Study Results
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Basic Information
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COMPLETED
741 participants
OBSERVATIONAL
2019-04-22
2021-02-21
Brief Summary
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Detailed Description
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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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Study Design
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COHORT
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.
Eligibility Criteria
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Inclusion Criteria
* Mother ≥18 years of age and intends to breastfeed for at least 6 months.
* Mother anticipates availability for all study visits.
Exclusion Criteria
* 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
24 Hours
ALL
Yes
Sponsors
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Makerere University
OTHER
Aga Khan University
OTHER
International Partnership for Human Development
UNKNOWN
Kathmandu University School of Medical Sciences
OTHER
University of California, San Francisco
OTHER
Responsible Party
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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
International Partnership for Human Development
Bissau, , Guinea-Bissau
Dhulikhel Hospital
Dhulikhel, , Nepal
Aga Khan University
Karachi, , Pakistan
Makerere University
Kampala, , Uganda
Countries
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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.
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.
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.
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.
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.
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.
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.
Other Identifiers
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A132356
Identifier Type: -
Identifier Source: org_study_id
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