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Special Topic Course: Development of the Infant’s Skin and Gut Microbiome.

Speakers: Joanne Kuller RN, MS, Neonatal Clinical Nurse Specialist

Topic: Development of the Infant’s Skin and Gut Microbiome.

Course Description: In 2008, the National Institutes of Health launched the Human Microbiome Project to characterize the human microbiome and analyze its role in health and disease. The Microbiome is the resident microbes that are living on and within our body. They are 10 times more prevalent than the human cells in our body! There has been a shift in the view towards microbes since we learned that a few microbes make us sick but most are commensal “good” bacteria. What has been most fascinating is how the baby’s skin and gut becomes colonized after birth. Skin colonization occurs rapidly after birth and coincides with significant skin barrier functions. How the intestine is colonized and the 4 sources of intestinal colonization will be reviewed and discussed. There is great interest in this process since the intestinal bacteria plays an important role in the systemic immune system and is linked to your mood. There is a vast difference in the bacteria between vaginal and cesarean delivered infants which has implications for some of these infant’s later health issues. C-section delivered babies have increased rates of obesity, asthma and Necrotizing Enterocolitis (NEC.) Factors that promote healthy microbiota in the neonate will be addressed. Implications for Practice in Birthing units, Nurseries and NICU’s will be covered with specific emphasis on the role of Breastfeeding and Skin-to Skin Care.

Speaker Bio: Joanne Kuller RN, MS, Neonatal Clinical Nurse Specialist has a 30 plus-year career in neonatal care and is currently a Neonatal Clinical Nurse Specialist at UCSF Benioff Children’s Hospital in Oakland, California. She has written numerous articles and book chapters on neonatal skin care and has been involved in several clinical research projects assessing the barrier function of the neonate’s skin. Ms. Kuller has been a member of the AWHONN Neonatal Skin Care Evidence-Based Guideline development team for all 4 editions.

0-15 min: Overview of Microbiome and Human Microbiome Project
15-19 min: The role Birth Route plays in the microbiome development
19-24 min: Factors that contribute to intestinal colonization
24-25 min: Early development of the immune system
25-30 min: Factors that promote a healthy infant microbiome
30-55 min: Implications for practice
55-60 min: Learning assessment

Joanne Kuller RN, MS, Neonatal Clinical Nurse Specialist
Financial Disclosures: No relevant disclosures.

Nonfinancial disclosures: Member of the Huggies Nursing Advisory Council.

Conflict of Interest: There is no conflict of interest for anyone with the ability to control content for this activity.

Target Audience: OT, SLP, PT, RN, MD and Neonatal professionals

Level: Intermediate


  1. Describe what the Human Microbiome is composed of.
  2. Describe how the infant’s skin and gut becomes colonized at birth.
  3. Explain why bacterial differences are so great between vaginal and cesarean delivered infants.

Instructional Method: Recorded webinar with lecture and handouts. Learning assessment and course evaluation follow course.

Course Completion Requirements: The learner must view the entire webinar, complete the course evaluation and complete the post webinar learning assessment with at least 80% to receive education credit. Login and logout times will be recorded and documented.
Following completion of this course physical therapists, nurses and other disciplines will receive a certificate of completion and a zip file containing information necessary to submit to their individual state for education credit. Zip file will include course bibliography. Physical therapists are responsible for knowing and adhering to their state’s deadlines, rules and regulations.

Registration information:

In order to obtain access to the course, click the “Register now” button at the bottom of the screen. You are required to be a NANT member in good standing to have access to this course. You may also purchase this courses as a non-member by clicking the “Buy Now” button at the bottom of the screen.

For ADA accommodations, please call NANT Customer Service for more information at (866) 999-5524.

Cancellation Policy: Click HERE to review NANT’s Course Cancellation Policy.


Continuing Education Information*


AOTA CEUs: National Association of Neonatal Therapists® (NANT) is an AOTA Approved Provider of professional development. This Distance-Learning Independent Course is offered at 0.1 CEUs (Intermediate level, Occupational Therapy Service Delivery & Professional Issues). AOTA does not endorse specific course content, products, or clinical procedures.

ASHA CEUs: Learners must complete the entire course in order to receive ASHA CEUs. No partial credit awarded. ASHA CE Provider approval and use of the Brand Block does not imply endorsement of course content, specific products or clinical procedures.
ASHA CE Registry users: NANT will submit your ASHA CEU credit to ASHA on your behalf. ASHA CEUs may take up to 100 days to appear on your ASHA Transcript.

Non-ASHA CE Registry users: Maintain your course records and please keep your registry status current in your NANT account. Update your NANT account with your ASHA number if your registry status changes. NANT is not responsible for tracking your registry usage.

PT CE Credit: This activity has been approved by the Texas Board of Physical Therapy Examiners for 1.0 CCUs for PTs and PTAs.

NANT is recognized by the New York State Education Department’s State Board for Physical Therapy as an approved provider of physical therapy and physical therapist assistant continuing education.

* If you attended this presentation at NANT 9, you can still receive CE Credit by completing this online version.

Questions regarding CE credit should be directed to the National Association of Neonatal Therapists at or (866) 999-5524.

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