Since its establishment through a research Centre award from Science Foundation Ireland,  and under the continuous leadership of Professor Geraldine Boylan, the INFANT Centre at UCC has been responsible for a number of innovative breakthroughs that are saving lives and improving outcomes for babies and their families every day, as well as shaping perinatal medicine around the world.

With a national and international focus, INFANT is now collaborating with over 35 industry and academic partners in more than 30 countries. INFANT research is continually published in top-ranking international journals, while pioneering research in pre-eclampsia, newborn brain injury, infant nutrition, and infant allergy is solving global clinical challenges.

INFANT Director Geraldine Boylan commented on the high impact research emanating from Ireland’s perinatal research centre, saying “INFANT has grown rapidly in its first 5 years. Not only have we grown in scale, industry collaborations and partnerships, but also in ambition and innovation. The INFANT team are responsible for internationally significant breakthroughs in perinatal and paediatric medicine, as well as research that is influencing and positively changing lives and outcomes for families every day.

“We are currently working on frontline research in areas such as early autism diagnosis, supporting newborn brain health and cognitive function, to treating the causes of allergy, eczema and asthma, among several other key projects.  INFANT will continue to break new ground, as well as seeing current breakthroughs mature and move from ‘the bench to bedside’ whilst also developing the next wave of research to deliver better outcomes for mums and babies. We are grateful for all the support we have received from funding agencies,  donors and industry partners  since our launch in 2013 and we will continue to work tirelessly to deliver for all the families who generously support the work we do”.

Having grown from a team of 5 in 2013, the INFANT research team now exceeds 100 researchers, innovators, paediatric clinicians and experts, based at University College Cork, Cork University Hospital (CUH) and Cork University Maternity Hospital (CUMH) in 2018.

In these 5 years, researchers at INFANT have developed a number of key scientific breakthroughs, many of which are world 1^st innovations such as an AI powered clinically validated seizure detection algorithm for newborns. This system automatically analyses and identifies seizures in newborn babies using EEG readings of the brain. Using artificial intelligence that detects brain seizures in newborns, INFANT has developed a new medical device for seizure detection in neonates that sets off an alarm at the cotside when baby seizures occur.  This technology, uniquely, has been validated in a clinical trial and licensed to a global patient monitoring company, which means that the INFANT device will soon be available to babies worldwide. This breakthrough is already changing patient care for the better and the INFANT team are recognised internationally for their leadership in the area of neonatal seizure detection.

INFANT has also developed the world’s first early predictive biomarkers for pre-eclampsia. Affecting 5% of first-time mothers, preeclampsia is one of the most common complications of pregnancy and is a leading cause of maternal and infant illness and death. Using the latest technology to study metabolites, INFANT researchers discovered a set of molecules (biomarkers), which identify women at risk of developing the disease.  A screening test has now been by a Cork-based start-up, Metabolomics Diagnostics who are leading a clinical study to commercialise the test to screen at risk first-time mothers to be easily identified leading to better pregnancy outcomes.

Newborn brain injury due to oxygen deprivation (HIE) remains a leading cause of acquired brain injury. INFANT researchers have identified biomarkers which could predict the occurrence of brain injury using INFANT’s extensive biobank. Using the data INFANT has collected on infants with HIE, the research centre has identified predictive markers found in umbilical cord blood. INFANT is working to develop a point-of-care diagnostic test which will help clinicians to predict HIE, which must be treated very quickly. The Clinical Risk Algorithm for Neonatal HIE is a real breakthrough for neonatal care. The aim of this work is to ensure all babies who require resuscitation at birth would be screened so that the narrow time available for treatment is maximised, saving large numbers of infants from long-term disability.

Most recently, INFANT’s allergy research has been part of a breakthrough treatment for peanut allergy. Without any treatment available, peanut allergy has put children and adults at risk of unpredictable and occasionally life-threatening reactions.  Clinical trials co-led by an INFANT principal investigator and supported by the Clinical Research Facility in Cork  , have found that a new oral treatment, can successfully reduce sensitivity to peanuts, offering a real lifeline to those affected by the most common food allergy and the single cause of most food allergy deaths. The immunotherapy is being fast tracked through the US Food and Drug Administration (FDA). Assuming FDA approval, the therapy could be available to patients around the world by late 2019.

