Southampton Academy of Research

Dr Mark Johnson is a Consultant Neonatologist at University Hospital Southampton and holder of a Research Leaders Programme (RLP) award, supported by the NIHR Southampton Biomedical Research Centre.

His research focuses on ensuring that premature babies have the best possible nutrition to support their growth and development.

Striking the balance

Babies born early do not usually grow as fast as they would in the womb, meaning they leave hospital smaller than would be expected for their age.

This can have knock-on effects later in life. It might, for example, mean that their brain is less well developed, so they struggle with their learning when they start school.

Some research shows that better growth in these babies reduces the likelihood of cerebral palsy for these children, and could mean they have a higher IQ later in life.

Conversely, if these babies grow too fast, or need to ‘catch up’ following a period of slow growth, it could put them at greater risk of obesity, diabetes and heart disease in adulthood. This could be because they do not have the correct ‘body composition’ – the relative amounts of fat and muscle in their body.

This means that the nutrition premature babies receive in hospital, and the way they grow, is important and could have lifelong consequences for their development and health. In particular, helping them to leave hospital with a good weight, may prevent them needing to ‘catch up’ and also may take the pressure off parents to ensure they grow well at home. It may also give mothers the confidence to continue breastfeeding.

Defining good growth

The first question Mark aims to answer with his RLP research is ‘what does good growth for premature babies look like?’ This involves working out the best pattern of growth for these babies in relation to their long-term outcomes.

He and his team are developing tools to collect data on premature babies who have good outcomes – in terms of their body composition, brain development and heart disease risk. Mark then plans to combine all this data to create a new growth chart for premature babies, based on the best-case scenario.

In addition to this, he is working with Professor Jonathan Swann to analyse urine samples from these babies. Together, they aim to investigate how certain patterns of  metabolism relate to the way babies deal with different types of feed, and their growth. This could open up the possibility of developing personalised nutrition plans for each baby.

Becoming an independent researcher

Mark has been a consultant for around six years now. He already has some leadership experience as Training Lead for the NIHR Southampton Biomedical Research Centre (BRC). However, while he’s continued his research during that time, this has all been funded through a series of small grants and support from the NIHR Southampton BRC.

With his RLP award, he now hopes to secure a larger fellowship or grant. This would mean he could split his time equally between his clinical work and research. It would enable him, he says, to reach the next stage in his career as a clinical academic.

“The whole point of the RLP is to get people to become more independent researchers,” says Mark, “and although I’ve published lots and I’ve got a few small grants, I haven’t really moved into that fully independent, self-funded stage of a clinical academic.

“So I think this is a good opportunity to work with other people in the same position, and get some mentoring on how to do that more effectively.”