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Finger Feeding as a Method of HMF Supplementation After Discharge

Not Applicable
Conditions
Low-Birth-Weight Infant
Breast Feeding
Interventions
Other: Finger feeding
Registration Number
NCT04036240
Lead Sponsor
Fakultas Kedokteran Universitas Indonesia
Brief Summary

Human Milk Fortifier (HMF) is designed to supply additional calories, protein, vitamins and minerals to infants less than 37 weeks gestation or those less than 1500 g at birth. Liquid and powder types of HMF are available in the commercial market. Usually, one packet of powdered HMF is mixed to 25-50 cc expressed breast milk. Fortification of human milk is technically difficult in fully breastfed infants and artificial teats such as bottle feedings are common used. A study reported lower breastfeeding rate in intervention group who used HMF in comparison with control. Finger feeding method is associated with a better breastfeeding rate in hospital use. A feasibility study in Vienna reports finger feeding method as a way to provide fortification at home was acceptable.We hypothesize that finger feeding is an easy way for HMF supplementation after discharge to increase successful breastfeeding and improve growth in preterm and or low birth weight infants.

Detailed Description

For infants with very low birth weight (\<1500 g) convincing evidence indicates that providing multi-nutrients fortification including protein, long-chain polyunsaturated fatty acid, and micro-nutrients improves infant growth during hospitalization and health outcomes. A study of predominantly breastfed preterm infants with fortification after discharge shows better growth than unsupplemented counterparts at 3 months corrected age. Another study showed that post discharged growth of \< 1800 g infants with human milk fortifier (HMF) supplementation until 48 weeks gestational age improved. But without the intensive lactation counselling the breast milk in HMF group were lower than control group if artificial teats were used. 4. Finger feeding is an alternative method to feed infants to increase successful breastfeeding, but unpopular in Indonesia. Study on finger feeding are still limited and most study of them are not randomized trial. We evaluate the method of supplementation on breastfeeding rate, growth and safety. We also do in depth interview with those who have high or low compliance.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
78
Inclusion Criteria
  • birth weight < 2500 g
  • need HMF supplementation after discharge
  • predominantly breastfed
  • live in Jakarta city and its surrounding
  • parents agree to follow study procedure with signed informed consent
Exclusion Criteria
  • major congenital anomaly or other conditions interfere with normal growth and oral feeding

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Finger feederFinger feedingHMF supplementation will be given by finger feeder
Primary Outcome Measures
NameTimeMethod
Breastfeeding rate28 days

Formula used (ml/kg/day)

Secondary Outcome Measures
NameTimeMethod
Infectionsup to 1 month

Fever or other acute illness episode

Stool consistencyup to 1 month

Diapered infant stool scale (1-5B)

Stool frequencyup to 1 month

Number of stool per day

Growth28 days

mean difference in weight, length, head circumference; skin fol thickness (mm)

Compliance28 days

Number of supplementation per day

Vomiting4 weeks

number per day

Chokingup to 1 month

Number per day

Trial Locations

Locations (4)

RS Hermina Jatinegara

🇮🇩

Jakarta, Indonesia

RS Hermina Bekasi

🇮🇩

Bekasi, Jawa Barat, Indonesia

Budi Kemuliaan Hospital

🇮🇩

Jakarta Pusat, Jakarta, Indonesia

Koja District Hospital

🇮🇩

Jakarta, Indonesia

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