology. This is in part due to great variability in blood pressure (BP) ranges among neonates and lack of supporting literature which correlate precise blood pressure values with poor clinical outcomes. Of those affected by hypotension, approximately 10-25% of infants weighing < 1500 grams at birth go on to require a vasoactive medication. Despite decades of research, there is still no definitive evidence regarding the impact of treatment for neonatal hypotension, aside from the fact that vasopressors do tend to increase blood pressure. Vasoactive medications are frequently utilized in hypotensive patients however the underlying pathophysiology should be backbone of which medication is chosen. After this presentation, the audience will have a better understanding of when to treat and benefits and risks of common pharmacotherapy agents for hypotension and shock.

Live Presentation Schedule Jun 6, 2022

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06-06-2022 17:00 06-06-2022 18:00 35 Get the LOW Down on Neonatal Hypotension At no other time does the hemodynamic status so drastically and rapidly change as the transition from fetal to extrauterine life. Neonates may experience hypotension due to delayed transition, factors of prematurity such as immature myocardium or secondary to a variety of comorbid states including but not limited to chorioamnionitis, perinatal asphyxia, hypovolemia, patent ductus arteriosus, necrotizing enterocolitis, and sepsis. The definition of hypotension and decision to treat are two of the most controversial topics within neonatology. This is in part due to great variability in blood pressure (BP) ranges among neonates and lack of supporting literature which correlate precise blood pressure values with poor clinical outcomes. Of those affected by hypotension, approximately 10-25% of infants weighing < 1500 grams at birth go on to require a vasoactive medication. Despite decades of research, there is still no definitive evidence regarding the impact of treatment for neonatal hypotension, aside from the fact that vasopressors do tend to increase blood pressure. Vasoactive medications are frequently utilized in hypotensive patients however the underlying pathophysiology should be backbone of which medication is chosen. After this presentation, the audience will have a better understanding of when to treat and benefits and risks of common pharmacotherapy agents for hypotension and shock. GOLD Neonatal Online Conference false DD/MM/YYYY

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Recent advances in next generation sequencing have improved our understanding of the important role of gut microbiota in influencing brain development and function; i.e: 'gut-microbiota-brain' (GMB) axis. This is a bi-directional pathway where brain and gut microbes share detailed communications through immunological pathways, hormones and metabolites. GMB plays a crucial role in early brain development and function and impacts on long-term neurodevelopment and neurobehaviour. Understanding these roles is important to understand effective management and potentially prevention. This presentation will cover important aspects of GMB development, physiology, function and translation in clinical medicine for neonates and infants.

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13-06-2022 23:00 14-06-2022 00:00 35 Gut-Microbiota-Brain Axis in Neonates and Infants Recent advances in next generation sequencing have improved our understanding of the important role of gut microbiota in influencing brain development and function; i.e: 'gut-microbiota-brain' (GMB) axis. This is a bi-directional pathway where brain and gut microbes share detailed communications through immunological pathways, hormones and metabolites. GMB plays a crucial role in early brain development and function and impacts on long-term neurodevelopment and neurobehaviour. Understanding these roles is important to understand effective management and potentially prevention. This presentation will cover important aspects of GMB development, physiology, function and translation in clinical medicine for neonates and infants. GOLD Neonatal Online Conference false DD/MM/YYYY

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In neonates, a comprehensive approach to the management of known or suspected cardiac defects is critical to ensuring diagnostic accuracy and the best possible outcome. Essential elements of this process include early recognition, initial resuscitation and stabilization, systematic evaluation, and immediate and long-term management strategies.

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07-06-2022 17:00 07-06-2022 18:00 35 Neonatal Cardiac Defects: Immediate and Long-Term Management In neonates, a comprehensive approach to the management of known or suspected cardiac defects is critical to ensuring diagnostic accuracy and the best possible outcome. Essential elements of this process include early recognition, initial resuscitation and stabilization, systematic evaluation, and immediate and long-term management strategies. GOLD Neonatal Online Conference false DD/MM/YYYY

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Acute kidney Injury (AKI) prior to the completion of nephrogenesis at 34 weeks’ gestation has significant life-long effects. The immature kidney only receives 3-4% of total cardiac output, compared to 20% in term infants, children and adults. Therefore, minimal decreases in oxygen delivery may substantially compromise proper oxygen utilization increasing the risk for morphologic changes and reduced nephron endowment. Current diagnostic criteria (serum creatinine (sCr) elevations with oliguria) cannot detect early-onset AKI, as up to 50% of nephron damage has already occurred by the time these abnormalities become apparent. This presentation will look at new research related to the current diagnostic criteria for AKI in the preterm infant, the physiologic mechanisms involved in AKI and short and long-term implications.

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31-05-2022 16:00 31-05-2022 17:15 35 Physiologic Biomarkers to Detect Subclinical Acute Kidney Injury in Premature Infants Acute kidney Injury (AKI) prior to the completion of nephrogenesis at 34 weeks’ gestation has significant life-long effects. The immature kidney only receives 3-4% of total cardiac output, compared to 20% in term infants, children and adults. Therefore, minimal decreases in oxygen delivery may substantially compromise proper oxygen utilization increasing the risk for morphologic changes and reduced nephron endowment. Current diagnostic criteria (serum creatinine (sCr) elevations with oliguria) cannot detect early-onset AKI, as up to 50% of nephron damage has already occurred by the time these abnormalities become apparent. This presentation will look at new research related to the current diagnostic criteria for AKI in the preterm infant, the physiologic mechanisms involved in AKI and short and long-term implications. GOLD Neonatal Online Conference false DD/MM/YYYY

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Newborns may develop respiratory distress for a number of reasons. Using a case study approach, several conditions will be explored with emphasis on what the standard of care is and what is the latest in our 2022 toolbox for treating them.

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13-06-2022 17:00 13-06-2022 18:00 35 Respiratory Problems in the Newborn: Where Are We in 2022? Newborns may develop respiratory distress for a number of reasons. Using a case study approach, several conditions will be explored with emphasis on what the standard of care is and what is the latest in our 2022 toolbox for treating them. GOLD Neonatal Online Conference false DD/MM/YYYY

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The use of telemedicine is an emerging trend in health care, this includes neonatal care. Benefits include real-time access to experts routinely and during emergency situations such as delivery room resuscitations and stabilizations, the ability for families to stay connected to their newborn in the Newborn Intensive Care Unit (NICU) after the mother has been discharged from the hospital, and to assist in the decision for transport of the newborn to a higher level of care. Several studies have documented the reduction in transfers from community hospitals since telehealth has been implemented in the nursery. Limitations include the need for knowledgeable and experienced providers to be at bedside, physicians who are familiar with advance practice providers and their abilities, and the technical challenges that can present and have to remedied.

