Bovine vs. Human Milk-Based Fortifier Study

NCT ID: NCT02137473

Last Updated: 2021-11-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

127 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-08-31

Study Completion Date

2016-03-31

Brief Summary

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Most very low birth weight infants accumulate a nutrient deficit in hospital due to minimal nutrient reserves and elevated nutritional requirements which may contribute to poor outcome. Adding nutrients to human milk improves their nutritional status and growth, but it is unclear if adding bovine protein-based fortifiers as is the current standard of care has some unintended negative consequences to neonates. Infants will be randomized to have their feeds (mother's own milk or pasteurized donor breastmilk) nutrient enriched with a human milk-based fortifier or a bovine protein-based fortifier and will be followed in hospital to assess feeding tolerance, growth, gut inflammation, mother's milk and infant gut microbiome, and neonatal morbidity and mortality.

Detailed Description

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Conditions

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Very Low Birth Weight Infant (<1250g)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Bovine protein-based fortifier

Group Type ACTIVE_COMPARATOR

Bovine protein-based fortifier

Intervention Type OTHER

Human milk-based fortifier

Group Type EXPERIMENTAL

Human milk-based fortifier

Intervention Type OTHER

Interventions

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Human milk-based fortifier

Intervention Type OTHER

Bovine protein-based fortifier

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* \<1250g birth weight
* Parent(s) or guardian(s) agree to use donor breastmilk if own mother's milk supply is insufficient

Exclusion Criteria

* Infant receives formula or a nutrient fortifier prior to randomization
* \>day 14 at the time of enrollment and enteral feeds have not commenced
* Infants with major congenital or chromosomal anomalies that could impact growth
* Enrollment in another research study affecting nutritional management during the feeding intervention
* Reasonable potential that the infant will be transferred to a neonatal intensive care unit where the study protocol will not be continued
Maximum Eligible Age

2 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Hospital for Sick Children

OTHER

Sponsor Role lead

Responsible Party

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Deborah O'Connor

Senior Associate Scientist, Research Institute

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Deborah L O'Connor, PhD RD

Role: PRINCIPAL_INVESTIGATOR

The Hospital for Sick Children, University of Toronto

Sharon L Unger, MD FRCPC

Role: PRINCIPAL_INVESTIGATOR

Mount Sinai Hospital, University of Toronto

Locations

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Izaak Walton Killam Health Centre

Halifax, Nova Scotia, Canada

Site Status

William Osler Health System-Brampton

Brampton, Ontario, Canada

Site Status

William Osler Health System-Etobicoke

Etobicoke, Ontario, Canada

Site Status

Markham Stouffville Hospital

Markham, Ontario, Canada

Site Status

Southlake Regional Health Centre

Newmarket, Ontario, Canada

Site Status

Lakeridge Health

Oshawa, Ontario, Canada

Site Status

Mackenzie Health

Richmond Hill, Ontario, Canada

Site Status

Rouge Valley Health System

Toronto, Ontario, Canada

Site Status

The Scarborough Hospital-General

Toronto, Ontario, Canada

Site Status

The Scarborough Hospital-Birchmount

Toronto, Ontario, Canada

Site Status

North York General Hospital

Toronto, Ontario, Canada

Site Status

Humber River Hospital

Toronto, Ontario, Canada

Site Status

Toronto East General Hospital

Toronto, Ontario, Canada

Site Status

Sunnybrook Health Sciences Centre

Toronto, Ontario, Canada

Site Status

St Michael's Hospital

Toronto, Ontario, Canada

Site Status

Mount Sinai Hospital

Toronto, Ontario, Canada

Site Status

The Hospital for Sick Children

Toronto, Ontario, Canada

Site Status

St Joseph's Health Centre

Toronto, Ontario, Canada

Site Status

Countries

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Canada

References

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Asbury MR, Shama S, Sa JY, Bando N, Butcher J, Comelli EM, Copeland JK, Forte V, Kiss A, Sherman PM, Stintzi A, Taibi A, Tomlinson C, Unger S, Wang PW, O'Connor DL; OptiMoM Feeding Group. Human milk nutrient fortifiers alter the developing gastrointestinal microbiota of very-low-birth-weight infants. Cell Host Microbe. 2022 Sep 14;30(9):1328-1339.e5. doi: 10.1016/j.chom.2022.07.011. Epub 2022 Aug 19.

Reference Type DERIVED
PMID: 35987195 (View on PubMed)

Hopperton KE, Pitino MA, Walton K, Kiss A, Unger SL, O'Connor DL, Bazinet RP. Docosahexaenoic acid and arachidonic acid levels are correlated in human milk: Implications for new European infant formula regulations. Lipids. 2022 May;57(3):197-202. doi: 10.1002/lipd.12338. Epub 2022 Feb 15.

Reference Type DERIVED
PMID: 35170053 (View on PubMed)

Hopperton KE, Pitino MA, Chouinard-Watkins R, Shama S, Sammut N, Bando N, Williams BA, Walton K, Kiss A, Unger SL, Bazinet RP, O'Connor DL. Determinants of fatty acid content and composition of human milk fed to infants born weighing <1250 g. Am J Clin Nutr. 2021 Oct 4;114(4):1523-1534. doi: 10.1093/ajcn/nqab222.

Reference Type DERIVED
PMID: 34254983 (View on PubMed)

Hopperton KE, O'Connor DL, Bando N, Conway AM, Ng DVY, Kiss A, Jackson J, Ly L; OptiMoM Feeding Group; Unger SL. Nutrient Enrichment of Human Milk with Human and Bovine Milk-Based Fortifiers for Infants Born <1250 g: 18-Month Neurodevelopment Follow-Up of a Randomized Clinical Trial. Curr Dev Nutr. 2019 Nov 12;3(12):nzz129. doi: 10.1093/cdn/nzz129. eCollection 2019 Dec.

Reference Type DERIVED
PMID: 32154499 (View on PubMed)

O'Connor DL, Kiss A, Tomlinson C, Bando N, Bayliss A, Campbell DM, Daneman A, Francis J, Kotsopoulos K, Shah PS, Vaz S, Williams B, Unger S; OptiMoM Feeding Group. Nutrient enrichment of human milk with human and bovine milk-based fortifiers for infants born weighing <1250 g: a randomized clinical trial. Am J Clin Nutr. 2018 Jul 1;108(1):108-116. doi: 10.1093/ajcn/nqy067.

Reference Type DERIVED
PMID: 29878061 (View on PubMed)

Other Identifiers

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1000044263

Identifier Type: -

Identifier Source: org_study_id