Individualized Maternal Milk Fortification for Feeding the Preterm Infants

Not Applicable

Completed

• Conditions: Metabolic Syndrome
• Interventions: Dietary Supplement: Tailored protein fortification

• Registration Number: NCT01947972
• Lead Sponsor: Aristotle University Of Thessaloniki

Brief Summary

Neonatal nutrition has to face a contradictory and conflicting nutritional regimen like a high percentage of amino acids from the first day of life in order to achieve normal neurodevelopment versus metabolic complications (insulin resistance, hyperglycemia, increased visceral fat) that this type feeding, in conjunction with complexity of prematurity, is likely to cause. Current study aims to investigate is whether individualized fortification of breast milk protein, based on the mother's milk protein content and targeting the recommended daily protein requirements, is associated with better nutrition, growth, biochemical and endocrine markers associated with the nutrition of preterm low birth weight neonates, compared to the standard fortification of human milk.

Detailed Description

Proteins are of the most important macromolecules in living organisms participating in almost all biological processes. Premature infants are forced to adapt to a new (extrauterine) environment where supply of nutrients, including amino acids, from mother ceases abruptly. Consequently, the aim of neonatologist is the appropriate, quantitatively and qualitatively nutritional support, to promote brain development, achieve normal endocrine and metabolic function, maintain a growth rate similar to the intrauterine one avoiding extrauterine growth restriction during postnatal period and at the same time encouraging the analogue modulation of body composition (increased muscle mass, decrease body fat, hydration).

Malnutrition or inadequate nutrition of preterm infant which remains undiagnosed and without proper treatment could have serious consequences on psychomotor development and metabolic activity. Indeed, 75% of low birth weight premature infants exhibit extrauterine growth restriction at discharge, even when they have achieved growth equal to the considered satisfactory, ie 15g/kg/day.

Beyond anthropometrics differences between preterm and full-term newborns, body composition varies as well. Preterms have higher percentage of body fat and decreased muscle mass at term time compared with full term neonates. However, it has not been clarified whether this differentiation is harmful predisposing to chronic diseases later in childhood or adult life (eg. obesity, metabolic syndrome).

Study Timeline

• Study First Submitted: 2013-09-10
• Study First Submitted QC: 2013-09-19
• Study First Posted: 2013-09-23
• Study Start: 2013-10
• Status Verified: 2016-07
• Primary Completion: 2016-07
• Study Completion: 2016-07
• Last Update Submitted: 2016-07-12
• Last Update Posted: 2016-07-13

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

• Infants with gestational age ≤ 34weeks
• very low birth weight (≤ 1500g)

Exclusion Criteria

• maternal health problems contradicting breastfeeding
• genetic or chromosomal abnormalities
• metabolic contraindications for increased amount of protein

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
protein intake of 4g/kg/d	Tailored protein fortification	Tailored protein fortification and nutritional status of preterm neonate. 4.5g protein per kg for preterms with body weight less than 1000g and 4g protein per kg for preterms with body weight more than 1000g, after human milk analysis. Intervention regards protein supplementation to fulfil the exact protein needs of preterms

Primary Outcome Measures

Name	Time	Method
Mean protein intake per kg of body weight between the groups	participants will be followed until discharge and at 40 weeks post gestational age

Secondary Outcome Measures

Name	Time	Method
growth assessment differences between groups	participants will be followed until discharge and at 40 weeks post gestational age	Anthropometric differences in body length, head circumference, body weight gain/kg, mid arm circumference
Differences in bioelectrical impedance between groups	participants will be followed until discharge and at 40 weeks post gestational age
Mean daily dietary intake of mothers and correlation with macronutrients of their's breast milk	from the moment of intervention, at least once in 10days, and until the end of intervention
Biochemical (lipidemic profile differences) between groups	at 36weeks post conceptual age and follow-up at 40 weeks postconceptual age

Trial Locations

Locations (1)

Hippokration Hospital Thessaloniki; 🇬🇷 Thessaloniki, Greece