Live Presentation Schedule Jun 6, 2022

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06-06-2022 19:00 06-06-2022 20:00 35 The Many Uses of Telemedicine in Neonatal Care The use of telemedicine is an emerging trend in health care, this includes neonatal care. Benefits include real-time access to experts routinely and during emergency situations such as delivery room resuscitations and stabilizations, the ability for families to stay connected to their newborn in the Newborn Intensive Care Unit (NICU) after the mother has been discharged from the hospital, and to assist in the decision for transport of the newborn to a higher level of care. Several studies have documented the reduction in transfers from community hospitals since telehealth has been implemented in the nursery. Limitations include the need for knowledgeable and experienced providers to be at bedside, physicians who are familiar with advance practice providers and their abilities, and the technical challenges that can present and have to remedied. GOLD Neonatal Online Conference false DD/MM/YYYY

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This presentation will focus on the nurturing care of extremely born infants and their parents. Parent-infant separation is commonplace in NICUs and even more if the infant is born extremely preterm. Parent’s presence could be restricted by the rules and routines in the neonatal intensive care environment and skin-to-skin contact is not always possible due to the infant’s condition. Early and extensive contact between the infant and the parents enables the parents to get to know their infant and to feel and act like parents. At the NICU in Uppsala, Sweden, our experience is that parents, even those who have an extremely preterm infant want to be present and to stay close, 24/7, to their infant during the infants NICU stay. The aim of this presentation is to report clinical experiences from the NICU in Uppsala about how the NICU environment and NICU staff can facilitate or hinder parental presence, parental participation, and skin-to-skin contact when the infant is born extremely preterm.

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06-06-2022 15:00 06-06-2022 16:00 35 The Swedish Experience of Parental Involvement and Nurturing Care of Extremely Preterm Infants in the NICU This presentation will focus on the nurturing care of extremely born infants and their parents. Parent-infant separation is commonplace in NICUs and even more if the infant is born extremely preterm. Parent’s presence could be restricted by the rules and routines in the neonatal intensive care environment and skin-to-skin contact is not always possible due to the infant’s condition. Early and extensive contact between the infant and the parents enables the parents to get to know their infant and to feel and act like parents. At the NICU in Uppsala, Sweden, our experience is that parents, even those who have an extremely preterm infant want to be present and to stay close, 24/7, to their infant during the infants NICU stay. The aim of this presentation is to report clinical experiences from the NICU in Uppsala about how the NICU environment and NICU staff can facilitate or hinder parental presence, parental participation, and skin-to-skin contact when the infant is born extremely preterm. GOLD Neonatal Online Conference false DD/MM/YYYY

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Preterm infants are at increased risk for impaired neurodevelopmental outcomes (Stoll et al, 2010). There is evidence supporting the differences in outcomes related to how we provide care to preterm infants and the effects of the environment in which the care takes place. One of the most effective ways to reduce impaired infant outcomes is inviting parents to actively participate in care activities and provide Kangaroo Care (Boundy et al., 2016; Charpak et al., 2017). Despite international recommendations, empirical evidence, and an implementation science project focused on strengthening Kangaroo Care in neonatal intensive care units in British Columbia, Canada, implementation has been slow due to various barriers to uptake (Charpak et al., 2020; Coutts et al., 2021; WHO, 2020). A ‘one size fits all’ approach cannot guide Kangaroo Care implementation as it is a complex intervention and each NICU presents unique barriers and enablers. The uptake of Kangaroo Care relies on the involvement of parents and healthcare providers and their understanding and commitment to the evolving paradigm shift in neonatal care. This transition requires environmental and social supports, systems level change of philosophies of care, and assistance for healthcare providers to recognize their changing role.

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13-06-2022 21:00 13-06-2022 22:00 35 What Is Stopping Us? Kangaroo Care Implementation in Neonatal Intensive Care Units Preterm infants are at increased risk for impaired neurodevelopmental outcomes (Stoll et al, 2010). There is evidence supporting the differences in outcomes related to how we provide care to preterm infants and the effects of the environment in which the care takes place. One of the most effective ways to reduce impaired infant outcomes is inviting parents to actively participate in care activities and provide Kangaroo Care (Boundy et al., 2016; Charpak et al., 2017). Despite international recommendations, empirical evidence, and an implementation science project focused on strengthening Kangaroo Care in neonatal intensive care units in British Columbia, Canada, implementation has been slow due to various barriers to uptake (Charpak et al., 2020; Coutts et al., 2021; WHO, 2020). A ‘one size fits all’ approach cannot guide Kangaroo Care implementation as it is a complex intervention and each NICU presents unique barriers and enablers. The uptake of Kangaroo Care relies on the involvement of parents and healthcare providers and their understanding and commitment to the evolving paradigm shift in neonatal care. This transition requires environmental and social supports, systems level change of philosophies of care, and assistance for healthcare providers to recognize their changing role. GOLD Neonatal Online Conference false DD/MM/YYYY

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Many preterm infants remain vulnerable following discharge from the neonatal intensive care unit (NICU). Health challenges persist beyond the NICU including respiratory illness, breastfeeding progression, bottle feeding incoordination, behavior and development issues, impaired growth, infrequent stooling, and gastroesophageal reflux. Preterm infants are up to two times more likely than full term infants to be hospitalized in the first year of life. Parents are challenged to transition their premature baby home and to keep them home!

Community-based, specialized follow-up services following NICU discharge have a powerful impact. The Neonatal Transition Team in Calgary, Alberta, Canada provides post-NICU follow-up for very-low-birth-weight infants and their families. The team consists of community health registered nurses with advanced skill in premature infant outcomes, feeding and neurodevelopmental assessment, and a consultation partnership with nutritional and feeding specialists. While home visits have been the backbone of this service, the team questioned the feasibility and acceptance of virtual care and completed a three month quality improvement pilot. This virtual care pilot demonstrated optimization of health-care resources by providing safe, high-quality care at a reduced operational cost. The pilot was instrumental in the team’s management during the SARS-COVID-19 pandemic. Virtual care has been fully operationalized into the service delivery model and expanded to serve other newborns with feeding or growth challenges.

