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Clinical Pearls

Nutrition experts provide personal perspectives on contemporary issues in clinical pediatric practice.

Instructions

Click on a Clinical Pearl topic and play the video. Then open ‘Additional Faculty Discussion’ to read expanded commentary from the
faculty.

To organize a group viewing activity

Watch the video and read the Additional Faculty Discussion together. Then use the provocative questions at the end of the
Additional Faculty Discussion to stimulate the discussion in your group

Topics

Interventions for Cow’s Milk Allergy in Children and Infants Roberto Berni Canani, MD, PhD
Inositol: A Nonglucose Carbohydrate Found in Human Breast Milk Laura D. Brown, MD
Potential Beneficial Effects of Human Milk Oligosaccharides Ardythe L. Morrow, PhD
Lactoferrin Supplementation and its Gut Health Benefits Bo Lönnerdal, PhD
Milk Fat Globule Membrane: Cognitive Development & Reduced Infections Bo Lönnerdal, PhD
Prebiotics: The Basics Craig L. Jensen, MD
Probiotics: The Basics Craig L. Jensen, MD
Neonatal Abstinence Syndrome (NAS) Evelyn Keppinger, MSN, RN
Cue-based Feeding of Preterm Infants Evelyn Keppinger, MSN, RN
Multicultural Beliefs About Colostrum Amy Gates, RD, CSP, LD
Improving Tolerance to Human Milk-fortified Feedings in Preterm Infants Amy Gates, RD, CSP, LD
DHA and its Role in Development Fernando R. Moya, MD
Use of Colostrum in Neonates Fernando R. Moya, MD
Food Security and Insecurity Robert J. Karp, MD
Human Milk Fortification Jae H. Kim, MD
Protect the Microbiome Robert J. Karp, MD
Donor Human Milk Jae H. Kim, MD

Note: The ideas and opinions presented in these educational activities are those of the faculty and do not necessarily reflect the views of the Annenberg Center and/or it’s agents. As in all educational activities, we encourage practitioners to use their own judgment in treating and addressing the needs of each individual patient, taking into account that patient's unique clinical situation. They are not certified for CE credit.

Interventions for Cow’s Milk Allergy in Children and Infants

- Roberto Berni Canani, MD, PhD

Roberto Berni Canani, MD, PhD, Chief of the Pediatric Allergy Program in the Department of Translational Medicine, University of Naples, shares his expertise in the study of cow’s milk allergy (CMA). Dr. Canani proposes interventions, including supplemental probiotics and their appropriate use in formula for neonates and infants. Current and ongoing research to reduce allergic manifestations in children with cow’s milk allergy is also highlighted.

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Inositol: A Nonglucose Carbohydrate Found in Human Breast Milk

- Laura D. Brown, MD

Laura D. Brown, MD, associate professor of pediatrics–neonatology and perinatal research at the University of Colorado Hospital and Children’s Hospital in Aurora, Colorado, reviews inositol, a naturally occurring nonglucose carbohydrate present in human breast milk. Dr. Brown discusses the benefits inositol may provide to developing infants while describing new and ongoing research in this area.

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Potential Beneficial Effects of Human Milk Oligosaccharides

- Ardythe L. Morrow, PhD

Ardythe L Morrow, PhD, Director, Center for Interdisciplinary Research in Human Milk and Lactation at the Cincinnati Children’s Hospital Medical Center, discusses human milk oligosaccharides (HMO) as an essential, bioactive component of breast milk. Dr. Morrow reviews the proposed advantages of HMO, and addresses the need for additional clinical trial testing to fully define the benefit of HMO-supplementation.

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Lactoferrin Supplementation and its Gut Health Benefits

- Bo Lönnerdal, PhD

Bo Lönnerdal, PhD, Distinguished Professor Emeritus in the Department of Nutrition and the Department of Internal Medicine at the University of California, Davis, discusses the current state of the science of lactoferrin as a nutritional supplement. Dr. Lönnerdal describes the antimicrobial properties of lactoferrin and how this is essential for shaping the composition of the microbiota, and he suggests how lactoferrin supplementation can improve outcomes for preterm infants.

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Milk Fat Globule Membrane: Cognitive Development & Reduced Infections

- Bo Lönnerdal, PhD

Bo Lönnerdal, PhD, Distinguished Professor Emeritus in the Department of Nutrition and the Department of Internal Medicine at the University of California, Davis, introduces the milk fat globule membrane (MFGM) as a key component missing from infant formula and as a nutritional supplement that only recently became commercially available. Dr. Lönnerdal describes the clinical trials that suggest how the introduction of MFGM supplements to formula could lead to outcomes that better approximate the outcomes for infants who are breast-fed.

