Description of the goods or services required
The Health Technology Assessment Programme is accepting stage 1 applications to their commissioned workstream for this primary research topic:
19/44 Nutrient enriched diet for babies with a brain injury
Perinatal brain injury, often as a result of either prematurity or oxygen deprivation (hypoxic ischaemic encephalopathy, HIE) around the time of birth, is associated with both short-term complications and increased risk of cognitive, motor and behavioural problems in the longer term, which can vary in severity depending on the location and extent of the damage inflicted.
Brain injury during the perinatal period is particularly damaging, as this is a period of critical brain growth and development. However, this period also offers a ‘window of opportunity’ for intervention. Evolving understanding of the brain’s capacity for plasticity (its ability to be functionally altered) during early life means targeted interventions can be implemented to mitigate the damage. Improved early (in hospital) nutrition, to increase the supply of essential nutrients to the growing brain, is one such intervention that has demonstrated improved neurodevelopmental outcomes in preterm babies in the form of improved formula and breastmilk fortification.
However, the critical period of brain plasticity continues throughout the first year of life so the question remains as to whether increased nutrients throughout this time could improve growth and neurodevelopmental outcomes, particularly among babies who have had a brain injury and are simultaneously at significantly increased risk of poor outcomes yet able to tolerate additional nutrient intakes. Recognising the inherent physiological and developmental differences between prematurity-related brain injury and term HIE-related brain injury, applicants should ensure sub-groups are adequately powered to answer the question. The role of breastfeeding should be addressed as should the potential for contamination between the arms of the trial.