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07-06-2022 19:00 07-06-2022 20:00 35 “Zooming Ahead”; Post-NICU Discharge Very-Low-Birth-Weight Infant Follow-up Program Goes Virtual Many preterm infants remain vulnerable following discharge from the neonatal intensive care unit (NICU). Health challenges persist beyond the NICU including respiratory illness, breastfeeding progression, bottle feeding incoordination, behavior and development issues, impaired growth, infrequent stooling, and gastroesophageal reflux. Preterm infants are up to two times more likely than full term infants to be hospitalized in the first year of life. Parents are challenged to transition their premature baby home and to keep them home! Community-based, specialized follow-up services following NICU discharge have a powerful impact. The Neonatal Transition Team in Calgary, Alberta, Canada provides post-NICU follow-up for very-low-birth-weight infants and their families. The team consists of community health registered nurses with advanced skill in premature infant outcomes, feeding and neurodevelopmental assessment, and a consultation partnership with nutritional and feeding specialists. While home visits have been the backbone of this service, the team questioned the feasibility and acceptance of virtual care and completed a three month quality improvement pilot. This virtual care pilot demonstrated optimization of health-care resources by providing safe, high-quality care at a reduced operational cost. The pilot was instrumental in the team’s management during the SARS-COVID-19 pandemic. Virtual care has been fully operationalized into the service delivery model and expanded to serve other newborns with feeding or growth challenges. GOLD Neonatal Online Conference false DD/MM/YYYY

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Feeding is the most complex task of infancy, even in term babies with no complications. There are many diagnoses, conditions, syndromes, and co-morbidities that can impact feeding in neonates and infants. This talk will briefly highlight many of those, but we will focus on three specific populations of interest –Cleft lip and palate, Infants of Diabetic Mothers, and Down Syndrome. We will discuss the specific implications these conditions can have on feeding, why these infants may have difficulty, and the classic symptoms one could expect to see. The differences between delayed and disordered feeding will also be addressed. Strategies and adaptions for both breast and bottle feeding will be discussed. Positioning, nipple flow rate, and external strategies will be explained. Case studies will be shared at the end of the presentation.

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31-05-2022 13:00 31-05-2022 14:00 35 Breastfeeding Medically Complex Infants in the Neonatal ICU Feeding is the most complex task of infancy, even in term babies with no complications. There are many diagnoses, conditions, syndromes, and co-morbidities that can impact feeding in neonates and infants. This talk will briefly highlight many of those, but we will focus on three specific populations of interest –Cleft lip and palate, Infants of Diabetic Mothers, and Down Syndrome. We will discuss the specific implications these conditions can have on feeding, why these infants may have difficulty, and the classic symptoms one could expect to see. The differences between delayed and disordered feeding will also be addressed. Strategies and adaptions for both breast and bottle feeding will be discussed. Positioning, nipple flow rate, and external strategies will be explained. Case studies will be shared at the end of the presentation. GOLD Neonatal Online Conference false DD/MM/YYYY

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In the neonatal period, low birth weight, preterm, and ill infants, regardless of gestational age, have greater nutritional needs than at any other time in their lives. Without the last trimester, the preterm infant faces the most demanding growth period with a nutritional deficit. For any NICU infant, the stress of medical conditions may contribute to increased nutrient needs. Human milk is a complex fluid that simultaneously provides nutrients and bioactive components that facilitate the adaptive, functional changes required for the optimal transition from intrauterine to extrauterine life. We will discuss the goals and methods of providing appropriate nutrition for NICU infants to promote optimal short- and long-term outcomes.

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31-05-2022 13:00 31-05-2022 14:00 35 NICU Nutrition: Best Practice for Best Outcomes In the neonatal period, low birth weight, preterm, and ill infants, regardless of gestational age, have greater nutritional needs than at any other time in their lives. Without the last trimester, the preterm infant faces the most demanding growth period with a nutritional deficit. For any NICU infant, the stress of medical conditions may contribute to increased nutrient needs. Human milk is a complex fluid that simultaneously provides nutrients and bioactive components that facilitate the adaptive, functional changes required for the optimal transition from intrauterine to extrauterine life. We will discuss the goals and methods of providing appropriate nutrition for NICU infants to promote optimal short- and long-term outcomes. GOLD Neonatal Online Conference false DD/MM/YYYY

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The feeding of breast milk during the NICU admission reduces the risk of short-and long-term morbidities especially in premature infants. Breastmilk provides immunological, anti-infective, anti-inflammatory, epigenetic, and mucosal membrane protecting properties. The mechanisms by which human milk provides its protection are varied. These mechanisms include immunological and specific unique human milk components that are not present in formula. Thus, the feeding of mother’s own breastmilk should be a NICU priority and every NICU should have a breastmilk storage and handling policy. In this presentation we will discuss how we can counsel parents about the infection control measures and guidelines related to storage, handling and administration of breastmilk to babies in the NICU. Learn more about hospital grade pumps, pumping at home vs pumping in hospital setting, prevention and management of potential mistakes such as giving a child another mother’s milk and how to handle and store fortified breastmilk.

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31-05-2022 13:00 31-05-2022 14:00 35 NICU Practices for Storage and Handling of Breastmilk The feeding of breast milk during the NICU admission reduces the risk of short-and long-term morbidities especially in premature infants. Breastmilk provides immunological, anti-infective, anti-inflammatory, epigenetic, and mucosal membrane protecting properties. The mechanisms by which human milk provides its protection are varied. These mechanisms include immunological and specific unique human milk components that are not present in formula. Thus, the feeding of mother’s own breastmilk should be a NICU priority and every NICU should have a breastmilk storage and handling policy. In this presentation we will discuss how we can counsel parents about the infection control measures and guidelines related to storage, handling and administration of breastmilk to babies in the NICU. Learn more about hospital grade pumps, pumping at home vs pumping in hospital setting, prevention and management of potential mistakes such as giving a child another mother’s milk and how to handle and store fortified breastmilk. GOLD Neonatal Online Conference false DD/MM/YYYY

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Breastmilk must be the food for every human on earth. During the last decades we have been learning much more about the immunoprotective and immunomodulating properties of human milk, specifically colostrum. With advancements in neonatal care, we also have new challenges. As health care professionals it is an ethical responsibility to protect and promote breastfeeding practices for every family. Oral colostrum care is the use of own mother's colostrum in the cheeks and mouth of the baby not for a feeding purpose. It is an opportunity to initiate an immunological intervention in small or sick babies, allowing interaction of immunological properties with the linfoid tissue, promoting and improving microbiome and immune response. The mother and the family can also benefit from this intervention improving and enhancing integral participation and prevalence of breastfeeding in the long term.

