James Boardman talks about crucial work on understanding how brain development is affected in infants who are born early.
Professor James Boardman is on a journey of discovery. The premature babies studied by him and his team in Edinburgh are in the very earliest stages of their lives - but their brains are developing at a breathtaking rate.
In the first 1,000 days of life – from conception to a child’s second birthday – the foundations for healthy growth and development across the whole of their life are set. It's when the brain connections that underpin the ability to think, learn and relate to others are established.
So understanding how problems during this period, such as preterm birth, poor nutrition and exposure to drugs, can affect brain development is crucial.
"Research saves lives and changes lives," said Professor Boardman.
The Professor of Neonatal Medicine gave a talk titled The Developing Human Brain at the University of Edinburgh on February 25, during which he spoke about his partnership with Theirworld.
It began in 2004 when the Jennifer Brown Research Laboratory was established at the University of Edinburgh/MRC Centre for Reproductive Health. Its innovative work seeks to advance our understanding of what causes early labour, how we can develop treatments to prevent it and how we can better help newborn babies in those first vital hours and days after birth.
Here's a look at some aspects of Professor Boardman's fascinating and inspiring talk.
Why is prenatal medicine so important?
Not only because it changes and saves lives. But because, he said:
- 15 million babies are born preterm each year. Survival rates have improved dramatically but more needs to be done.
- Childhood interventions can help in later life with problems such as obesity. Preterm babies, especially those born before 30 weeks, are more likely to have a range of issues including low IQ, autism, poor growth and - later in life - other problems such as mental health issues and high blood pressure.
- Parents of preterm babies want to know how the child will turn out. Will they survive and then how will they develop?
"Prognosis is very firmly in the minds of parents," said Professor Boardman. "They also ask 'what can I do to help my child?' and - sadly but inevitably - 'what caused it and was it my fault?'"
The birth cohort
Professor Boardman told how, after the Jennifer Brown Research Laboratory had been established, he then discussed with Theirworld setting up a cohort to allow long-term studies into preterm babies and their mothers.
Out of this came The Edinburgh Birth Cohort, a 25-year study of 400 premature babies to adulthood. Using magnetic resonance imaging (MRI) and other technologies, he said, "We created a structural atlas of the developing brain.
"We found that the brain architecture that supports intelligence in adulthood is already established when a child is born - and this is altered by preterm birth."
Nutrition and preterm baby development
For this, the team's studies focused on breast milk, which has many proven benefits including reducing infections, obesity and sudden infant death syndrome.
Research found that babies whose milk intake in the neonatal unit was 75% breast milk had stronger connections in their brain. At 90% breast milk, that was even more pronounced.
"It really points to breast milk being a neuro-protective treatment for preterm infants," said Professor Boardman.
Picking up on problems early in life
On the issue of early detection for early intervention, Professor Boardman said: "Many preterm babies have these difficulties around the first few months. But it is often not until they are five or six years old that anyone picks up on these problems.
"We need to get sharper tools for working out who has got difficulties."
He showed pictures of a young child taking part in eye-tracking experiments, which revealed that preterm babies spend less time looking at social content such as faces.
The team is now investigating whether there is an infant test that would show what cognitive path young children are on.
Drugs and the developing brain
"There is a lot of drug use around the world and it is going up," said Professor Boardman. "In Scotland we also have a crisis, with an increase in deaths among women."
Many women are prescribed methadone as a heroin substitute and the Edinburgh team decided to look at the development outcomes of babies exposed to methadone while in the womb.
They recruited a group of women and used technology to examine the white structure matter of the brains within a couple of days of birth. Tests found differences in the integrity of the neural pathways in methadone-exposed infants.
"This really focuses attention on what prescribed drugs are doing to the foetal brain - and can we do better by using more selective treatments for certain problems," said Professor Boardman.
He said that while the team's work had achieved so much understanding and that the treatment of neonatal babies has moved on so much, more research is still needed to unlock further progress to save and improve the lives of the most vulnerable babies in the UK and around the world.
This is an exciting time for research at the Jennifer Brown Research Laboratory.