Humans of health research

Dr Sabita Uthaya is Honorary Clinical Senior Lecturer in the School of Public Health at Imperial College London and Consultant in Neonatal Medicine at Chelsea and Westminster Foundation NHS Trust.  Dr Uthaya’s research interests include neonatal nutrition, body composition (amount and distribution of fat and muscle) and long-term health outcomes of preterm infants.

“I first got into research over 20 years ago.  My first research project done as part of my MD compared preterm babies with healthy term babies to see whether they deposited fat differently to healthy full-term babies. This study used MRI scans to evaluate body composition for the first time in very preterm infants.  

“At the time there was increasing evidence that premature babies were at high risk of suffering from conditions such as coronary arteries disease, diabetes and obesity in adulthood. 

"My research showed for the first time that very premature babies deposit more fat in the abdomen compared to healthy term babies.  This type of body fat distribution in adults is associated with increased risk of cardiovascular complications showing that risk factors for later health problems in preterm infants may be present as early as their due date.

“Another study that I led on was comparing two different types of intravenous feeding - a method of getting nutrition into the body through the veins - given to preterm babies. In this study, which is one of the largest trials of intravenous nutrition in preterm infants, we showed that giving early and high intakes of protein which was increasingly becoming the norm at the time was no different to a lower amount increased slowly over time. Both groups had similar pattern of body composition. The intravenous nutrition used in the trial is one of two recommended for use in neonatal units in London.

“Doing a clinical job is very satisfying.  You get gratification from helping save babies’ lives and seeing them years later, doing well, is amazing.  However, through doing research you help change clinical practice in the future, even if in a small way; that for me is the biggest reward.”

Amy Eccles’ son Arthur took part in Imperial’s NEON study -  a trial to confirm the safety and efficacy of providing nutrition to premature babies via an injection into the bloodstream rather than the gut as early as possible after birth– in 2011.  Arthur was born at 26 weeks weighing 950 grams and spent 14 weeks in hospital.

 “I remember Arthur being so tiny like a size of kitten.  His eyes weren’t open but he had eyelashes and fingers nails – he was perfect but just not ready. 

“Arthur was transferred to Chelsea and Westminster Hospital three hours after giving birth and we were told about the NEON study led by Dr Sabita Uthaya, Consultant in Neonatal Medicine at Chelsea and Westminster NHS Foundation Trust and Honorary Senior Lecturer at Imperial College London, very soon after his admission. 

"The trial was looking at the most effective feeding strategies to improve the growth and health of premature babies.  It involved comparing different types of nutrition such as plant based or oil based nutrition and whether increasing fat content over time or starting at a high level of fat impacted health outcomes.

"My husband Simon and I were very keen to get involved in the study.  We are both doctors and we understand the importance of research.  The team at Chelsea and Westminster Hospital talked us through what was involved, they reassured us that it wouldn’t change Arthur’s standard of care and it would help guide nutrition for newborns. At that point it felt very straight forward and obvious to say yes.

"Arthur was so young that he wasn’t able to feed normally and couldn’t absorb food into his stomach via an nasogastric tube -  a thin tube that passes through the nose down into the stomach-  so he needed to have his calories and nutrition injected into his veins as part of the trial.

"He gained weight well throughout his time in hospital and was able to receive breast milk within three weeks.  He was monitored closely by the team and he was able to go home after 14 weeks where he continues to have follow up assessments such as MRI scans to monitor his liver function.

"Being part of the trial helped me mentally.  It made me feel that I was able to do something as you can feel helpless in that situation. 

"Arthur is doing really well - he's eleven now - and he is a great big brother to his sister.  We have told him that he has been involved in research and that his involvement will help how other babies who are born early are treated."

 

 

Professor Neena Modi is Professor of Neonatal Medicine at Imperial’s School of Public Health, and one of the UK’s leading experts in child health. She is also Honorary Consultant in Neonatal Medicine at Chelsea and Westminster NHS Foundation Trust and heads the Neonatal Medicine Research Group at Imperial, and the Neonatal Data Analysis Unit.

“I first became interested in research when I was a junior doctor.  I felt some of the treatments we were using could be improved.  I worked with some great senior doctors who encouraged me to do the research and find the right answers. 

“I think we have made quite a journey in neonatal research. For example, when I was at medical school it was considered unethical to include babies in research.  What wasn’t appreciated at the time is that without research, patient care can’t move forwards and you could do patients harm.  One example of this is that we were taught for many years that babies should always have oxygen when they are resuscitated at birth.  We now know through research that it is the wrong thing to do and can adversely impact babies. 

“I have leaned on my own research experience in my other roles - president of the UK Medical Women’s Federation, President of the British Medical Association and past-president of the Royal College of Paediatrics and Child Health (RCPCH). 

“When I was president of the RCPCH I established a new fund to support post-doctoral paediatric researchers as there is a real bottleneck and there are not enough academic posts which means people fall off and return back to clinical work fulltime.

“Another thing we did is to establish a children’s research charter with children talking about their experience of research and how they like to get involved. 

"These initiatives are important as funding for paediatric research is a tenth of what it is in adult research and children are disadvantaged.  This is also the case for women’s research.

“I would like to see more equity in research and it should benefit all of society.”