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31-05-2022 13:00 31-05-2022 14:00 35 Oral Colostrum Care as an Immunological Intervention in the NICU Breastmilk must be the food for every human on earth. During the last decades we have been learning much more about the immunoprotective and immunomodulating properties of human milk, specifically colostrum. With advancements in neonatal care, we also have new challenges. As health care professionals it is an ethical responsibility to protect and promote breastfeeding practices for every family. Oral colostrum care is the use of own mother's colostrum in the cheeks and mouth of the baby not for a feeding purpose. It is an opportunity to initiate an immunological intervention in small or sick babies, allowing interaction of immunological properties with the linfoid tissue, promoting and improving microbiome and immune response. The mother and the family can also benefit from this intervention improving and enhancing integral participation and prevalence of breastfeeding in the long term. GOLD Neonatal Online Conference false DD/MM/YYYY

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Perinatal professionals in hospitals have great influence over how much human milk a baby receives, as well as how encouraged parents feel related to pumping and initiating and maintaining their milk production and eventually meeting their infant feeding goals. When hospital staff help with pumping in the early hours, days, and weeks of a new and fragile baby’s life—especially when at breast, chest or body feeding isn’t possible—getting that professional support is likely to make a difference in the long-term health of that child as well as the health of their parent. Healthcare providers can facilitate milk collection and provision of it to babies and support parents with specific and updated guidance on pump choices, pump usage, flange fit and milk storage. Those who work in hospitals with families can make an important positive impact on long-term breastfeeding and human-milk feeding rates. This session will cover 12 simple ways (including the what, why, how, when and where of pumping) that healthcare providers can support parents who pump for their hospitalized baby.

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31-05-2022 13:00 31-05-2022 14:00 35 Pumping for Hospitalized Babies: 12 Keys to Supporting Families Perinatal professionals in hospitals have great influence over how much human milk a baby receives, as well as how encouraged parents feel related to pumping and initiating and maintaining their milk production and eventually meeting their infant feeding goals. When hospital staff help with pumping in the early hours, days, and weeks of a new and fragile baby’s life—especially when at breast, chest or body feeding isn’t possible—getting that professional support is likely to make a difference in the long-term health of that child as well as the health of their parent. Healthcare providers can facilitate milk collection and provision of it to babies and support parents with specific and updated guidance on pump choices, pump usage, flange fit and milk storage. Those who work in hospitals with families can make an important positive impact on long-term breastfeeding and human-milk feeding rates. This session will cover 12 simple ways (including the what, why, how, when and where of pumping) that healthcare providers can support parents who pump for their hospitalized baby. GOLD Neonatal Online Conference false DD/MM/YYYY

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Although human milk confers important health promotion benefits to all infants, vulnerable babies admitted to an NICU stand to benefit even more. Their parents are typically strongly motivated to provide their own milk, although for a variety of reasons, such as parental ill health and stress (often complicated by the pandemic), parents may not have a full volume of their own milk. In this case, donor milk is the recommended supplement to bridge until parent’s milk is available. There is strong research evidence to support the use of human donor milk in preterm infants to prevent necrotizing enterocolitis, while there is less available evidence for the use of donor milk in late preterm infants. There are important differences between parent’s milk and donor milk with respect to their nutrient and non-nutrient components which may be secondary to processing techniques used in creating batches of donor milk. It is important to understand these differences and be able to interpret nutritional labelling on donor milk. Newer techniques in pasteurization may address some of the losses of bioactive molecules in human milk.

Live Presentation Schedule May 31, 2022

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31-05-2022 13:00 31-05-2022 14:00 35 Updates on the Use of Human Donor Milk in the NICU Although human milk confers important health promotion benefits to all infants, vulnerable babies admitted to an NICU stand to benefit even more. Their parents are typically strongly motivated to provide their own milk, although for a variety of reasons, such as parental ill health and stress (often complicated by the pandemic), parents may not have a full volume of their own milk. In this case, donor milk is the recommended supplement to bridge until parent’s milk is available. There is strong research evidence to support the use of human donor milk in preterm infants to prevent necrotizing enterocolitis, while there is less available evidence for the use of donor milk in late preterm infants. There are important differences between parent’s milk and donor milk with respect to their nutrient and non-nutrient components which may be secondary to processing techniques used in creating batches of donor milk. It is important to understand these differences and be able to interpret nutritional labelling on donor milk. Newer techniques in pasteurization may address some of the losses of bioactive molecules in human milk. GOLD Neonatal Online Conference false DD/MM/YYYY

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Late preterm infants struggle with feeding challenges. Due to the oscillating nature of breastfeeding progress in the late preterm population coupled with the innate issues of prematurity, families need support to navigate waters toward breastfeeding success. A model for evidence-based education and breastfeeding assessment will be presented to support infant development and empower mothers to achieve their breastfeeding goals.

Live Presentation Schedule Feb 26, 2020

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26-02-2020 08:00 26-02-2020 09:00 35 Assisting Late Preterm Dyads Achieve Breastfeeding/Chestfeeding Success Late preterm infants struggle with feeding challenges. Due to the oscillating nature of breastfeeding progress in the late preterm population coupled with the innate issues of prematurity, families need support to navigate waters toward breastfeeding success. A model for evidence-based education and breastfeeding assessment will be presented to support infant development and empower mothers to achieve their breastfeeding goals. GOLD Neonatal Online Conference false DD/MM/YYYY

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Most children, happily, encounter no significant illness during childhood. Of those who do, some will be breastfed. Exclusive breastfeeding for 6 months, as well as continued breastfeeding alongside appropriate introduction of solid foods until the age of two years and beyond is recommended by the World Health Organisation. Breastfeeding is known to confer multiple well-documented protective properties, and the risks of not being breastfed are profound, even in well-developed countries.
Although breastfeeding reduces the overall risk of many serious childhood illnesses and malignancies, it is not a panacea. Many children who are breastfed optimally will still develop a serious health condition. This small group of children, and their families are an important population, with specific needs that are under-represented in policy, literature and professional training.
This presentation will identify specific childhood cancers, their prevalence and common treatments. It will also introduce some of the challenges experienced by parents breastfeeding their child through cancer, and some practical ways to support families facing this ordeal.

