Nicholas Embleton
Consultant in Neonatal Medicine, Associate Clinical Lecturer

  • Email: nicholas.embleton@ncl.ac.uk
  • Telephone: +44 (0) 191 282 5156
  • Address: Newcastle Neonatal Service
    Ward 35 Royal Victoria Infirmary
    Newcastle upon Tyne NE1 4LP

I have worked as a Consultant Neonatal Paediatrician at the RVI, Newcastle since 2003 (qual.1990), and have held an Honorary University post since appointment. I work closely with the Comprehensive Local Research Network (CLRN) groups for Reproductive Health and Child Health and support several NIHR funded studies as Chief Investigator (SHIFT) and Principal Investigator or neonatal lead (BOOST II, I2S2, BEST, MERIDIAN, OPTIMUM, STAMP, HOLDS etc.) I lead a broad programme of research as a member of the Causes and Patterns of Disease research theme within IHS. I am a co-investigator on two NIHR Health Technology Assessment (HTA) studies (£5.8M total funding). These will be coordinated by the National Perinatal Epidemiology Unit (NPEU, Oxford) and will start in 2013. I will coordinate a series of underpinning mechanistic microbiomic and metabolomic studies in regionally recruited infants. These link with my over-arching research focus: the influence of early life nutrition, infection/inflammation and growth on health and development in childhood and later life.

My current research activity falls within four themes:

1.    Long term outcome of preterm birth. Dr M Pearce (IHS), Prof A Adamson (IHS), Prof  C Relton (IHG), Prof M Trenell (ICM), Dr T Cheetham (IHG). I initiated the Newcastle Preterm Birth Growth Study (PTBGS) of >200 children who were born preterm and are now approaching 19 years old. This cohort was formed from a series of controlled trials published over the last 12 years, and containing extremely detailed measures of early life nutritional exposures and their relationship to cognitive outcomes and metabolic phenotype. Our studies on the relationship between DNA methylation and life course phenotypic changes are amongst the first published in this high-risk population. Current work is using newer MRI and MRS techniques to examine intra-hepatic and intra-myocellular lipid deposition and examine muscle fatigue.

2.    Nutrition, lactoferrin, probiotics and microbiome in preterm infants. Dr J Berrington (IHS), Prof W McGuire (Child Health, York), Prof S Cummings (Microbiology, Northumbria), Prof E Juszczak (NPEU, Oxford). We have established a unique position to examine the effects of nutritional modification of bowel microbiota and relate this to serious morbidities and death, and longer term outcomes in this high-risk patient population. Our preliminary research findings using new generation technologies were published this year. We have funding to conduct large RCTs as part of a national networks and track these cohorts into later life. These trials have been developed with close public patient involvement and will have a major impact on clinical practice.

3.    Health related quality of life, congenital anomalies and perinatal epidemiology. Prof J Rankin (IHS), Prof H McConachie (IHS). I am a key member of Prof Rankin’s group examining long term outcomes for infants born with congenital anomalies and communicating this information to parents and health professionals. Our systematic review was published this year.

4.    Qualitative sociological research with parents and staff. Prof J Rankin (IHS), Dr R Graham (School of GPS), Prof S Robson (ICM). We have conducted innovative social scientific studies into the feelings and perceptions of both parents and staff in the context of withdrawal of active care, and reproductive loss (stillbirth or neonatal death) in multiple pregnancies. Our findings have been disseminated and translated into better knowledge and care via a series of workshops, supported in part, by a £37k grant from the Department of Health. I am working with key stakeholders and national bodies to help further translate our findings into the clinical environment

I aim to further develop a programme of multi-disciplinary translational research to explore the causal mechanisms linking adverse early life events, and nutritional interventions to ameliorate these, with health and developmental outcomes in childhood. This will be achieved through the juxtaposition of my clinical environment with academic collaborators in relevant disciplines.

 

Working with colleagues across Europe we have published data on current practices and areas of research priority. In 2004 I helped establish the UK Neonatal Nutrition Network (www.nicunutrition.com) which brings together clinicians from more than 40 major tertiary care units across the UK and Ireland to discuss best practice and translational research. We act as the clinical specialty group for the national Medicine for Children Research Network helping refine and prioritise research. It is through this collaboration that I helped develop and secure funding for the two large HTA funded trials. These will have a key impact on neonatal care

 

I have co-authored more than 25 peer-reviewed publications in the last 5 years including original research and invited submissions, and presented several abstracts at international society meetings. Through these research efforts I am recognised as an expert in my field. I have been invited to lecture at major international meetings, including in the last 2 years - the Norwegian Pediatric Society, European Society for Pediatric Research, European Society for Pediatric Gastroenterology Hepatology and Nutrition, British Association of Perinatal Medicine, and World Congress of Pediatric Gastroenterology Hepatology and Nutrition in Taiwan. I teach at medical student and postgraduate level, supervised two MD candidates to successful award, and am currently supervising a further two MD students. I have also supervised at MRes and Masters level, and provide mentorship to numerous other clinical trainees.

 


Research Interests

Neonatal Nutrition; Perinatal infections and epidemiology; Collaborative multicentre trials

Current Work

  • Long term cognitive outcome in childhood of infants born preterm;
  • Epigenetics;
  • Growth, body composition and metabolic profiles in ex-preterm infants;
  • Protein requirement in preterm infants;
  • Breast milk;
  • Antenatally diagnosed cerebral ventriculomegaly and other CNS lesions;
  • Perinatal infections esp. group B streptococcal infections;
  • Parental and staff views of withdrawal of active treatment in sick preterm infants;
  • Multicentre trials coordinated by the NPEU - PI for ADEPT, BOOST, I2S2, DNSIYC

Future Research

Programming of early life events, Lactoferrin, Neonatal Infections,


Postgraduate Supervision

MD student

Research Nurse

Funding

  1. Breast milk fortification or supplementation in preterm neonates: a controlled trial. PI; 2006- 08, £30k Tiny Lives charity
  2. Growth, body composition and metabolic outcome in children who were born preterm. PI; 2007- 09. £42k Novo Nordisk, Endocrine Fund £4k Special Trustees £13k
  3. Parent and staff perceptions of withdrawal of active treatment from sick neonates. Joint PI; collaboration with IHS, ICM and School of GPS; 2006- 09. £62k Tiny Lives Charity
  4. Relationship between early growth, body composition, serum leptin, adiponectin and IGF-1PI; 2008-09. £15k  Nutricia UK
  5. Dietary protein in the very low birthweight infant. PI. Multicentre RCT; 2007-11. £28k  Nestec SA
  6. Long term cognitive outcome of birthweight discordant monochorionic twins. PI; 2007-09. £4k Children's Foundation
  7. Nutrition and Early Life Programming: Exploring Epigenetic Mechanisms . Collaborator; PI: Dr Relton (IHG); 2008- 11. £410k BBSRC
  8. Benefits of extended screening tests in Neonates (BEST). Co-applicant; 2010-12. £169k SPARKS
  9. Quality of Life in infants with congenital anomalies (Systematic review). Co-applicant; 2010-11. £20k FSF, NUTH
  10. Lifecourse data and epigenetic variation (Biostatistician post). Co-applicant; 2010-11. £38k FSF, NUTH
  11. Diversity in staff and parental perspectives to neonatal palliative care. Co-PI; 2010-11 .
  12. £37k Department of Health

 

 

Projects