Spacesuits, twice-filtered air and a ban on make-up - how the miracle drip feed for premature babies is made
The process of ordering and making the drip feeds for tiny, vulnerable premature babies is strictly controlled and hugely high-tech.
Specialists at the hospital prescribe the individual feeds for each baby in the morning and they are sent to the manufacturer.
Once there each feed is made up individually in aseptic clean rooms.
These rooms use a pressurised filtered air system, to ensure minimal bacteria and particles are present. The staff must be naked under their 'space suits' made of low lint material which has been washed in filtered water.
They wear a hat under their hood, a mask, gloves, and boots up to their knees. Only their eyes are visible and they are not allowed to wear make-up or jewellery.
Any hint of a cough or cold and they are banned from the building.
The feeds themselves are made up in a specialised cabinet which has its own filtered air supply circulating the atmosphere from back to front to any bacteria is swept away.
The feeds are made up in two separate bags, one with amino acids as the protein source and glucose as the carbohydrate source with water soluble vitamins such as C and B and minerals like calcium, phosphate, magnesium and sodium. The second bag, known as the lipid phase, which is where the current investigation is focussed, contains the fats and vitamins A, D, E and K.
In total the feeds might contain eight or ten pharmalogical solutions which are poured or pumped from large bags in the cabinet into the individual feed bags.
For tiny premature babies each feed may only be 50ml to 150ml.
Dr Susan Hill, from the British Society of Paediatric Gastroenterology Hepatology and Nutrition and a consultant paediatric gastroenterlogist said: "This is a life savings treatment for babies who are born very prematurely or with a severe gut problem.
"These are often babies who are born very prematurely at 22, 23 and 24 weeks gestation and are very vulnerable.
"However babies can grow and develop normally on parenteral nutrition.
"It is one of the biggest advantages of modern medicine that we can keep these babies alive on it."
At every stage the feed bags, equipment and ingredients are sprayed with industrial strength metholated spirits.
The bags, which cost up to £100 each, are then either packed into validated cool boxes with ice packs or into refridgerated vans and sent to hospitals where the babies then receive them through a tube into the bloodstream over 24 hours.
The lab technicians making the feeds are tested on their skills every three months and must make three dummy bags each free of bacteria before they are allowed to continue working.
The whole lab is closed down, monitoring equipment is checked and the whole room deep cleaned every quarter.
Around the room and in the cabinets, plates hang collecting any bacteria in the air which are then grown, counted and analysed.
International standards stipulate acceptable levels and the labs are regularly inspected by independent experts.
Jackie Eastwood, a pharmacist and spokesman for the British Association of Parentral and Enteral Nutrition, said: "We are the dirtiest things in the room."
Rebecca Smith - telegraph.co.uk