Live Presentation Schedule Feb 26, 2020

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26-02-2020 08:00 26-02-2020 09:00 35 Breastfeeding Children with Cancer Most children, happily, encounter no significant illness during childhood. Of those who do, some will be breastfed. Exclusive breastfeeding for 6 months, as well as continued breastfeeding alongside appropriate introduction of solid foods until the age of two years and beyond is recommended by the World Health Organisation. Breastfeeding is known to confer multiple well-documented protective properties, and the risks of not being breastfed are profound, even in well-developed countries. Although breastfeeding reduces the overall risk of many serious childhood illnesses and malignancies, it is not a panacea. Many children who are breastfed optimally will still develop a serious health condition. This small group of children, and their families are an important population, with specific needs that are under-represented in policy, literature and professional training. This presentation will identify specific childhood cancers, their prevalence and common treatments. It will also introduce some of the challenges experienced by parents breastfeeding their child through cancer, and some practical ways to support families facing this ordeal. GOLD Neonatal Online Conference false DD/MM/YYYY

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Breastfeeding can sometimes be challenging for some families even when baby and mother are healthy. The Inmunological and nutritional benefits provided by breast milk must be considered when feeding any baby, it is by far the best start for babies that have any other disease where they can tend to suffer from multiple respiratory infections and other medical complications putting babies health, wellbeing and lives at risk. When there is a baby with a congenital cardiac disease we can face a lack of evidence and homogenous practices regarding breastfeeding. Many mothers feel helpless and many surgeons and cardiologists are not convinced that breastfeeding is better and easier for the infant with congenital heart disease. They are uncomfortable with not knowing the volume baby consumes and are not use to observing oxygen saturation an heart rate when the baby Is feeding at the breast. Current challenges in treating patients with chronic conditions include the prioritization of breastfeeding, identification of the most effective nutritional interventions, and the prevention or recovery of acquired growth failure.
Children with congenital heart disease who breastfeed have better growth, shorter hospital stays, and higher oxygen saturations than children with congenital heart disease who receive formula. It is necessary to support this families with evidenced based information to promote and support of breastfeeding to all mothers and babies. Create programs to meet the needs of this vulnerable babies and train surgical and pediatric staff of the neonatal surgery unit so they can support and facilitate a multidisciplinary work.

Live Presentation Schedule Feb 26, 2020

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26-02-2020 08:00 26-02-2020 09:00 35 Breastfeeding The Baby With Congenital Heart Disease Breastfeeding can sometimes be challenging for some families even when baby and mother are healthy. The Inmunological and nutritional benefits provided by breast milk must be considered when feeding any baby, it is by far the best start for babies that have any other disease where they can tend to suffer from multiple respiratory infections and other medical complications putting babies health, wellbeing and lives at risk. When there is a baby with a congenital cardiac disease we can face a lack of evidence and homogenous practices regarding breastfeeding. Many mothers feel helpless and many surgeons and cardiologists are not convinced that breastfeeding is better and easier for the infant with congenital heart disease. They are uncomfortable with not knowing the volume baby consumes and are not use to observing oxygen saturation an heart rate when the baby Is feeding at the breast. Current challenges in treating patients with chronic conditions include the prioritization of breastfeeding, identification of the most effective nutritional interventions, and the prevention or recovery of acquired growth failure. Children with congenital heart disease who breastfeed have better growth, shorter hospital stays, and higher oxygen saturations than children with congenital heart disease who receive formula. It is necessary to support this families with evidenced based information to promote and support of breastfeeding to all mothers and babies. Create programs to meet the needs of this vulnerable babies and train surgical and pediatric staff of the neonatal surgery unit so they can support and facilitate a multidisciplinary work. GOLD Neonatal Online Conference false DD/MM/YYYY

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Lactation professionals often hear from their clients that their breastfed babies have been diagnosed as lactose intolerance. This lack of understanding regarding types of lactose intolerance and potential issues with breastfeeding involving the newborn gut often lead to a cessation of breastfeeding. This session will cover the three main types of lactose intolerance, as well as galactosemia. Maternal gut damage and protein sensitivity and how that can impact the breastfed baby will also be addressed. Attendees will also learn about the most common foods that cause food sensitivity and allergy and what referrals are best made with these issues.

Live Presentation Schedule Feb 26, 2020

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26-02-2020 08:00 26-02-2020 09:00 35 Can a Baby Be Allergic to Breastmilk?: Sensitivities, Allergies, Galactosemia, and Lactose Intolerance Lactation professionals often hear from their clients that their breastfed babies have been diagnosed as lactose intolerance. This lack of understanding regarding types of lactose intolerance and potential issues with breastfeeding involving the newborn gut often lead to a cessation of breastfeeding. This session will cover the three main types of lactose intolerance, as well as galactosemia. Maternal gut damage and protein sensitivity and how that can impact the breastfed baby will also be addressed. Attendees will also learn about the most common foods that cause food sensitivity and allergy and what referrals are best made with these issues. GOLD Neonatal Online Conference false DD/MM/YYYY

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Neurologic conditions often have a significant impact on the breastfeeding/chestfeeding dyad. The majority of these conditions are congenital, however some may be acquired during the first year of life. Breastfeeding/chestfeeding management of the hypotonic and hypertonic infant will be discussed. Hypotonic neurologic conditions that will be reviewed include floppy infant syndrome, infantile botulism, medullary lesions, Prader-Willi Syndrome and Trisomy 13, Trisomy 18 and Trisomy 21. The hypertonic neurologic conditions cerebral palsy and drug exposed infant will be discussed along with neural tube defects and Congenital Zika Syndrome. Case studies of special needs babies with these neurologic conditions will be presented.

