Exclusive Enteral Nutrition in Preterm Neonates

NCT ID: NCT04337710

Last Updated: 2025-08-17

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

102 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-05-27

Study Completion Date

2026-05-31

Brief Summary

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To test the hypothesis that early exclusive enteral nutrition with the minimal use of parenteral nutrition will improve preterm infants' nutritional outcomes when compared to delayed progression of enteral nutrition and prolonged use of parenteral nutrition.

Detailed Description

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Qualifying participants will be randomly assigned to one of two study groups: 1) Exclusive Enteral Feeds or 2) Progressive Enteral Feeds with supplemental parenteral nutrition. Regardless of study group assignment, donor human milk will be offered if the mother's expressed breast milk is not enough to complete the intervention as assigned.

Intervention group: Feeds will be initiated with a target volume of 60-80 ml/kg/day and then advanced by 20-30 ml/kg/day until the total volume of 150ml/kg/day is achieved.

Control group: Enteral feeds will be initiated with a target volume of 20-30 ml/kg/day and then advanced by 20-30 ml/kg/day until the total volume of 150 ml/kg/day is achieved.

If parent agrees, stool "dirty" diapers will be collected 2 times during this study.

One time around the time of birth and one time at 28 days or discharge (whichever occurs first).

Conditions

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Premature; Infant, Light-for-dates Enteral Feeding Intolerance

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Exclusive Enteral Nutrition

This group will receive enteral feeding volumes at a rate of 60-80 ml/kg/day starting within the first 24 hours after birth. Volumes will increase by 20-30 ml/kg/day until intake is 150ml/kg/day.

Group Type EXPERIMENTAL

Exclusive Enteral Nutrition

Intervention Type PROCEDURE

Mom's milk or donor milk at 60-80 ml/kg/day after randomization within the first 24 hours.

Progressive Enteral Nutrition

This group will receive enteral feeding volumes at a rate of 20-30 ml/kg/day starting within the first 24 hours after birth. Volumes will increase by 20-30 ml/kg/day until intake is 150ml/kg/day.

Group Type ACTIVE_COMPARATOR

Progressive Enteral Nutrition

Intervention Type PROCEDURE

Mom's milk or donor milk at 20-30 ml/kg/day after randomization within the first 24 hours.

Interventions

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Exclusive Enteral Nutrition

Mom's milk or donor milk at 60-80 ml/kg/day after randomization within the first 24 hours.

Intervention Type PROCEDURE

Progressive Enteral Nutrition

Mom's milk or donor milk at 20-30 ml/kg/day after randomization within the first 24 hours.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Gestational age between 28 and 32 weeks of gestation

Exclusion Criteria

* Intrauterine growth restriction (birth weight \< 10th percentile)
* Major congenital or chromosomal anomalies
* Terminal illness in which decisions to withhold or limit support have been made
Minimum Eligible Age

1 Hour

Maximum Eligible Age

48 Hours

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Alabama at Birmingham

OTHER

Sponsor Role lead

Responsible Party

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Ariel A. Salas

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Vivek Shukla, MD

Role: STUDY_CHAIR

University of Alabama at Birmingham

Ariel Salas, MD, MSPH

Role: STUDY_DIRECTOR

University of Alabama at Birmingham

Jacqueline Razzaghy, MD

Role: PRINCIPAL_INVESTIGATOR

University of Alabama at Birmingham

Locations

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University of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status

Countries

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United States

References

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Razzaghy J, Shukla VV, Gunawan E, Reeves A, Nguyen K, Salas AA. Early and exclusive enteral nutrition in infants born very preterm. Arch Dis Child Fetal Neonatal Ed. 2024 Jun 19;109(4):378-383. doi: 10.1136/archdischild-2023-325969.

Reference Type RESULT
PMID: 38135494 (View on PubMed)

Salas AA, Stewart CJ, Young GR. Early gut microbiome composition of very preterm infants randomised to receive human milk volumes of 60 ml/kg/day or more within the first 36 hours after birth. Pediatr Res. 2025 Oct 2. doi: 10.1038/s41390-025-04456-5. Online ahead of print.

Reference Type DERIVED
PMID: 41034647 (View on PubMed)

Related Links

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Other Identifiers

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300004922

Identifier Type: -

Identifier Source: org_study_id

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