In Ireland, 1 in 100 babies are born preterm and very low birth weight (under 5.5lbs). INFANT’s BabyGrow study has developed a way to measure nutritional support and growth rate in preterm infants in the Neonatal Intensive Care Unit (NICU). The earlier a baby is born, the lower the birthweight may be and this can have knock-on effects for health at birth and beyond. Very low-birthweight babies are more likely to have health problems as a new-born and will need special care in the hospital’s NICU. As a result of the BabyGrow project, two new nutrition products were introduced to Cork University Maternity Hospital. The PiNPoINT (Personalised Nutrition for the Preterm Infant) project is now observing the babies who are receiving the new nutrition product and conducting detailed assessments in these babies throughout their hospital stay and during infancy. This collaborative project has delivered innovative, evidence-based solutions to a long-standing unmet need for the benefit of the most vulnerable people in society.

In collaboration with UCC, Science Foundation Ireland and Cork University Maternity Hospital, INFANT opened Ireland’s first Integrated Clinical Academic Research Unit for Paediatrics.  The first of its kind in ireland, the new paediatric academic unit focuses on improving health outcomes for children, from infancy through to adolescence through teaching, research and innovation.

Applauding INFANT’s achievements over the last five years, UCC’s Head of the College of Medicine and Health, Professor Helen Whelton, said, “INFANT has built the research infrastructure, capability and projects that are delivering the vision to create an internationally renowned Maternal and Child Health Research Institute. We, at UCC, are very proud of the INFANT Centre and all that the Centre has already achieved. We look forward to many  more breakthroughs in maternal and child health research research.”

We’ve reached a milestone!

The ENRICH team recently reached a significant milestone in the study completing all the 4-month appointments.

The Infant Baby Enrichment Research Programme, is better known as ENRICH. The programme – co-funded by Johnson & Johnson and Science Foundation Ireland – is focused on understanding how sleep contributes to the healthy development of infants. Studies have shown that brain development and learning are heavily influenced by sleep. Regular, quality sleep helps to optimise physical growth and brain plasticity, while a lack of sleep has been linked to long term negative impacts on behaviours and learning ability.

The ENRICH programme is examining the effect of massage, delivered by the parents, trained according to a structured programme, on both the quality and quantity of sleep and on subsequent neurodevelopment.

Baby Conor and his mom Colleen pictured with Sean Mathieson, ENRICH senior clinical physiologist.

Since October 2017, a total of 182 participants attended the 4-month appointment in Cork University Hospital. Each appointment included a standardised development assessment (known as the Griffiths III assessment), a tool that is used to assess developmental ability in children. Following this assessment, infants then undertook a sleep EEG study. The EEG study was used to record a full sleep cycle which typically lasts 40 minutes for 4 month old infants.

What next?

The developmental outcome recorded will allow researchers to compare developmental performance with quality of sleep, massage and maternal wellbeing. Repeat assessment at 18 months of age will allow the ENRICH team to see how development progresses and if any improvements in performance are sustained.

Well done to all the team!

Last Friday, Fáilte Ireland honoured 83 of its leading Conference Ambassadors at a glamourous award ceremony at Christ Church Cathedral. The recipients – from a variety of backgrounds, including academia, medical science, technology, environment, and culture amongst others – were nominated for an award by the Irish conference and meetings industry.

INFANT Director Prof Geraldine Boylan pictured with Fáilte Ireland Chairman Michael Cawley and Chief Executive Paul Kelly.

INFANT Director Professor Geraldine Boylan was given special recognition on the night for her significant contribution to international conferencing in Ireland, taking home the Conference Ambassador of the Year Award. In 2015, Geraldine won her bid to host the 9th International Conference on Brain Monitoring and Neuroprotection in the Newborn in Cork. Having hosted a successful conference, Geraldine won it again for 2017, this time bringing the delegates to her home county of Kerry. Delegates came from Europe, America, Australia, New Zealand, China and Japan.