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26-02-2020 08:00 26-02-2020 09:00 35 Neurologic Conditions and The Breastfed Infant Neurologic conditions often have a significant impact on the breastfeeding/chestfeeding dyad. The majority of these conditions are congenital, however some may be acquired during the first year of life. Breastfeeding/chestfeeding management of the hypotonic and hypertonic infant will be discussed. Hypotonic neurologic conditions that will be reviewed include floppy infant syndrome, infantile botulism, medullary lesions, Prader-Willi Syndrome and Trisomy 13, Trisomy 18 and Trisomy 21. The hypertonic neurologic conditions cerebral palsy and drug exposed infant will be discussed along with neural tube defects and Congenital Zika Syndrome. Case studies of special needs babies with these neurologic conditions will be presented. GOLD Neonatal Online Conference false DD/MM/YYYY

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As a health professional you may find yourself supporting a mother who is breastfeeding or requires support to breastfeed her baby with Down syndrome. Babies with Down syndrome can often have additional health needs, which may affect how successful they are with breastfeeding. Down syndrome or trisomy 21 is the most common genetic cause of intellectual disability for around 1 in 700 births worldwide. People with Down syndrome are not all the same but may have similar characteristic physical features, health and developmental challenges and some level of intellectual disability. Research has shown many benefits associated with breastfeeding a baby with Down syndrome. It contributes to establishing long term skill development, particularly with speech and feeding skills, as well as aiding brain growth. It also provides an opportunity for mother baby bonding during stressful periods after learning of their baby’s diagnosis. Regardless of these known benefits, some mothers may nevertheless be told their baby will not be able breastfeed. This presentation will explore some of the common challenges mothers may face when breastfeeding a baby with Down syndrome and tips on how to address these for the mother and baby. The material presented will also assist health professionals to support mothers with babies who may have similar health/developmental needs.

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26-02-2020 08:00 26-02-2020 09:00 35 Yes You Can! Breastfeeding A Baby With Down Syndrome As a health professional you may find yourself supporting a mother who is breastfeeding or requires support to breastfeed her baby with Down syndrome. Babies with Down syndrome can often have additional health needs, which may affect how successful they are with breastfeeding. Down syndrome or trisomy 21 is the most common genetic cause of intellectual disability for around 1 in 700 births worldwide. People with Down syndrome are not all the same but may have similar characteristic physical features, health and developmental challenges and some level of intellectual disability. Research has shown many benefits associated with breastfeeding a baby with Down syndrome. It contributes to establishing long term skill development, particularly with speech and feeding skills, as well as aiding brain growth. It also provides an opportunity for mother baby bonding during stressful periods after learning of their baby’s diagnosis. Regardless of these known benefits, some mothers may nevertheless be told their baby will not be able breastfeed. This presentation will explore some of the common challenges mothers may face when breastfeeding a baby with Down syndrome and tips on how to address these for the mother and baby. The material presented will also assist health professionals to support mothers with babies who may have similar health/developmental needs. GOLD Neonatal Online Conference false DD/MM/YYYY

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Premature and sick babies are often born in locations ill-equipped to care for them. They are then transported to higher levels of care for sophisticated diagnostic tests and specialized care. However, while such transport is necessary, it is not without risk. Since critically-ill infants can deteriorate clinically during transport, ideally only specialized teams should transport sick infants. Unfortunately, this is not pragmatically possible nor is the standard of care. With regionalization of care, more infants are transferred to tertiary-care centers for specialized care than ever before and not all centers have specialized transport teams to transport infants. Despite best efforts, not all transports will go well, and often processes and outcomes may leave much to be desired. Hence, it is vital for hospital administrators and clinicians to learn quality improvement (QI) methodology, monitor relevant metrics, and implement QI initiatives to order to improve outcomes. Fortunately, developing a QI mindset and applying it to neonatal transport can easily be done with practice. Learning how to prioritize QI initiatives, assemble QI teams, lead healthcare change, sustain improvements, and develop a culture that strives to improve are all desirable and can yield significant tangible benefits for clinicians and their patients.

Live Presentation Schedule Jun 1, 2021

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01-06-2021 08:00 01-06-2021 09:00 35 Improving the Quality of Neonatal Transport Premature and sick babies are often born in locations ill-equipped to care for them. They are then transported to higher levels of care for sophisticated diagnostic tests and specialized care. However, while such transport is necessary, it is not without risk. Since critically-ill infants can deteriorate clinically during transport, ideally only specialized teams should transport sick infants. Unfortunately, this is not pragmatically possible nor is the standard of care. With regionalization of care, more infants are transferred to tertiary-care centers for specialized care than ever before and not all centers have specialized transport teams to transport infants. Despite best efforts, not all transports will go well, and often processes and outcomes may leave much to be desired. Hence, it is vital for hospital administrators and clinicians to learn quality improvement (QI) methodology, monitor relevant metrics, and implement QI initiatives to order to improve outcomes. Fortunately, developing a QI mindset and applying it to neonatal transport can easily be done with practice. Learning how to prioritize QI initiatives, assemble QI teams, lead healthcare change, sustain improvements, and develop a culture that strives to improve are all desirable and can yield significant tangible benefits for clinicians and their patients. GOLD Neonatal Online Conference false DD/MM/YYYY

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Retrieval medicine is associated with certain hazards. These can affect the patient or staff. Avoidable adverse events often arise as a consequence of suboptimal communication, drug error, inadequate preparation or equipment failure. Applying the principles of risk management and clinical safety is essential. To understand issues associated with neonatal transport one needs to look at the infrastructure of transfer teams, arrangements for governance, risk identification, incident reporting, feedback and learning from experience. One also needs to look at audit processes, training, communication and ways of team working. Adherence to current recommendations for equipment and vehicle design are also vital. Benchmarking between services and sharing best practice with a view to optimising safety and reducing risk is recommended.

