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CFDR Research in Action: Tracking the Growth of Preterm Infants
  • Preterm infants have the highest nutritional needs of any hospital patient, but feeding intolerances, medical complications and limitations on the amount of fluids they can tolerate make it challenging to determine if they are receiving necessary nutrition to ensure their growth.
    As a Registered Dietitian with 18 years’ experience working in neo-natal care, Tanis Fenton first addressed this problem in 2003 with her development of a Preterm Growth Chart for use in the neonatal intensive care unit (NICU). While this chart was later adopted by healthcare centres around the world, Tanis knew that it required further validation.  Wishing to learn more about research, Tanis went back to school to complete a PhD in Epidemiology.
                          Through a CFDR grant in 2010, Tanis and her colleagues combined in-patient measurements from the medical charts of very low birthweight infants in Calgary, Regina and San Diego with their post-discharge measurements, as well as descriptive information about the infants’ state of health and their nutrition intake. Being aware of important advancements in the research on growth monitoring after the World Health Organization published their growth standard for infants born at term, Tanis and a Colleague revised her Preterm Growth Chart in 2013. She and several Colleagues then compared the infants’ growth patterns to the 2013 Preterm Growth Chart.

    Their results showed that the weight of most infants at 10 weeks post term fell within the percentile curves of the 2013 Growth Chart even though the majority had weights below the 10th percentile at 36 weeks —an important verification that will help clinical dietitians in planning nutrition plans for their patients to optimize their development. Tanis will continue with further assessment and validation through a follow-up CFDR-funded project beginning this year.

    The impact of this ongoing work has been resounding. The Fenton Preterm Growth Charts are used across Canada and have been included in 21 textbooks. Her web-page for the growth chart (www.ucalgary.ca/fenton) is regularly accessed by dietitians and healthcare professionals in 141 countries around the world. The charts are endorsed by the pediatric societies in Portugal and Columbia, included in the Merck Manual and have been built into two Apps. One App is for health professional or parents to plots babies’ growth on the growth chart, and other one is for health professionals to calculate exact percentiles and z-scores.   
    The American Academy of Pediatrics 2014 Handbook on Nutrition noted that these growth charts are “commonly used in NICUs”.  The development papers have so far been cited in 324 papers (Web of Science). Finally, Tanis and her colleagues have instructed on the use of the growth charts and presented their research findings at dozens of conferences and research symposia across North America as well as in Paris and Bogota.  
    “The funding and support I have received from CFDR has been invaluable to me,” Tanis said. “The reviewers at CFDR have been well informed and intelligent in their reviews of our proposals. It is simply terrific to have funding allocated to nutrition research in Canada, and I commend the CFDR for the excellent work that it does.” 
    With a mandate of enhancing the health of Canadians by contributing new knowledge about food and nutrition, CFDR measures our success in part by the number of qualified research projects we are able to fund each year. In this regard we are proud of the more than 125 research teams that have received almost $1.8M in funding over the years thanks to the support of our donors.
    An equally important measure is the impact of these research projects. CFDR’s long-term success will be measured by demonstrated enhancements to dietitians’ practice through new knowledge that is generated from research.
    We hope you will consider a donation to CFDR to help researchers like Tanis continue their important work and contribute to the body of knowledge that will inform dietitians and ultimately improve the health of Canadians across generations and across the country.

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