This morning an in depth discussion around nutrition in the ELBW infant. Some familiar challenges, but a real breadth of approaches and possible solutions. Local practices, specific challenges here in Tokyo with some very interesting clinically focused research – well done National Centre for Child Health and Development, excellent initiative to answer some taxing PN (parenteral nutrition) questions. Enteral feeding practices subtly different from those typical in the UK with some interesting food for thought (excuse the excellent pun) around breast milk fortification, oral supplements and metabolic bone disease.
In between observations and meetings, some important down time with the admin team… an origami swan Masterclass! Now mine looks a little er, less than perfect, but it’s a good start. Also a heart for the origami Christmas tree. Feeling very welcomed.
Some hugely thought provoking discussions on working practices too. Am mindful of the working and workforce issues which may seem so challenging back home, but the many privileges we have too. How about 1 week of annual leave per year UK trainees?