Featured Course: “What Goes In, Must Come Out:” Neonatal Therapy Care for the Premature Infant Post GI Surgery

This month’s featured course receives overwhelmingly positive feedback from neonatal PTs, OTs, and SLPs. And for good reason. All healthcare professions are certainly welcome to participate.

“Excellent presentation on NEC – its causes, surgical and post-surgical care. Good information on the neonatal therapist’s role regarding scar assessment, handling, positioning, and resuming feeding.” – Anne Marie Nelson, PT, CNT, NTMCT

“This was one of those practice-changing, mind-opening, and mind-blowing presentations for me. I listened to it several times over.” – Melissa Flores, OTR

Speakers: Holly Schifsky, OTR/L, CNT, NTMTC, CBIS & Danielle Prince, OTD, OTR/L

Topic: “What Goes In, Must Come Out:” Neonatal Therapy Care for the Premature Infant Post GI Surgery

Course Description: Preterm infants are surviving younger gestational ages due to advances in medical care. The risk of necrotizing enterocolitis (NEC) is inversely related to younger premature infants. The development of the gastrointestinal system is interdependent upon cardiac, pulmonary, and immune system maturation. Infants with NEC are at risk for intestinal perforation which requires surgical intervention for creation of a fistula and ostomy. The neonatal therapist working with these premature infants utilizes their knowledge of gastrointestinal maturation, surgical recovery, gross motor development of the abdominal wall, understanding of GI motility, and feeding skill development to create comprehensive care plans that progress these infants motor and feeding goals.

During this presentation, we will review the anatomical changes to the GI system as related to initial surgical correction and re-anastomosis of the small intestine. Clinical education will be provided regarding critical reasoning for pain management, scar assessment/treatment, re-feeding stool to the distal fistula to assist with the development of the rectal anal inhibitory reflex, nutritional factors to reduce weight loss, risk factors for dumping syndrome, oral feeding strategies, assessing the infant for complex oral feeding co-morbidities associated with prolonged NPO status, positioning strategies to support GI motility, and interpretation of perfusion monitoring to the GI system. We will share the critical reasoning algorithm our neonatal therapy team has created for continuity of care with premature infants’ post-surgical correction for NEC.

Upon completion of this session, participants will have a deeper understanding of intestinal correction surgery for premature infants and treatment strategies to address the positioning, handling, developmental, and oral feeding goals for the infant.

Speaker Bios:

Holly Schifsky, OTR/L, CNT, NTMTC, CBIS is an Occupational Therapist who has worked in pediatrics for the past 23 years with the past 15 years in a level IV NICU. She is a Certified Neonatal Therapist, Certified Neonatal Touch and Massage Therapist, Certified Brain Injury therapist, an active member of National Association of Neonatal Therapists, and has completed 6-month mentorship in infant/child NDT. She has worked within the NICU and NICU follow-up clinic to maximize patient and family outcomes for the most complex premature and medically-fragile term infants. Holly received her bachelor’s degree in Occupational therapy from the University of North Dakota in 1997. She has dedicated her career to clinical care and advancing developmental care practice patterns for all multidisciplinary team members. She has presented at many regional and national conferences including NANT, Audrey Harris Vision NICU conference, and the University of Minnesota NICU conference. She provides frequent Developmental Care, Feeding Intervention, and NICU education throughout the country. She is a faculty member for the Neonatal Touch and Massage certification. She is the recipient of the National Association of Neonatal Therapists Clinical Excellence award in 2018, due to her clinical expertise and dedication to premature infants with cardiopulmonary conditions.

Danielle Prince, OTD, OTR/L is a 2019 graduate of Washington University School of Medicine Occupational Therapy program and a 2016 graduate of Virginia Commonwealth University with her bachelor of science degree in exercise science and kinesiology. During her time at Washington University, she was an active member in Dr. Roberta Pineda PhD, OTR/L NICU research lab and completed her capstone professional OT rotation, with a focus on cardiopulmonary interventions for medically fragile neonates, under Holly Schifsky, OTR/L at the University of Minnesota level IV NICU. She works full-time as a neonatal therapist at the University of Minnesota NICU providing assessment, intervention, family training, and multidisciplinary education to care providers of the infants in the neonatal intensive care unit. She has been actively involved in program implementation of the SENSE program at the University of MN and has provided education to team members regarding her research interests as referenced on her curriculum vitae. She provides developmental and feeding interventions to infants in the University of Minnesota NICU follow-up clinic.

Target Audience: OT, SLP, PT and neonatal professionals

Educational Level: Advanced

CE Credit: OT, SLP, PT – 1 hour

Fee: $57 or Free for NANT Members


  1. Identify the anatomical changes to the premature infant gastrointestinal anatomy post-surgical intervention for necrotizing enterocolitis
  2. Apply individualized care planning to premature infants with post intestinal surgical correction to positioning, handling, and feeding interventions
  3. Assess the premature infants scar maturation with consideration of the effects to GI motility, gross motor development, and oral feeding outcomes

Instructional Methods: Recorded webinar, lecture, videos, case studies, and recorded question and answer session. Learning assessment and course evaluation follow course.

Click here to take this course now.

“Holly’s depth of knowledge in neonatal post GI surgery is remarkable. This presentation is very beneficial to units where there is a preponderance of GI malformations, surgical repairs, and ongoing GI/feeding challenges.” – Jim Brudney, MA, CCC-SLP

“My mind is blown anytime I listen to Holly. Her level of understanding of the human body is only something I can aspire to! Thank you for sharing so many practical strategies with us and teaching us how to implement them. I can’t wait to use them with some of my post-op babies.” – Katie Ross, OTD, OTR/L, NTMTC, CNT