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Keck School of Medicine opens Center for Premature Infant Health

They are our most fragile citizens, these newborns whose weight is often measured in ounces and grams rather than pounds and kilograms. They no longer live in the warm, watery darkness of their mother’s womb, but instead are thrust into a world of metal and light and beeping, hissing, clattering sounds. They need help to breathe, to eat, to keep their tiny bodies warm. They need help—oftentimes a lot of help—to stay alive.

But what worries Jack Turman Jr., associate professor of biokinesiology and physical therapy at USC, is what happens afterward—after the tubes and the monitors have been removed and the round-the-clock care is no longer necessary. He worries about what happens when it is time for the baby to go about living the life for which it has been saved.

“In our effort to keep these babies alive, we often don’t think about—or even know—what we’re setting them up for down the road,” said Turman, who has a joint appointment in cell and neurobiology at the Keck School of Medicine.

But that reasoning is about to change, if Turman has anything to say about it. Turman has spent the past five years laying the groundwork for what is now one of the Keck School’s newest centers, the Center for Premature Infant Health and Development. Its goal is to create new strategies to help medically fragile infants and their families not just survive, but thrive.

“Our emphasis is on helping the whole family unit—the baby and the family—develop and grow,” Turman explained. “It’s a truly interdisciplinary research group that aims to understand the biological, psychosocial and economic consequences of preterm birth.”

Turman is not exaggerating when he calls his center interdisciplinary. Faculty members involved in the Center for Premature Infant Health and Development come from all across the Keck School, including the Institute for Genetic Medicine, the Department of Cell and Neurobiology and the Department of Pediatrics. They come from Childrens Hospital Los Angeles, from LAC+USC Medical Center, from USC’s Department of Biokinesiology and Physical Therapy, the USC School of Dentistry and its Center for Craniofacial Molecular Biology, USC College of Letters, Arts & Sciences, USC School of Pharmacy and USC School of Social Work.

Turman may have only founded the center recently, but he has been working toward it for a long time.

He received his bachelor’s degree in physical therapy from Washington University in St. Louis, then went on to get his doctorate at UCLA, where he did postdoctoral studies in child and adolescent psychiatry, looking at “abnormal oral behaviors”—in other words, studying what goes wrong with feeding, and when. It was then that he began to realize just how many of the so-called “feeding problems” could be traced back to birth and, in particular, to premature birth.

“Focusing on this fundamental thing called feeding, looking at it from the point of view of both basic and clinical sciences, gives our center a unique focus,” Turman said. “No other center has this sort of broad-ranging perspective on the problem.”

The family approach to helping premature infants thrive is apparent in almost all of the center’s research activities.

Turman and his colleagues are looking at the various behavioral and physiological problems that impact feeding development in preterm or medically fragile full-term infants, with the knowledge that many of these problems stem from the lack of ongoing support given to parents after the initial medical crisis has abated.

And so, in association with Childrens Hospital, Turman’s center is working on a pilot study in which clinical psychologists will be sent into the neonatal intensive care unit (NICU) to assess the mothers of premature infants for anxiety disorder and depression, and then to provide intense intervention for the moms who need it.

They will then compare these mother-child pairs and their feeding interaction with mothers and children who were not given these assessments and treatments.

In addition, the center is looking at “the cumulative impact of perinatal brain injury and maternal separation on development,” said Turman, using mouse models that experience stressors similar to those encountered by preterm infants and their families.

Ultimately, Turman believes that USC—with its Los Angeles County and Childrens Hospital affiliations and its strengths in obstetrics as well as pediatrics and other relevant specialties—has the opportunity to create the sort of interdisciplinary, cooperative network of researchers and physicians that few other places can replicate.

“We have great potential to establish something really unique and special,” he said. “My job now is to form matches and get the funding to make it happen.”

Keck School of Medicine opens Center for Premature Infant Health

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