Live Presentation Schedule Jun 1, 2021

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01-06-2021 08:00 01-06-2021 09:00 35 Risk Management in Neonatal Transport Retrieval medicine is associated with certain hazards. These can affect the patient or staff. Avoidable adverse events often arise as a consequence of suboptimal communication, drug error, inadequate preparation or equipment failure. Applying the principles of risk management and clinical safety is essential. To understand issues associated with neonatal transport one needs to look at the infrastructure of transfer teams, arrangements for governance, risk identification, incident reporting, feedback and learning from experience. One also needs to look at audit processes, training, communication and ways of team working. Adherence to current recommendations for equipment and vehicle design are also vital. Benchmarking between services and sharing best practice with a view to optimising safety and reducing risk is recommended. GOLD Neonatal Online Conference false DD/MM/YYYY

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This presentation will take the audience on a journey spanning over 40 years, documenting the evolution of the Acute Care Transport Service (ACTS) team from Toronto, Ontario, Canada. We will take a closer look at the systems and infrastructure required for inter-facility transport of high-risk neonatal patients within a regionalized context. The session will reflect on the essential competencies of a transport service and review the scope of practice, key curricular themes and the ACTS staffing model. Through the integration of case-based discussion this session will also explore how the advancements in data and technology can impact patient safety and enhance quality of care.

Live Presentation Schedule Jun 1, 2021

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01-06-2021 08:00 01-06-2021 09:00 35 The Evolution of Transport- One Team’s Journey This presentation will take the audience on a journey spanning over 40 years, documenting the evolution of the Acute Care Transport Service (ACTS) team from Toronto, Ontario, Canada. We will take a closer look at the systems and infrastructure required for inter-facility transport of high-risk neonatal patients within a regionalized context. The session will reflect on the essential competencies of a transport service and review the scope of practice, key curricular themes and the ACTS staffing model. Through the integration of case-based discussion this session will also explore how the advancements in data and technology can impact patient safety and enhance quality of care. GOLD Neonatal Online Conference false DD/MM/YYYY

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Air transport is commonly required for acute patient transport; including of sick newborns. Regionalization of tertiary neonatal care often means longer transport distances for patients between local referring hospitals and places of definitive care. The physiology of the newborn and some unique features of disease processes in the newborn present some challenges in safe transport by air. Fixed wing and rotary wing transport modes expose the sick newborn to different stressors according to their own unique variable cabin environments and altitude. An understanding of how newborns react to air transport and how to modify the air transport environment can both contribute to safer, more effective transport of the newborn.

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01-06-2021 08:00 01-06-2021 09:00 35 The Unique Challenges of Transporting Newborns by Air Air transport is commonly required for acute patient transport; including of sick newborns. Regionalization of tertiary neonatal care often means longer transport distances for patients between local referring hospitals and places of definitive care. The physiology of the newborn and some unique features of disease processes in the newborn present some challenges in safe transport by air. Fixed wing and rotary wing transport modes expose the sick newborn to different stressors according to their own unique variable cabin environments and altitude. An understanding of how newborns react to air transport and how to modify the air transport environment can both contribute to safer, more effective transport of the newborn. GOLD Neonatal Online Conference false DD/MM/YYYY

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This session will highlight important aspects of resuscitation and stabilization of the neonate with an evidence based approach to clinical practice. Through case based examples, the audience will explore how effective communication, interprofessional collaboration and reference to clinical care pathways can promote patient safety and quality of care for the most vulnerable neonatal patients. Learners will gain a better understanding of the triage process and the preparation of patients for acute care transport. The session will conclude with a review of the ‘lessons learned’ from transport case presentations and their outcomes.

Live Presentation Schedule Jun 1, 2021

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01-06-2021 08:00 01-06-2021 09:00 35 Triage and Transport- a Case Based Discussion This session will highlight important aspects of resuscitation and stabilization of the neonate with an evidence based approach to clinical practice. Through case based examples, the audience will explore how effective communication, interprofessional collaboration and reference to clinical care pathways can promote patient safety and quality of care for the most vulnerable neonatal patients. Learners will gain a better understanding of the triage process and the preparation of patients for acute care transport. The session will conclude with a review of the ‘lessons learned’ from transport case presentations and their outcomes. GOLD Neonatal Online Conference false DD/MM/YYYY

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Managing pain and discomfort in the neonatal patient is complex in many ways. Immature metabolic processes can lead to unpredictable effects that may lead to either negative effects and/or unsuccessful control of pain. As we have learned more about these metabolic pathways and how these medications are utilized, more evidence now exists that determine when one medication may be preferred over another depending on the clinical situation. Looking into the future of drug dosing, we may soon be able to determine a neonate's pharmacogenomic profile in order to provide true personalized medicine.

This presentation will help the learner understand the complexities of these challenges and provide them with the information and the tools to provide state-of-the-art medical care.

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01-06-2021 08:00 01-06-2021 09:00 35 Clinical Pain Management in the Neonate Managing pain and discomfort in the neonatal patient is complex in many ways. Immature metabolic processes can lead to unpredictable effects that may lead to either negative effects and/or unsuccessful control of pain. As we have learned more about these metabolic pathways and how these medications are utilized, more evidence now exists that determine when one medication may be preferred over another depending on the clinical situation. Looking into the future of drug dosing, we may soon be able to determine a neonate's pharmacogenomic profile in order to provide true personalized medicine. This presentation will help the learner understand the complexities of these challenges and provide them with the information and the tools to provide state-of-the-art medical care. GOLD Neonatal Online Conference false DD/MM/YYYY

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As part of their lifesaving care, infants born very preterm (8 to 16 weeks too early) undergo repeated invasive procedures for what can be weeks to months on end. There is accumulating evidence demonstrating the negative long-term effects of repeated neonatal pain on the developing brain and neurodevelopmental outcomes of children born very preterm. The presentation will outline why infants born ≤32 weeks gestational age, are particularly vulnerable to repeated exposure to invasive procedures. I will highlight the latest literature exploring the long-term effects of neonatal pain on the brain and neurodevelopmental outcomes of both children born very preterm and animal models of prematurity. Furthermore, I will discuss evidence-based pain prevention and intervention strategies applied during neonatal intensive care. It is imperative that we continue to find ways to reduce the negative long-term effects of pain within this vulnerable population of infants born very-preterm.

