Donor Milk vs. Formula in Extremely Low Birth Weight (ELBW) Infants
This study is currently recruiting participants.
(see Contacts and Locations)
Verified September 2016 by NICHD Neonatal Research Network
Sponsor:
NICHD Neonatal Research Network
Collaborator:
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Information provided by (Responsible Party):
NICHD Neonatal Research Network
ClinicalTrials.gov Identifier:
NCT01534481
First received: February 13, 2012
Last updated: September 20, 2016
Last verified: September 2016
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Purpose
The Milk Trial seeks to determine the effect on neurodevelopmental outcomes at age 22-26 months of donor human milk as compared to preterm infant formula as the in-hospital diet for infants whose mothers choose not to provide breast milk or are able to provide only a minimal amount. Infants will be randomized to receive donor breast milk or formula during their hospital stay. Infant's will be followed until they reach 22-26 months of age.
| Condition | Intervention | Phase |
|---|---|---|
|
Infant, Newborn Infant, Small for Gestational Age Infant, Extremely Low Birth Weight |
Biological: Donor Milk Dietary Supplement: Preterm Formula |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Prevention |
| Official Title: | Neurodevelopmental Effects of Donor Human Milk vs. Preterm Formula in Extremely Low Birth Weight (ELBW) Infants |
Resource links provided by NLM:
Further study details as provided by NICHD Neonatal Research Network:
Primary Outcome Measures:
- Neurodevelopmental Outcome [ Time Frame: 22-26 months corrected age ] [ Designated as safety issue: Yes ]As measured by scores on Bayley Scales of Infant Development III (BSID III)
Secondary Outcome Measures:
- In Hospital Morbidities [ Time Frame: Up to one year ] [ Designated as safety issue: Yes ]
These include:
- Death
- Late onset sepsis or meningitis
- Length of TPN use
- Length of initial hospital stay
- Necrotizing enterocolitis
- Bronchopulmonary dysplasia (BPD), defined as room air oxygen saturation of less than 90% at 36 weeks postmenstrual age using the NRN standard physiologic definition of BPD.
- Necrotizing enterocolitis or death
- BPD or death
- Growth outcomes [ Time Frame: 36 Weeks and 22-26 months corrected age ] [ Designated as safety issue: Yes ]In-Hospital growth parameters, including rate of weight gain, weight, length and head circumference at 36 weeks or discharge, whichever comes first. Weights will be obtained from hospital records weekly, length and head circumference will be measured bi-weekly by study personnel.
- Follow-up Outcomes [ Time Frame: 22-26 months corrected age ] [ Designated as safety issue: Yes ]
- Number of hospital admissions between initial discharge and follow-up
- Motor and Language scores on the BSID III
- Cerebral Palsy
- Neurodevelopmental Impairment (NDI), using current Follow-Up Study definition.
- Profound Impairment, defined as BSID III Cognitive subscale score of 70
- NDI or death
- Profound Impairment or death
| Estimated Enrollment: | 670 |
| Study Start Date: | August 2012 |
| Estimated Study Completion Date: | June 2018 |
| Estimated Primary Completion Date: | June 2017 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Donor Milk
Donor milk provided by the Human Milk Banking Association of North America
|
Biological: Donor Milk
Donor milk provided by the Human Milk Banking Association of North America
|
|
Placebo Comparator: Preterm Formula
Preterm formula determined by center practice
|
Dietary Supplement: Preterm Formula
Preterm Formula determined by center practice.
|
Detailed Description:
There is strong evidence that maternal breast milk feedings in infancy confer multiple health benefits in the extremely preterm population (extremely low birth weight, ELBW, <1000 g). Studies suggest an IQ advantage of up to 8 points conferred by maternal milk feeding in this population. Rates of sepsis and necrotizing enterocolitis are also lower in human milk fed ELBW infants, and they experience shorter hospital stays and fewer re-hospitalizations in the first year of life. When mothers choose not to or are unable to provide milk, preterm formula is usually used. Recently, pasteurized donor human milk is available in some NICUs in the US as an alternative to preterm formula. Donor milk has not been well studied with regard to its safety and efficacy. It is unknown if donor human milk confers the same benefits as maternal milk with regard to neurodevelopmental and health outcomes. The proposed study will be the first US multicenter randomized trial of the health and developmental effects of donor milk as compared to preterm formula in ELBW infants receiving little or no maternal milk. Our long-term goal is to optimize neurodevelopmental and health outcomes for ELBW infants, maximizing their quality of life and societal functionality throughout their lives. If donor human milk has similar effects to maternal milk, the public health benefit of donor milk feedings in ELBW infants unable to receive maternal milk would be considerable.
