Little Giraffe Foundation voted to fund 3 Neonatal Research Grants to forward medical care for premature babies.

2023 Neonatal Research Grants

University of Florida, Gainesville, FL - $9,796 Awarded

Research: Advancing Antimicrobial Resistance Management in Preterm Infants

Luiz Fernando Wurdig Roesch. PhD – PI, Assistant Professor, University of Florida

Antibiotic resistance is a global health threat affecting hospital and community settings. Preterm infants (PEI) are highly susceptible to bacterial infections due to immaturity and reduced gut microbial diversity (Gasparrini et al., 2019). The universal standard practice of administering antibiotics (ABX) to PEIs within 24 hours of birth, even without culture-confirmed infections, can lead to long-term collateral damage to the PEI by disrupting the developing gut microbiome (Ruoss et al., 2021) (Puopolo et al., 2018).However, the impact of consistent ABX use on the prevalence of antimicrobial resistance (AMR) genes and microbiome composition in this high-risk population remains poorly understood.

This study aims to detect and quantify the prevalence of AMR genes in Routine Early Antibiotic Use in Symptomatic Preterm Neonates (REASON), specifically looking at PEIs' meconium and stool. This investigation will assess whether the routine use of ABX in symptomatic PEI after birth, as standard care, increases the prevalence of AMR genes and how it alters the PEI microbiome. Findings from this study are essential for improving the management of ABX in PEI, ultimately reducing the prevalence of AMR and optimizing the long-term health outcomes of PEIs. Furthermore, such insights can inform effective strategies for minimizing unnecessary ABX exposure, promoting judicious ABX use, and improving neonatal care.

University of Connecticut, Hartford, CT - $9,700 Awarded

Research: Impact of Breast Milk HMO Composition on Premature Infant Gut Microbiome and Neurodevelopment

Michelle Judge, Ph.D., RD, CD-Nr – Co-PI, , Associate Professor, School of Nursing, University of Connecticut

Taylor Reilly, Ph.D – Co-PI, School of Nursing, University of Connecticut

The overarching goal of the proposed research study is to investigate the critical role of human milk oligosaccharide (HMO) composition in mother’s breast milk on premature infant health. Human milk oligosaccharides (HMOs) are important prebiotic agents that following fermentation, produce short chain fatty acids (SCFAs) which cross the blood-brain barrier and play a critical role in the gut-brain axis. Concentrations of HMOs in human milk are individualized and studies have shown that concentrations of HMOs in preterm breast milk are different than that of term breast milk. Therefore, this study aims to investigate the relationship between HMO composition of mother’s breast milk and premature infant gut microbiome patterns through available breast milk and stool samples. Further, the relationship between HMO composition of breast milk and neurodevelopment outcomes will be investigated through available NeoNatal Neurobehavioral Scale (NNNS) data for a subset of premature infants included in the sample. Results from this investigation will increase our current understanding of the influential role that HMOs have on premature infant health outcomes.

David Geffen School of Medicine at UCLA, Los Angelos, CA - $10,000 Awarded

Research: Creating a Better Treatment Pathway for Infants with Congenital Heart Disease and Necrotizing Enterocolitis

Justin Wagner, MD - Co-PI, Assistant Professor, Department of Surgery, Division of Pediatric Surgery, David Geffen School of Medicine at UCLA

Jordan Rook, MD - Co-PI, Resident, General Surgery, Fellow, National Clinician Scholars Program, David Geffen School of Medicine at UCLA

The rate of mortality among patients with necrotizing enterocolitis (NEC) is 20-30%.1 Classically, NEC has been considered a disease of preterm infants resulting from inflammation and necrosis due to bacterial infiltration of the underdeveloped intestinal mucosal barrier.2 As many as 4% of patients with congenital heart disease (CHD) receive a diagnosis of NEC. For these children, unlike classical NEC, bowel ischemia may occur from a systemic cardiogenic state of inadequate perfusion.3 Emerging research has shown that when compared to infants with classical NEC, infants with CHD and NEC less often fail medical management.4 Despite this, existing treatment pathways do not differentiate between these entities, and thus, those with CHD are managed identically to those with classical NEC. This potentially results in unnecessary x-rays, antibiotics, parenteral nutrition, and days without feeds.3–5 This prospective single-institution pretest-posttest study seeks to apply an evidence-based diagnostic and treatment algorithm for patients with CHD and NEC to achieve non-inferior outcomes to current treatment while reducing the duration of antibiotic therapy, parenteral nutrition, days without feeds, and ICU and hospital stay.