INFANT Principal Investigator Dr Keelin O’Donoghue was also presented with a Conference Ambassador award, recognising her contribution to conferencing in Ireland. Keelin was instrumental in delivering the International Stillbirth Alliance Conference in Cork last year.

Dr Keelin O’Donoghue (bottom left) pictured with fellow Medical Sciences Conference Ambassador Awardees.

Geraldine said, “Bringing scientific conferences to Ireland is hugely important for showcasing Irish science and innovation internationally. It is also a very strong endorsement of the quality of research and science we do as a country – you need to be credible, excellent and have international standing in your field to attract International Conferences to Ireland as a host. There are many direct and spill-over benefits that arise as a result. International delegates and sponsoring companies get to visit the region often as first time visitors. They also visit local academic centres and businesses as part of the event and develop new relationships for further partnerships all of which serves to boosting scientific standing, bring economic benefit and hopefully show the way for more conference opportunities.

“The support provided by Fáilte Ireland was incredible and instrumental in my decision to bid for a second conference in Ireland. Sincere thanks to Fáilte Ireland for all of their support, along with the Cork Convention Bureau and Science Foundation Ireland. I had certainly not appreciated how much support was available until I hosted the first conference; as a result the second one was much easier. I would encourage anyone thinking of hosting a conference to just take the plunge and contact Failte Ireland – they will guide you all the way and it’s a fantastic win for all national stakeholders.”

Our Phd researcher, Sonia Lenehan, was voted the winner of Neon Zone’s I’m a Scientist, Get me out of here! I’m a Scientist is an online STEM engagement event where students chatted and interacted with scientists through online chats and forums. The students then voted for their favourite scientist.

Sonia was asked a variety of questions such as ‘what got you into brain development’, ‘what are you hoping to achieve with your eye-tracking assessments’, and ‘which do you prefer, Ravenclaw or Gryffindor’ (Gryffindor!!). The students were incredibly engaging and Sonia really enjoyed being a part of the event. The questions were incredibly thoughtful and insightful. Sonia had an amazing experience and would encourage scientist at all stages of their careers to consider taking part in this event.

Sonia wins €500 to be used for a public engagement project of her choice. Sonia plans to work with the National Council for the Blind with the intention of setting up an interactive science programme for children with visual impairments or blindness.

The world’s largest peanut allergy treatment trial, involving more than 30 Irish children, has found that a new oral treatment can successfully reduce senstivity to peanuts, and offers a real lifeline to those affected by the most common food allergy and the single cause of most food allergy deaths.

Through his work as Principal Investigator at the INFANT Centre, Professor of Paediatrics and Child Health at University College Cork, Jonathan Hourihane has been leading the revolutionary immunotherapy trial in Ireland, which has shown that more than two thirds (67%) of those on the treatment could tolerate peanuts after the trial. This tolerance gives peanut allergy sufferers real safety, and the ability to cope with accidental exposure in the community.

“Up to now, without any treatment available, peanut allergy has put children and adults at risk of unpredictable and occasionally life-threatening reactions.  The AR101 immunotherapy is a real breakthrough for those affected by peanut allergy.  It works by introducing initially minute controlled amounts of peanut protein, with escalation over a sustained period of 6 to 12 months, building up a patient’s tolerance to peanut. We have seen patients go from being highly allergic to very small doses, like one tenth of a peanut, to being able to manage to eat the equivalent of 2 or 3 peanuts without a significant reaction. This is a game changer for anyone living with this allergy,” said Prof. Hourihane of the INFANT Centre.

This industry-sponsored research and clinical trial has resulted in the publication of Prof. Hourihane’s co-authored paper in the world’s leading medical journal, The New England Journal of Medicine this week.

