Presentations
- Abdominal distension
- Anorectal malformations
- Bilious vomiting
- Delayed passage of meconium
- Faltering growth
- Feeding difficulties
- Jaundice:
- conjugated
- prolonged
- unconjugated
- Sepsis
- Structural gastrointestinal abnormalities
Conditions
- Congenital gastrointestinal anomalies:
- Cow milk allergy
- Hepatobiliary and pancreatic disease, such as:
- biliary atresia
- cholestatic jaundice
- cystic fibrosis
- gestational alloimmune liver disease (GALD)
- neonatal hepatitis – infectious and non-infectious causes
- secondary disorders, such as:
- total parenteral nutrition-associated liver failure
- Infectious conditions
- Inguinal hernias
- Malabsorption syndromes and nutritional deficiencies
- Metabolic bone disease of prematurity
- Necrotising enterocolitis
- Nutritional conditions
- Short gut syndrome
- Spontaneous intestinal perforation
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when
developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate
preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and
management
Presentations
- Congenital gastrointestinal disorders
- Jaundice
- Sepsis
Conditions
- Abdominal wall defects
- Atresia:
- biliary
- gastrointestinal tract, such as:
- oesophageal
- small intestinal
- Congenital duplications of the gastrointestinal tract
- Cysts – biliary / choledochal
- Hirschsprung disease
- Stenosis:
- congenital
- infantile hypertrophic pyloric
- Syndromes, such as:
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when
developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate
preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and
management
- Feeding of sick and preterm infants, including:
- breastfeeding
- expressed breast milk and donor breast milk / breast milk banking
- fortifiers
- haematinics
- special formulas
- supplements
- vitamins
- Normal development and functional maturation of the gastrointestinal system, including:
- gut hormones
- infant feeding ability
- motility
- Normal development of the hepatobiliary system:
- bile acid metabolism
- bilirubin
- Normal growth, nutritional requirements, and organ maturation of fetuses and neonates
- Normal lactation process and problems that can arise:
- management strategies to support problematic lactation
- Pathophysiology of:
- faltering growth
- hepatobiliary and pancreatic disease
- jaundice:
- non-physiological
- physiological
- specific conditions, such as:
- necrotising enterocolitis
- Principles of parenteral nutrition, such as:
- indications for use, and recognition and treatment of complications secondary to parenteral
nutrition
- mineral and vitamin requirements
- monitoring for complications of parenteral nutrition
- nutritional components
- trace elements
Investigations
- Assessment and investigation of poor growth and nutrition
- Gut imaging modalities, such as:
- bedside ultrasound
- contrast studies
- MRI
- nucleotide scans
- ultrasound
- x-rays
Procedures
- Insertion and positioning of percutaneous long lines
- Methods of delivering parenteral nutrition
- Phototherapy and methods of treating different types of jaundice
- Knowledge of different milks and nutritional supplements, including:
- different types of formulas for specific indications, such as:
- formulas for allergy:
- amino acid formulas
- cow milk-free, such as rice or soy
- extensively hydrolysed
- formulas for kidney failure
- formulas for metabolic conditions
- preterm formulas
- donor human milk
- milk fortifiers – indication and management, including human and bovine derived
- parent's own milk
- supplementation:
- Promotion of breastfeeding throughout the hospital, including the neonatal unit
- Psychological issues around those who are unable to or choose not to breastfeed
- Support for parents wishing to breastfeed sick and preterm babies