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01-06-2021 08:00 01-06-2021 09:00 35 Long-Term Effects of Neonatal Pain on the Developing Brain As part of their lifesaving care, infants born very preterm (8 to 16 weeks too early) undergo repeated invasive procedures for what can be weeks to months on end. There is accumulating evidence demonstrating the negative long-term effects of repeated neonatal pain on the developing brain and neurodevelopmental outcomes of children born very preterm. The presentation will outline why infants born ≤32 weeks gestational age, are particularly vulnerable to repeated exposure to invasive procedures. I will highlight the latest literature exploring the long-term effects of neonatal pain on the brain and neurodevelopmental outcomes of both children born very preterm and animal models of prematurity. Furthermore, I will discuss evidence-based pain prevention and intervention strategies applied during neonatal intensive care. It is imperative that we continue to find ways to reduce the negative long-term effects of pain within this vulnerable population of infants born very-preterm. GOLD Neonatal Online Conference false DD/MM/YYYY

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There is abundant high-quality evidence demonstrating analgesic effects of breastfeeding, skin-skin care and sweet solutions (sucrose and glucose) for newborn infants during short lasting acute painful procedures. There is also growing and concerning evidence about long lasting adverse effects of painful procedures. Yet, studies continue to show that painful procedures are routinely performed on newborns with no pain management. This presentation will include an overview of the three recommended newborn procedural pain management strategies and the knowledge to action (KTA) gap concerning utilization of evidence in practice. Barriers and facilitators to using the three strategies in diverse clinical settings will be discussed and knowledge translation strategies being used to address KTA gaps in pain management in newborns will be presented.

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01-06-2021 08:00 01-06-2021 09:00 35 Neonatal Pain: The Evidence and the Knowledge to Action Gap There is abundant high-quality evidence demonstrating analgesic effects of breastfeeding, skin-skin care and sweet solutions (sucrose and glucose) for newborn infants during short lasting acute painful procedures. There is also growing and concerning evidence about long lasting adverse effects of painful procedures. Yet, studies continue to show that painful procedures are routinely performed on newborns with no pain management. This presentation will include an overview of the three recommended newborn procedural pain management strategies and the knowledge to action (KTA) gap concerning utilization of evidence in practice. Barriers and facilitators to using the three strategies in diverse clinical settings will be discussed and knowledge translation strategies being used to address KTA gaps in pain management in newborns will be presented. GOLD Neonatal Online Conference false DD/MM/YYYY

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Neonates admitted to the Neonatal Intensive Care Unit (NICU) undergo numerous painful procedures each day, with fewer than one-third receiving analgesia. This is alarming as neonates who are critically ill and in pain are susceptible to developing life-threatening complications, since they cannot maintain homeostasis in a state of stress. Additionally, the cumulative effects of these painful experiences, has significant negative consequences to the neurodevelopment of these vulnerable neonates.

Pain assessment is fundamental to effective pain management although there is currently no universally accepted scale for pain assessment in neonates, and more evidence is required to determine the reliability and validity of existing pain assessment tools. Additionally, health clinicians do not know if the physiological and behavioural indicators of pain they observe are specific to pain, or a manifestation of the neonates medical condition, disease process, agitation, distress, fear, stress or even sadness. This issue is compounded when the expressive capacity of critically ill neonates is compromised by the administration of heavy sedation and muscle-relaxants. This presentation explores some of the complexities of pain assessment in neonates followed by practical advice for the health clinician, including a look at the modified Pain Assessment Tool (mPAT) and how it can help improve neonatal pain assessment in the clinical setting.

Live Presentation Schedule Jun 1, 2021

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01-06-2021 08:00 01-06-2021 09:00 35 Pain Assessment in Ventilated, Sedated, and Muscle-Relaxed Neonates Neonates admitted to the Neonatal Intensive Care Unit (NICU) undergo numerous painful procedures each day, with fewer than one-third receiving analgesia. This is alarming as neonates who are critically ill and in pain are susceptible to developing life-threatening complications, since they cannot maintain homeostasis in a state of stress. Additionally, the cumulative effects of these painful experiences, has significant negative consequences to the neurodevelopment of these vulnerable neonates. Pain assessment is fundamental to effective pain management although there is currently no universally accepted scale for pain assessment in neonates, and more evidence is required to determine the reliability and validity of existing pain assessment tools. Additionally, health clinicians do not know if the physiological and behavioural indicators of pain they observe are specific to pain, or a manifestation of the neonates medical condition, disease process, agitation, distress, fear, stress or even sadness. This issue is compounded when the expressive capacity of critically ill neonates is compromised by the administration of heavy sedation and muscle-relaxants. This presentation explores some of the complexities of pain assessment in neonates followed by practical advice for the health clinician, including a look at the modified Pain Assessment Tool (mPAT) and how it can help improve neonatal pain assessment in the clinical setting. GOLD Neonatal Online Conference false DD/MM/YYYY

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Pain in infancy has negative long-term consequences and its prevention is a clinical priority, but adequate pain treatment requires mechanistic understanding of the structural and functional development of human pain-related brain circuitry. Recent scientific and technological advances provide insights into how noxious information is transmitted to the infant brain, providing a platform to ask how intrinsic brain network connectivity and the environment affect pain-related brain activity, behaviour and ultimately pain perception in the developing infant nervous system.

As infants cannot describe their pain, we are reliant on alternative methods to measure their pain experience. My goal is to understand the mechanisms that drive and modulate pain perception in early human development. In this talk, I will discuss a series of mechanistic studies in human infants that aim to better understand the development of human pain. I will address fundamental questions regarding the functional development of pain-related brain activity and behavior, and will discuss whether inherent individual differences in how the infant brain behaves at rest drives differences in pain vulnerability. Finally, I will describe how these mechanistic insights can be used to test new analgesic treatment options and improve the treatment of infant pain.

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01-06-2021 08:00 01-06-2021 09:00 35 The Development of Human Pain Pain in infancy has negative long-term consequences and its prevention is a clinical priority, but adequate pain treatment requires mechanistic understanding of the structural and functional development of human pain-related brain circuitry. Recent scientific and technological advances provide insights into how noxious information is transmitted to the infant brain, providing a platform to ask how intrinsic brain network connectivity and the environment affect pain-related brain activity, behaviour and ultimately pain perception in the developing infant nervous system. As infants cannot describe their pain, we are reliant on alternative methods to measure their pain experience. My goal is to understand the mechanisms that drive and modulate pain perception in early human development. In this talk, I will discuss a series of mechanistic studies in human infants that aim to better understand the development of human pain. I will address fundamental questions regarding the functional development of pain-related brain activity and behavior, and will discuss whether inherent individual differences in how the infant brain behaves at rest drives differences in pain vulnerability. Finally, I will describe how these mechanistic insights can be used to test new analgesic treatment options and improve the treatment of infant pain. GOLD Neonatal Online Conference false DD/MM/YYYY

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