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Weight Gain in Extremely Premature Infant With Targeted Versus Adjusted Fortification

Not Applicable
Completed
Conditions
Preterm
Very Low Birth Weight Infant
Food, Fortified
Feeding, Breast
Interventions
Dietary Supplement: Protein supplementation based on plasma urea concentration every other week or human milk analysis on experiment
Registration Number
NCT04982133
Lead Sponsor
Hospital Universitario La Paz
Brief Summary

Investigation about the effect on weight gain in extremely low birth weight preterm with individualized fortification, according to human milk analysis versus fortification adjusted according to urea serum concentration.

Detailed Description

1. Study design This is an interventional, randomized, controlled study.

2. Description of the study The very premature newborn will be identified by daily evaluation of the infants admitted for consultation in the income book.

Informed consent will be requested from the infant´s father, mother or legal guardian between the fifth and tenth day of life.

Fortification will be done according to the randomization group.

3. Outline of the study design

* Excel calculation sheet of individualized supplementation according to the composition of breast milk in the target fortification group. Methodology of analysis of breast milk in FOSS analyzer.

* In the adjusted fortification group, urea concentration levels will be kept between 19-30 mg / dL

* Fenton curves or https://www.growthcalculator.org/ will be used for Z-scores calculation.

* Growth speed calculation: Weight gain: (1000x ln \[Final weight / Initial weight\]) / number of days.

4 Duration of the study for each participant The duration of participation in the study and the fortification intervention period will be a maximum of 132 days.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
38
Inclusion Criteria
  1. Preterm infants born <1000 g of birth weight that are fed with breast milk or donated milk.
  2. Written informed consent signed by the mother, father or legal guardian.
  3. To tolerate enteral feeding, at least 100mL / kg / day.
Exclusion Criteria
  1. Non-premature or premature patients weighing ≥ 1000 gr.
  2. Patients with major malformations.
  3. Patients with diagnosed chromosomal diseases or of high diagnostic suspicion.
  4. Patients with short bowel syndrome or any surgery on the gastrointestinal tract.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Individualized fortification according to the nutritional characteristics of breast milkProtein supplementation based on plasma urea concentration every other week or human milk analysis on experimentIndividualized fortification according to the nutritional characteristics of the mother's own milk or pasteurized milk taken by the premature infant. In this arm, fortification is adjusted based on the macronutrient analysis of breast milk or donated twice weekly.
Fortification adjusted according to ureaProtein supplementation based on plasma urea concentration every other week or human milk analysis on experimentFortification adjusted according to urea with FM 85 at 4% and oligopeptides. In this arm, fortification at 4% is started, and according to plasma urea control every 15 days the fortification is modified.
Primary Outcome Measures
NameTimeMethod
Growth rate 28 days after the start of fortification and birth28 days

To investigate the effect on weight gain during admission of individualized fortification, according to milk analysis, versus fortification adjusted according to urea level.

Secondary Outcome Measures
NameTimeMethod
Mineralization differences between both fortication methodsUntil 36 weeks of postmenstrual age (EPM) or at discharge

Difference in phosphate and alkaline phosphatase values

Trial Locations

Locations (1)

University Hospital La Paz

🇪🇸

Madrid, Spain

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