INFANT Director Geraldine Boylan said, “This is an example of the excellent, world leading clinical research ongoing at the INFANT centre at UCC, which is making a huge difference to lives of children and their families, not just in Ireland but all over the world. We are delighted to be a significant player in bringing this new therapy to fruition and acknowledge the incredible work of our INFANT allergy research team, and particularly the incredible work of our colleague, Prof.Jonathan Hourihane.”

UCC President Pat O’Shea said “We applaud the development of a new immuno-therapy for peanut allergy by Professor Jonathan Hourihane.  This research has the potential to have a positive effect on patients globally and is a wonderful example of the hugely relevant research being carried out at the INFANT research centre.  University College Cork’s College of Medicine and Health (CoMH) is committed to the development of excellent and impactful clinical research and, in that regard, INFANT is of strategic importance to the CoMHand to UCC.

The AR101 trial has been ongoing around the world for almost 2 years in total. The double-blind placebo-controlled food challenge saw participants go from allergic reactions, such as immediate vomiting, swelling of the throat, blisters on tongue, stomach pain and other signs of hypersensitivity,   after exposure to 1mg of peanut protein, to being able to safely injest up to 600mg of peanut protein. The AR101 treatment has been developed for daily dosing so that patients continue to take the oral immunotherapy on an ongoing basis to remain desensitised to peanuts.

The AR101 immunotherapy will be submitted to the US Food and Drug Administration (FDA) for a Biologics Liencse Application by the end of 2018, and is expected to be fast-tracked on the FDA Breakthrough Therapy Designation for peanut allergic patients from ages 4 to 17 years. Assuming FDA approval, and subsequent approval by the European Medicines Agency in 2019, AR101 could be available to patients around the world by late 2019.

Original Article: https://www.nejm.org/doi/full/10.1056/NEJMoa1812856

INFANT’s preterm nutrition team last night received the Health and Social Care Professions Driving Quality and Improvement Award for their BabyGrow Project. The winners were announced at the Inaugural Best Practice and Innovation Awards hosted by the HSE’s Health & Social Care Professions Office in the Royal College of Surgeons, Dublin, on the 6th November.

The National HSCP awards recognise and celebrate examples of best practice and innovation.

Pictured L to R: Ms. Sarah Fenton, Senior Pharmacist; Dr. Ann-Marie Brennan, Clinical Specialist Neonatal Dietitian; Ms. Jennifer Wilkinson, Senior Neonatal Dietitian; Mrs. Annemarie Fanning, Dietitian Manager; Dr. Brendan Murphy, Consultant Neonatologist.

BabyGrow: Translating Research into Improved Nutritional Care for Preterm Infants was a multi-disciplinary preterm nutrition project, led by Prof Mairead Kiely (Nutrition Scientist, INFANT Nutrition platform lead), Dr Brendan Murphy (Consultant Neonatologist) and Dr AnnMarie Brennan (Neonatal Dietitian). The collaboration in preterm nutrition between Cork University Maternity Hospital (CUMH), University College Cork (UCC), industry and the HSE was initiated over a decade ago and continues to grow within the Nutrition platform at the INFANT centre.

The goals of the BabyGrow study was to quantify nutritional support and growth rate in preterm infants in the NICU and to develop and deliver data driven innovations for improvement of nutritional support.

Dr Brennan conducted her PhD on BabyGrow and her analysis of parenteral nutrition, the focus of the HSCP award, was a transformative piece of research, which led to the development and implementation of a new intravenous nutrition solution for safer and better nutritional support in the NICU.

In Ireland, ~1 in 100 babies (~600 babies per annum) are born preterm and very low birth weight (VLBW <1500g). One in four preterm infants has evidence of developmental delay by the time they reach school-age. Appropriate nutrition during early life is essential for healthy growth and neurological development. As these vulnerable infants transition from exclusively intravenous nutrition onto milk feeds over the first 7 to 10 days of life, nutrition provision is complex and challenging, with a high risk for adverse short and long term effects. In the absence of evidence-based practice guidelines, nourishing preterm infants during this critical period has traditionally been based on a ‘best guess’ approach.

