A multidisciplinary team (MDT) of professionals have spent the last 12 months developing a ground-breaking new framework for best practice for the nutrition and feeding management of the surgical neonate.
The new holistic framework was first proposed a year ago, when a gap in current guidance was identified. There was excellent engagement in the development of the working group, greater highlighting the need for standardisation around neonatal nutrition and feeding in a surgical setting. The final working group included nurses, dieticians, speech and language therapists, specialist, pharmacists, infant feeding advisors, neonatologist, neonatal nutritional nurse specialists, colorectal nurses and ANNPs. We forged strong links with the BDA Neonatal dietetic interest group (BDA NDiG), SLT in neonatal care CEN group, pharmacy groups and specialist nurse groups.
This impressive MDT was brought together by the National Neonatal Surgical Interest Group (NNSIG). Heading up the group, Chairperson Fiona Metcalfe and Education Lead Rhiannon Jones have been instrumental in helping so many knowledgeable professionals reach a consensus on this exciting but previously overlooked area of practice.
Commenting on the significance of the MDTs work, Moriam Mustapha – Lead Neonatal Dietitian, London Neonatal Operational Delivery Network, said: “This framework provides a vital first step in standardising nutritional care in this vulnerable population. The NNSIG have been trailblazers in bringing together multiple healthcare professionals, parents and families to reach a national consensus on the nutritional management of surgical infants – an area with very limited clinical research due to heterogeneity and relatively small numbers that make robust clinical trials difficult”.
While the expertise and experience of the many professionals involved in the framework was critical, so too was the input from parents of parents of a premature infant who required surgery and had a stoma. Their recommendations for care and communication have also been included in the guidance to ensure the resulting framework considers all aspects of caring for a surgical neonate. It’s this depth of research that ensures the document is inclusive of all neonates and families, while simultaneously optimising care from a clinical perspective.
“It’s been an absolute privilege and joy coming together as a really inclusive, multi professional & respectful group to develop some guidance that extends beyond feed volumes and processes and reflects the equal importance of more holistic, family integrated and neuroprotective care,” said Zoë Gordon – Neonatal speech and language therapist, (SALT) & lactation consultant- Oxford, TVW Neonatal Network Lead SALT.
“To have a surgical based document that reflects the importance of breast milk and breastfeeding rather than assuming all infants will be bottle fed feels like a huge milestone I was never sure I would see.”
The new framework is being launched on 3rd November at the Neonatal Surgical MDT Education Day, during which members of the MDT will deliver presentations around key aspects of neonatal surgical, nutritional care that is recommended in the document.
Book now to ensure you secure a place at the launch of this exciting framework.

I’m Lora Alexander, one of the Quality Improvement coaches in a busy Level 3 NICU. QI is all about understanding problems, thinking of solutions, implementing ideas and analysing the results.
My name is Adedoyin Yissau, also known as Dee. I am the Education and Workforce Lead for the London Operational Delivery Network. I came into post as a Network Educator in 2019 and have since developed nursing education region wide, with the current focus on developing a nursing career pathway for London.
Neonatal Network Nurse Educator
My name is Dr. Julia Petty, and I am a nurse lecturer specialising in children’s nursing with a particular interest in neonatal care. My nursing career in paediatric and neonatal clinical nursing practice began after a BSc Hons degree in Psychology at Warwick University, when I moved to Great Ormond Street Hospital, London. Here, I trained in children’s and adult nursing before working there for many years in children’s and neonatal surgical care. I then gained my neonatal nursing qualification at St George’s NHS Trust London and worked at the Whittington NHS Trust NICU before moving back to Great Ormond Street for a senior education role on NICU where I worked until 2001. I then worked as Senior Lecturer at City University, London for 12 years leading the neonatal nursing education portfolio. I studied for a MSc, a PGCE and MA in academic practice during this time, In 2013, I moved to the University of Hertfordshire where my role is Associate Professor (learning and teaching) and Senior lecturer child nursing. I teach on the BSc Hons nursing and master’s degree programmes including leadership of modules, face-to-face/online teaching, assessing and supervision of students at all levels up to doctorate level. I am also research active and have completed a Doctorate in Education. As a nurse, educator and post-doctorate researcher, my interests focus on parents’ premature birth experiences, supporting parents in the transition home from NICU, exploring communication needs of neonates and their carers and studying the educational value of digital storytelling. This combination and variety of roles enriches my working life and brings together my experience as a child / neonatal nurse, educator and researcher. My role and related activities enable me to engage in both education and research while supporting students on their nursing career and education pathway, which is a privilege to be part of.
Hello my name is Claire Richards and I’m the Lead Nurse for the Wales Maternity and Neonatal Strategic Network. This covers nursing leadership but also Neonatal transport. I also have a clinical honorary contract in one Health Board.
Hello, my name is Kim Edwards, and I am a Neonatal Nurse. I am currently the Lead Nurse and Workforce, Education Lead for the Thames Valley and Wessex Neonatal Operational Delivery Network (ODN)
Hello, my name is Jean and I am a registered children’s nurse with 27 years experience. I qualified with a DipHE after struggling academically due to dyslexia. Over my career I have worked mainly in PICU, NICU and children’s cardiac critical care. I am dual qualified in speciality (QIS) for both Neonatal and Paediatrics. The QIS program is a post graduate modular course completed at level 6/7. To be considered QIS you must successfully complete 4 separate modules, each have an academic and practical component. Only on completion of the QIS course can you apply for a band 6 role. In addition to the above qualifications it is expected you would have several years proven experience in speciality at Band 6 and 7 prior to applying for a Matron’s role.
My name is Lisa Baker, I’m a Ward Manager on a Level 2 Special Care Baby Unit in South Wales and I’ve been in this role since 2020.
Hello, my name is Wesell, and I am currently a trainee Advanced Neonatal Nurse Practitioner (ANNP) at Great Western Hospital, which is a Local Neonatal Unit (LNU). Prior to this, I gained substantial experience in a tertiary neonatal unit where I completed my QIS course at master’s level. This course, alongside my role as a senior nurse, provided me with the expertise required to develop my career further in neonatal care.
My name is Hannah Wells, and I am a Neonatal Surgical Clinical Nurse Specialist (CNS).
Hi, I am Amanda and work as the Neonatal Infant Feeding Coordinator for a NICU and a SCBU within one service. While the role is not standardised, many neonatal units now have dedicated posts.
Hello, my name is Daniela Machado, and I am proud to be a Developmental Care Specialist/Lead Nurse and a sister/charge nurse, working across two different trusts. I am originally from Porto, Portugal, and have spent 14 years building my nursing career in the UK. My role involves applying and advancing neuroprotective/developmental care practices for our preterm and neonatal patients/families.
Hello! I am Renjita Raju , a Neonatal Junior Sister working in London. After completing my BSc nursing degree in India, I moved to UK, and completed NMC OSCE to get registered and QIS course to become specialised in neonatal care. I recently qualified as an NLS instructor with the support from NNA scholarship programme. My role involves caring for premature and critically ill newborns, ensuring their safety and health with a highly collaborative multidisciplinary team. I also teach in NLS courses as an instructor following my passion in neonatal resuscitation. I love witnessing infants grow stronger each day and supporting their families through this journey. I’m grateful for the opportunity to provide meaningful compassionate care to the tiniest, most vulnerable patients.