Eligibility| Ages Eligible for Study: | up to 21 Days (Child) |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Criteria
Inclusion Criteria:
- Gestational age less than 29 weeks.
- Admitted to the NICU at less than or equal to 72 hours of life
- Survived at least 12 hours
Exclusion Criteria:
- Chromosomal anomalies
- Cyanotic congenital heart disease
- Diagnosed intrauterine infection
- Other congenital disorders known to impair neurodevelopment
- NEC or IP prior to seeking consent
- Decision documented to limit intensive care therapies
- Congenital disorders that may affect feeding
Feeding Group Eligibility:
- Sole Diet Group: Infants will be eligible for the sole diet feeding protocol if the mother declines to provide breast milk for the baby.
- Supplemental Diet (minimal maternal milk) Group: Infants whose mothers initially choose to provide breast milk and begin pumping will be re-screened for eligibility at least weekly until the infant is 21 days old. If the mother stops expressing milk at any point prior to the infant's 21st day of life, her infant will be eligible for randomization. In addition, those whose mothers are providing less than 20% of the infant's dietary needs (averaged over past 5 days) when the infant reaches 21 days of age will be eligible for randomization at this point. No infant will be randomized after reaching 21 days.
Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study.
To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below.
For general information, see Learn About Clinical Studies.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01534481
Please refer to this study by its ClinicalTrials.gov identifier: NCT01534481
Contacts
| Contact: Tarah Colaizy, MD, MPH | 319-356-3508 | ||
| Contact: Rosemary D Higgins, MD | 301-496-5575 |
Locations
| United States, Alabama | |
| University of Alabama at Birmingham | Recruiting |
| Birmingham, Alabama, United States, 35233 | |
| Contact: Waldemar A. Carlo, MD 205-934-4680 | |
| Principal Investigator: Waldemar A. Carlo, MD | |
| United States, California | |
| Stanford University | Recruiting |
| Palo Alto, California, United States, 94304 | |
| Contact: Krisa P. Van Meurs, MD | |
| Principal Investigator: Krisa P. Van Meurs, MD | |
| United States, Georgia | |
| Emory University | Recruiting |
| Atlanta, Georgia, United States, 30303 | |
| Contact: David Carlton, MD | |
| Principal Investigator: David Carlton, MD | |
| United States, Indiana | |
| Indiana University | Active, not recruiting |
| Indianapolis, Indiana, United States, 46202 | |
| United States, Iowa | |
| University of Iowa | Recruiting |
| Iowa City, Iowa, United States, 52242 | |
| Contact: Tarah Colaizy, MD, MPH 319-356-3508 | |
| Principal Investigator: Edward F. Bell, MD | |
| United States, Michigan | |
| Wayne State University | Active, not recruiting |
| Detroit, Michigan, United States, 48201 | |
| United States, Missouri | |
| Children's Mercy Hospital | Active, not recruiting |
| Kansas City, Missouri, United States, 64108 | |
| United States, New Mexico | |
| University of New Mexico | Recruiting |
| Albuquerque, New Mexico, United States, 87131 | |
| Contact: Kristi L. Watterberg, MD | |
| Principal Investigator: Kristi L. Watterberg, MD | |
| United States, New York | |
| University of Rochester | Recruiting |
| Rochester, New York, United States, 14642 | |
| Contact: Carl T D'Angio, MD 585-273-4911 | |
| Principal Investigator: Carl T D'Angio, MD | |
| United States, North Carolina | |
| RTI International | Active, not recruiting |
| Durham, North Carolina, United States, 27705 | |
| Duke University | Recruiting |
| Durham, North Carolina, United States, 27710 | |
| Contact: C. Michael Cotten, MD | |
| Sub-Investigator: C. Michael Cotten, MD MHS | |
| United States, Ohio | |
| Case Western Reserve University, Rainbow Babies and Children's Hospital | Recruiting |