The BabyGrow nutrition and growth study revealed substantial nutrient deficits and growth failure in VLBW infants during the first weeks of life. This had been observed previously in other units, but the BabyGrow database, which was uniquely designed to provide the most disaggregated and detailed portrait of nutrient delivery within the NICU, provided a first-time opportunity to conduct in silico data modelling experiments.  The outcome of this data-driven approach was the development of novel parenteral products with improved nutritional composition, making them suitable to deliver recommended levels of nutrients to support growth without providing excessive intakes. This is the first time nutrient modeling has been used to determine the composition of intravenous nutrition that fully meets the needs of VLBW infants, who have a complex nutritional journey. The team partnered with industry to translate this research into clinical practice and embarked on a 6 month product development phase.

In February 2018, following a dietitian-led implementation strategy, the two new intravenous nutrition products, supported by an evidence-based guideline, were introduced into CUMH. The post implementation audit shows full adoption with infants receiving safer and better nutrition. To date, this work has been published in four international peer-reviewed publications and the evaluation is ongoing.

As part of the PiNPoINT (Personalised Nutrition for the Preterm Infant) project, funded by a consortium led by Science Foundation Ireland, the same team is observing infants receiving the new intravenous nutrition products and conducting detailed growth, developmental and neurological assessments in these babies throughout their hospital stay and during infancy.

The National Clinical Programme for Paediatrics and Neonatology Parenteral Nutrition Expert Group have endorsed the new products and evidence-based guideline and national rollout is planned. Utilising the improved intravenous nutrition products instead of bespoke individualised prescriptions on a daily basis will deliver cost savings of ~€60,000 per annum to CUMH, a 20% saving on our overall intravenous nutrition costs supply, with potential for far greater cost savings nationally. Very positive feedback has been received from a staff evaluation, who have reported the new developments as “user friendly”, “easy to follow”, “prescribing is easier and safer” and, “babies in my care are receiving better and safer nutrition”.

This collaborative project, between HSE dietitians, neonatologists, pharmacists and nutrition scientists at UCC, has delivered innovative, evidence-based solutions to a long-standing unmet need for the benefit of the most vulnerable people in society.

As published in UCC, College of Medicine and Health “The Research Impact Anthology – Research for a Healthier Future”.

When babies are born it is usually a joyous occasion. In most cases it goes well, but some babies are born either too soon or very sick. They may not have grown well enough in the womb or may have suffered an injury during labour. When you consider that there are 65,000 babies born annually in Ireland – the highest birth rate in Europe – then it is not surprising that we need a research centre to explore how we can make pregnancy and birth safer for our mums and babies,and improve outcomes.

Our dedicated perinatal translational research centre reaches out from the bench to the cotside – often little incubators – in a very real way, so that our innovations are put into clinical practice. Our centre is the first of its kind in the country. INFANT, the Irish Centre for Fetal and Neonatal Translational Research, was established in September 2013 by Prof. Geraldine Boylan and Prof. Louise Kenny, two innovative academics in perinatal
research at our college. They secured a starting grant
from Science Foundation Ireland (SFI) to develop a dedicated research centre in UCC.

Geraldine’s speciality was in the neurophysiology of the baby brain and Louise’s expertise was in preeclampsia and obstetrics. They had each built their own individual talented research teams for several years, and in INFANT, they pooled their resources and built multi-disciplinary programmes. Geraldine, INFANT director, says: “We combined our efforts. We said mothers and babies should be together, so the research should be together!

“We had an excellent research team and a bedrock of good work going on; we were all in the right place at the right time. And what we have in Cork, also, is a great synergy between the university and the hospitals (Cork University Maternity Hospital and Cork University Hospital); it has been perfect for working well in the perinatal space.”

“We received €5.9M from SFI to set up the centre in 2013, which enabled us to build the core infrastructure of the centre, and now we have a funding portfolio of €30M. We have outperformed all of our key performance targets and now have 100 staff working in INFANT. We have won funding from the EU, the Wellcome Trust and from industry and received donations through philanthropy. For every one euro of funding we have received from the state, we have been awarded another five euros on top of that, from non-Exchequer sources,” she says proudly.

