Weight Patterns in the Month After Birth

NCT ID: NCT04025827

Last Updated: 2021-05-13

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

Total Enrollment

741 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-04-22

Study Completion Date

2021-02-21

Brief Summary

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This is a prospective cohort study that will be conducted in four low income countries to describe newborn weight patterns in the first month after birth and their association with clinical and demographic factors including dietary intake.

Detailed Description

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Background: Worldwide, more than 50 million children under 5 are wasted (weight-for-length/height Z-score (WLZ) \<-2) and over 150 million children under 5 are stunted (length/height-for-age Z-score (LAZ) \<-2); such wasting and stunting often begin during infancy. Optimal early nutrition can prevent wasting and stunting. In low income countries, there is therefore a need to understand early weight patterns and how they relate to dietary intakes.

Objectives: The proposed study will assess the relationship between infant dietary intake and weight change in low income countries by characterizing neonatal weight loss/gain patterns, dietary intake, and growth.

Methodology: We will use a prospective cohort study design to describe early infant weight patterns and their relationship to dietary intake. Up to 880 newborns and their mothers will be enrolled in four countries: Guinea-Bissau, Nepal, Pakistan and Uganda (up to 220 newborns/site). Enrolled infants will be followed from birth until one month of age and will be assessed by anthropometry, dietary survey and hemoglobin measurement. Mothers will also be assessed for anthropometry and hemoglobin. Infants' fathers and next-oldest siblings will also be enrolled for anthropometry if available and willing to participate.

Descriptive statistics will be used to describe sample characteristics. We will use various regression modeling techniques to examine the links between individual, family, and community characteristics and early infant weight patterns. Logistic regression models will also be used to consider potential confounding.

Study findings will allow us to describe weight patterns in the first 30 days after birth and their relationship to the dietary intake during that time. We hypothesize that infants who lose 6% or more of their birth weight prior to beginning weight gain will have lower WAZ at 30 days of age. We also hypothesize that at 12 days of age, weight change relative to birth weight will be lower for infants born \<2500g then for infants born ≥2500g.

Conditions

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Stunting Wasting Undernutrition Feeding Patterns Feeding; Difficult, Newborn Feeding, Breast

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Interventions

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Dietary intake

We will collect detailed data on dietary intake and weight for healthy newborns in four low income countries.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Birth weight ≥ 2000g.
* Mother ≥18 years of age and intends to breastfeed for at least 6 months.
* Mother anticipates availability for all study visits.

Exclusion Criteria

* Birth weight \<2000g
* Respiratory distress including tachypnea, head nodding, nasal flaring, chest retractions or grunting
* Known major congenital anomalies including orofacial clefts, neural tube defects and congenital heart defects
* Contraindication to breastfeeding at each site as determined by a site's national or sub-national health authorities
* Twins and other multiples.
* Newborns whose birth weight was not obtained in the first six hours.
* Newborns whose mothers intend to move or otherwise become unavailable during the follow up period of 30 days after birth
Maximum Eligible Age

24 Hours

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Makerere University

OTHER

Sponsor Role collaborator

Aga Khan University

OTHER

Sponsor Role collaborator

International Partnership for Human Development

UNKNOWN

Sponsor Role collaborator

Kathmandu University School of Medical Sciences

OTHER

Sponsor Role collaborator

University of California, San Francisco

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Valerie Flaherman, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

University of California, San Francisco

Locations

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University of California, San Francisco

San Francisco, California, United States

Site Status

International Partnership for Human Development

Bissau, , Guinea-Bissau

Site Status

Dhulikhel Hospital

Dhulikhel, , Nepal

Site Status

Aga Khan University

Karachi, , Pakistan

Site Status

Makerere University

Kampala, , Uganda

Site Status

Countries

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United States Guinea-Bissau Nepal Pakistan Uganda

References

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Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, Mathers C, Rivera J; Maternal and Child Undernutrition Study Group. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008 Jan 19;371(9608):243-60. doi: 10.1016/S0140-6736(07)61690-0. No abstract available.

Reference Type BACKGROUND
PMID: 18207566 (View on PubMed)

Aguayo VM, Menon P. Stop stunting: improving child feeding, women's nutrition and household sanitation in South Asia. Matern Child Nutr. 2016 May;12 Suppl 1(Suppl 1):3-11. doi: 10.1111/mcn.12283.

Reference Type BACKGROUND
PMID: 27187906 (View on PubMed)

Engebretsen IM, Jackson D, Fadnes LT, Nankabirwa V, Diallo AH, Doherty T, Lombard C, Swanvelder S, Nankunda J, Ramokolo V, Sanders D, Wamani H, Meda N, Tumwine JK, Ekstrom EC, Van de Perre P, Kankasa C, Sommerfelt H, Tylleskar T; PROMISE EBF-study group. Growth effects of exclusive breastfeeding promotion by peer counsellors in sub-Saharan Africa: the cluster-randomised PROMISE EBF trial. BMC Public Health. 2014 Jun 21;14:633. doi: 10.1186/1471-2458-14-633.

Reference Type BACKGROUND
PMID: 24950759 (View on PubMed)

Jakobsen MS, Sodemann M, Biai S, Nielsen J, Aaby P. Promotion of exclusive breastfeeding is not likely to be cost effective in West Africa. A randomized intervention study from Guinea-Bissau. Acta Paediatr. 2008 Jan;97(1):68-75. doi: 10.1111/j.1651-2227.2007.00532.x. Epub 2007 Dec 3.

Reference Type BACKGROUND
PMID: 18053000 (View on PubMed)

Paul IM, Schaefer EW, Miller JR, Kuzniewicz MW, Li SX, Walsh EM, Flaherman VJ. Weight Change Nomograms for the First Month After Birth. Pediatrics. 2016 Dec;138(6):e20162625. doi: 10.1542/peds.2016-2625. Epub 2016 Nov 9.

Reference Type BACKGROUND
PMID: 27940721 (View on PubMed)

Flaherman VJ, Schaefer EW, Kuzniewicz MW, Li SX, Walsh EM, Paul IM. Early weight loss nomograms for exclusively breastfed newborns. Pediatrics. 2015 Jan;135(1):e16-23. doi: 10.1542/peds.2014-1532. Epub 2014 Dec 1.

Reference Type BACKGROUND
PMID: 25554815 (View on PubMed)

Flaherman VJ, Schaefer EW, Kuzniewicz MK, Li S, Walsh E, Paul IM. Newborn Weight Loss During Birth Hospitalization and Breastfeeding Outcomes Through Age 1 Month. J Hum Lact. 2017 Feb;33(1):225-230. doi: 10.1177/0890334416680181. Epub 2017 Jan 20.

Reference Type BACKGROUND
PMID: 28107100 (View on PubMed)

Other Identifiers

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A132356

Identifier Type: -

Identifier Source: org_study_id

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