| Cleveland, Ohio, United States, 44106 | |
| Contact: Michele C. Walsh, MD MS | |
| Principal Investigator: Michele C. Walsh, MD MS | |
| Research Institute at Nationwide Children's Hospital | Recruiting |
| Columbus, Ohio, United States, 43205 | |
| Contact: Pablo Sanchez, MD | |
| Principal Investigator: Pablo Sanchez, MD | |
| United States, Pennsylvania | |
| University of Pennsylvania | Recruiting |
| Philadelphia, Pennsylvania, United States, 19104 | |
| Contact: Barbara Schmidt, MD | |
| Principal Investigator: Barbara Schmidt, MD | |
| United States, Rhode Island | |
| Brown University, Women & Infants Hospital of Rhode Island | Recruiting |
| Providence, Rhode Island, United States, 02905 | |
| Contact: Abbot R. Laptook, MD | |
| Principal Investigator: Abbot R. Laptook, MD | |
| United States, Texas | |
| University of Texas Southwestern Medical Center at Dallas | Recruiting |
| Dallas, Texas, United States, 75235 | |
| Contact: Myra Wyckoff, MD | |
| Principal Investigator: Myra Wyckoff, MD | |
| University of Texas Health Science Center at Houston | Recruiting |
| Houston, Texas, United States, 77030 | |
| Contact: Kathleen A. Kennedy, MD MPH | |
| Principal Investigator: Kathleen A. Kennedy, MD MPH | |
| Sub-Investigator: Jon E. Tyson, MD MPH | |
Sponsors and Collaborators
NICHD Neonatal Research Network
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Investigators
| Study Director: | Tarah Colaizy, MD, MPH | University of Iowa |
| Principal Investigator: | Michele C Walsh, MD | Case Western Reserve University, Rainbow Babies and Children's Hospital |
| Principal Investigator: | Seetha Shankaran, MD | Wayne State University |
| Principal Investigator: | Abbot R Laptook, MD | Brown University, Women & Infants Hospital of Rhode Island |
| Principal Investigator: | Ron N Goldberg, MD | Duke University |
| Principal Investigator: | Barbara J Stoll, MD | Emory University |
| Principal Investigator: | Brenda B Poindexter, MD, MS | Indiana University |
| Principal Investigator: | Abhik Das, PhD | RTI International |
| Principal Investigator: | Krisa P Van Meurs, MD | Stanford University |
| Principal Investigator: | Waldemar A Carlo, MD | University of Alabama at Birmingham |
| Principal Investigator: | Kristi L Watterberg, MD | University of New Mexico |
| Principal Investigator: | Pablo J Sanchez, MD | University of Texas, Southwestern Medical Center at Dallas |
| Principal Investigator: | Kathleen A Kennedy, MD, MPH | The University of Texas Health Science Center, Houston |
| Principal Investigator: | Barbara Schmidt, MD | University of Pennsylvania |
| Principal Investigator: | Carl T D'Angio, MD | University of Rochester |
| Principal Investigator: | Leif Nelin, MD | Research Institute at Nationwide Children's Hospital |
| Principal Investigator: | William Truog, MD | Children's Mercy Hospital Kansas City |
More Information
Additional Information:
| Responsible Party: | NICHD Neonatal Research Network |
| ClinicalTrials.gov Identifier: | NCT01534481 History of Changes |
| Other Study ID Numbers: | NICHD-NRN-0047 U10HD021364 U10HD040689 U10HD021385 U10HD027851 U10HD027853 U10HD027856 U10HD027904 U10HD027880 U10HD034216 U10HD021373 U10HD040492 U10HD053109 U10HD040461 U10HD068244 U10HD068263 U10HD068278 U10HD068284 U10HD036790 |
| Study First Received: | February 13, 2012 |
| Last Updated: | September 20, 2016 |
| Health Authority: | United States: Federal Government United States: Institutional Review Board |
Keywords provided by NICHD Neonatal Research Network:
|
NICHD Neonatal Research Network Extremely Low Birth Weight (ELBW) Prematurity |
Neurodevelopmental Impairment Donor Breast Milk Preterm Formula |
Additional relevant MeSH terms:
|
Body Weight Birth Weight Signs and Symptoms |
ClinicalTrials.gov processed this record on September 27, 2016