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Prebiotics: The Basics

- Craig L. Jensen, MD

Craig L. Jensen, MD, associate professor of pediatrics—gastroenterology at Texas Children’s Hospital and Baylor College of Medicine in Houston, Texas, reviews current knowledge about the benefits of adding prebiotics, nondigestible food components, to infant formula. Dr. Jensen also discusses safety data associated with the administration of prebiotics in the pediatric population.

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Probiotics: The Basics

- Craig L. Jensen, MD

Craig L. Jensen, MD, associate professor of pediatrics—gastroenterology at Texas Children’s Hospital and Baylor College of Medicine in Houston, Texas, reviews the use of probiotics, live microorganisms that confer health benefits for the host. Dr. Jensen makes evidence-based recommendations for the use of probiotics in common clinical scenarios encountered by pediatric clinicians, such as in the settings of cow’s milk protein allergy and infant colic.

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Neonatal Abstinence Syndrome (NAS)

- Evelyn Keppinger, MSN, RN

Evelyn Keppinger, MSN, RN, clinical nurse navigator at Wolfson Children’s Hospital and NICU, Baptist Health System, in Jacksonville, Florida, reviews the signs and symptoms of neonatal abstinence syndrome (NAS) in preterm infants. She also suggests appropriate assessment and management strategies for dealing with these infants using evidence-based clinical practice guidelines.

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Cue-based Feeding of Preterm Infants

- Evelyn Keppinger, MSN, RN

Evelyn Keppinger, MSN, RN, clinical nurse navigator at Wolfson Children’s Hospital and NICU, Baptist Health System, in Jacksonville, Florida, describes the benefits of adopting a cue-based feeding strategy for preterm infants in the NICU. She also reviews behaviors that indicate an infant is or is not ready to transition to oral feedings, and offers tips for creating a stress-free, calm, feeding environment.

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Multicultural Beliefs About Colostrum

- Amy Gates, RD, CSP, LD

Amy Gates, RD, CSP, LD, Pediatric Nutrition Specialist at Children’s Hospital of Georgia and Georgia Regents University in Augusta, addresses negative cultural perceptions of colostrum and how to overcome them. She also shares her institution’s protocol for administration of colostrum to extremely low-birth-weight infants via oral swabbing.

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Improving Tolerance to Human Milk-fortified Feedings in Preterm Infants

- Amy Gates, RD, CSP, LD

Amy Gates, RD, CSP, LD, Pediatric Nutrition Specialist at Children’s Hospital of Georgia and Georgia Regents University in Augusta, describes strategies for improving tolerance to human milk-fortified feedings in preterm infants, highlighting appropriate preparation, handling, and storage techniques in the NICU.

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DHA and its Role in Development

- Fernando R. Moya, MD

Fernando R. Moya, MD, Director of Neonatology at New Hanover Regional Medical Center, Wilmington, NC summarizes current evidence describing the role DHA plays in brain and retinal development, its protective effects in some neonatal diseases and strategies to improve the source of DHA in maternal diet.

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Use of Colostrum in Neonates

- Fernando R. Moya, MD

Fernando R. Moya, MD, Director of Neonatology at New Hanover Regional Medical Center, Wilmington, NC discusses the benefits of colostrum in neonates, particularly while they are staying in the intensive care unit.

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Food Security and Insecurity

- Robert J. Karp, MD

Robert J. Karp, MD, Professor of Pediatrics at SUNY- Downstate Medical Center offers a simple and practical question that you can use to engage families in a discussion about their sources of food and nutrition.

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Human Milk Fortification

- Jae H. Kim, MD

Jae H. Kim, MD, Associate Professor of Pediatrics at UC San Diego Medical Center discusses preterm infants and the importance of supporting mom’s base milk with a fortification strategy.

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Protect the Microbiome

- Robert J. Karp, MD

Robert J. Karp, MD, Professor of Pediatrics at SUNY-Downstate Medical Center relates simple strategies you can implement to help protect the microbiome in your patients.

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Donor Human Milk

- Jae H. Kim, MD

Jae H. Kim, MD, Associate Professor of Pediatrics at UC San Diego Medical Center addresses a common misconception about the processing of donor human milk.

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