Unraveling the Mysteries of "Preemies"
09/28/2007

Researcher works to understand developmental challenges of premature babies.
By Beth Dunham

Jack Turman knows just how much difference a little time can make – especially when a premature baby doesn’t get to spend a full nine months inside its mother’s womb.

Turman, associate professor in the Division of Biokinesiology and Physical Therapy in the School of Dentistry, and the Departments of Pediatrics, and Cell and Neurobiology in the Keck School of Medicine, wants to understand what genetic and environmental factors lead to feeding problems in babies, something premature infants encounter all too often. The Keck School of Medicine’s Center for Premature Infant Health and Development, which Turman founded and directs, investigates these and many other problems that affect preemies, including the impact of perinatal brain injury on development, interventions to promote maternal-preterm infant attachment formation, factors causing racial disparities in adverse birth outcomes, and oral health concerns in premature babies.

Turman’s extensive efforts to understand the challenges that preterm infants face have not gone unnoticed. Earlier this year, he was named the academic and research representative for the California Coalition for Premature Infant Health Project, and on November 16, he will host a meeting and reception for the Project at the USC Health Sciences Campus. Several faculty members from the School of Dentistry as well as other USC researchers will present findings to state officials involved in the Project.

Turman first became interested in the feeding problems preemies encounter while practicing pediatric physical therapy. He said he often saw mothers’ concerns about their children’s feeding difficulties dismissed by the health care team as something that would “eventually improve” as long as the rest of the gastrointestinal tract had no problems, and he found their attitudes were a result of little knowledge about the root causes of the problems.

Turman says. “I went back to school to get my Ph.D. in neuroscience shortly after that so I could study the neurobiology of feeding. I credit my years in physical therapy practice with highlighting a real need that my work hopes to address.”

He says a desire for more basic scientists on faculty influenced the USC’s Department of Biokinesiology and Phyisical Therapy to recruit him in 1995. Turman says this inclusion of basic scientists in the department is very important and very unique in the world of physical therapy.

He was also excited to collaborate with researchers at the School of Dentistry’s Center for Crainofacial Molecular Biology. He especially credits the CCMB faculty, including Malcolm Snead, Margarita Zeichner-David and Charles Shuler, as being a great set of mentors and a huge force behind his research.

“Through the generosity of the folks at CCMB and the School of Dentistry, we were able to develop a colony of  Krox-20 knockout mice,” Turman says. “These animals in which the Krox-20 gene was non-functional died after birth or at weaning because they couldn’t feed,” Turman says.

Turman and his team found that the Krox-20 gene has an important role in the development of jaw-opening muscles, which are critical for suckling behavior. They also discovered that the gene is crucial in the development of neurons that that relay information about jaw position and bite force to the brain. “Deficits in the development of these essential craniofacial muscles and sensory neurons account for why the animals didn’t thrive” Turman says.

There are more benefits to healthy oral feeding abilities than just getting healthy nutrition, Turman adds. The simple act of suckling promotes attachment formation between a mothers and her infant, thus fulfilling an innate sense of duty felt by mice, humans and every mammal in between.

“Every mammalian mother has an instinct to feed her infants,” he says. “When a preterm baby is unable to feed normally, it can be heartbreaking.”

Turman hopes that his work, along with the work of his colleagues and the support of the California Premature Infant Health Project, will help to lessen the rate of preterm birth and provide better care for the babies who survive.

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