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Effect of Extensively Hydrolyzed Liquid Human Milk Fortifier on Growth and Tolerance in Moderately Premature Infants

Phase 4
Completed
Conditions
Complication of Prematurity
Interventions
Dietary Supplement: Powder HMF
Dietary Supplement: Liquid HMF
Registration Number
NCT02632266
Lead Sponsor
University of Kansas Medical Center
Brief Summary

The purpose of this study is for the researchers to examine the safety and efficacy of liquid human milk fortifier (HMF) in moderately preterm infants compared to powdered human milk fortifier.

Detailed Description

This is a prospective, randomize, double-blinded study in preterm infants born between 28-34 weeks gestation admitted to the NICU at the University of Kansas Hospital. After obtaining informed consent, babies will be randomized to either liquid or powdered HMF using opaque, sealed envelopes with preassigned randomization. The feeding protocol as established in the KU NICU will be followed, beginning with initiation of trophic feeds, and advancement of enteral feeds depending on the gestational age and preceding illnesses. Once infants reach 80ml/kg/day of enteral feeds, human milk will be fortified to 22 kilocalories by adding either liquid or powdered fortifier. The beginning of the study(Study day 1) will be defined as reaching and tolerating 100ml/kg/day of 24 kilocalorie human milk fortified with either liquid or powdered fortifier. Enteral feeds will be advanced per unit protocol until they reach 150-160ml/kg/day and 110-120 kcal/kg/day. the volume of feeds will be adjusted based on the documented weight to provide energy and protein requirements as recommended by the ESPGHAN guidelines. Babies will be followed up until the time of NICU discharge.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Inborn preterm infants born between 28 0/7 and 34 0/7 weeks gestation and fed either mother's own milk or donor human milk
Exclusion Criteria
  • Newborn infants <28 weeks and >34 weeks gestation, those with life threatening illness, congenital and chromosomal anomalies, gastrointestinal anomalies or necrotizing enterocolitis and fed premature formula

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Powder HMFPowder HMFOnce patient has reached 80ml/kg/day of enteral feedings, 1 pack of powder HMF will be added to 50 ml of human or donor breast milk, then increased to a maximum of 2 packs for 50 ml following the unit feeding advancement protocol and this will be continued up until 48 hours prior to discharge.
Liquid HMFLiquid HMFOnce patient has reached 80ml/kg/day of enteral feedings, researchers will add 1 packet (5 ml) of liquid HMF to 50 ml of human or donor breast milk, then increase to 2 packs to 50 ml following the unit feeding protocol and this will be continued up until 48 hours prior to discharge.
Primary Outcome Measures
NameTimeMethod
Cumulative weight gainBaseline to 36 Weeks post-conceptional age or Study Day 28, whichever is earlier

Weight gain of baby during the course of the study

Change in weightBaseline to 36 Weeks post-conceptional age or Study Day 28, whichever is earlier

Weight gain of baby week-to-week, during the course of the study

Linear lengthBaseline to 36 Weeks post-conceptional age or Study Day 28, whichever is earlier

change in length week-to-week during the course of the study

Head growthBaseline to 36 Weeks post-conceptional age or Study Day 28, whichever is earlier

Change in head measurements week-to-week during the course of the study

Secondary Outcome Measures
NameTimeMethod
Nutrition biomarkersBaseline to 36 Weeks post-conceptional age or Study Day 28, whichever is earlier

Measurements of a baby's Ca, P, Mg, Alkaline Phosphatase and Prealbumin will be taken

Tolerance to enteral feedsBaseline to 36 Weeks post-conceptional age or Study Day 28, whichever is earlier

number of significant residuals, number of times feeds were held, NEC

Trial Locations

Locations (1)

University of Kansas Medical Center

🇺🇸

Kansas City, Kansas, United States

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