“Working closely with industry enables our team to get their technologies or new devices or drugs realised, as speedily as possible. This is so important for these vulnerable populations.” Research at INFANT, of course, touches all humanity. Our dedicated researchers are on call 24/7 since a lot of their work explores problematic situations that happen at birth and afterwards, and how these can be prevented down the road for other mums and babies.

None of this could be done, of course, without the families who engage in our research with our multidisciplinary team of doctors, nurses, scientists, engineers, postgraduate students and research support staff. “We need to study mothers and we need to study the babies to find out why problems happen, and we can only do that because of the parents and families who engage with our research. They really understand why we are doing it,” says Geraldine. “I am constantly overwhelmed by their altruism and their generosity. It doesn’t matter what funding in the world we get – without them, this research wouldn’t happen.”

“For a long time children did not participate in research, and as a result, most of the medical devices and many of the drugs we use have never been properly tested for infants or children – even though their development and physiology are completely different to adults. The evidence base isn’t there, so we are working to make sure that medical devices and treatments for children are tested and developed to the best possible standards.”

INFANT is changing that landscape nationally and internationally. Our research is known all over the world; we have delivered over 300 highly cited academic publications in the last four years alone. We are known throughout the world in relation to pre-eclampsia, newborn brain injury, maternal and infant nutrition, and infant allergy. We have lots of high impact papers published in those areas and more in the pipeline.

For the director, she is fully confident that there is no stopping their phenomenal pace of growth: “We have only just scratched the surface of what we need to do for mothers and babies,” she says. “There’s so much more yet to be done and we won’t stop!”

Emma Snapes, INFANT’s Biobanking Manager received the National Standards Authority of Ireland award at the NSAI Annual Standards Forum in Dublin. The award was in recognition of Emma’s exceptional dedication to standards development.

Emma is the Irish academic representative and International Expert to ISO TC276 for Biotechnology and was instrumental in the development of ISO 20387 (2018): EN, the first dedicated biobanking standard.

Emma is continuing her work with ISO TC276 and is currently working on a technical report that will accompany the biobanking standard to help interpret the requirements for each unique set up.

“I would likely to sincerely thank all the many individuals too numerous to mention in helping promote the Irish biobanking voice and in particular its expression in the horizontal biobanking standard. Encouragingly, this voice was one I often heard echoed back from other countries experts. It is my hope that those who undertake to fulfil the requirements laid out in the standard will realise the value in resultant high quality, reproducible results and timely achievement of research goals. Special thanks to my biobanking colleague and dear friend, Dr Aisling Doyle, who accompanied me to the award ceremony in Dublin. Aisling and I work closely together and together provide constant round the clock support for INFANT’s biobanking concerns. I remain ever grateful to INFANT directorship and UCC management for enabling her to partake in standards creation”.

Well done Emma!

INFANT research matters

A huge thanks to everyone who contacted us or campaigned to raise awareness about INFANT over the last few weeks. Your generosity and support is extraordinary and we are immensely grateful. We want you to know that the INFANT team is determined to continue delivering high impact and vitally important research for the benefit of women and children in Ireland and worldwide.

Geraldine Boylan

Director, INFANT Research Centre

New Research by INFANT PhD candidate, Gwinyai Masukume has been published in Scientific Reports.

The work is exploring the association between Caesarean Section (CS) and childhood obesity. Childhood obesity has been linked to CS via lack of exposure to vaginal microflora although the literature is inconsistent. The team investigated the association between CS birth and the risk of childhood obesity using the nationally representative Growing-Up-in-Ireland (GUI) cohort.

The study recruited 11134 infants. The exposure was categorised into normal vaginal birth (VD) [reference], assisted VD, elective (planned) CS and emergency (unplanned) CS.

After further analysis of the infants weight and height the team found insufficient evidence to support a causal relationship between elective CS and childhood obesity.

FULL PAPER HERE: https://www.nature.com/articles/s41598-018-33482-z