- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03822104
Bovine Colostrum as a Human Milk Fortifier for Preterm Infants (FortiColos-Ⅱ)
Bovine Colostrum to Fortify Human Milk for Preterm Infants: A Randomized, Controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Objectives
- To test if fortification of human milk with BC reduces feeding intolerance compared with currently used HMF.
- To verify the safety and tolerability of BC fortification and to monitor the rates of growth, NEC and sepsis, as investigated in a parallel trial in Denmark
Trial design This study is a dual-center, non-blinded, two-armed, randomized, controlled trial.
Participants Parents to eligible very preterm infants admitted to the Neonatal Intensive Care Units (NICU) at Nanshan People's Hospital (NAN) and Baoan Maternal and Children's Hospital in Shenzhen, China will be asked for participation.
Sample size 68 infants per group, 136 in total
Data type Clinical data
A parallel trial on BC used as human milk fortifier is conducting in Denmark (NCT03537365)
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Shenzhen, China
- Shenzhen Nanshan People's Hospital
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Guangdong
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Shenzhen, Guangdong, China, 518133
- Shenzheng Baoan Maternity and Child Healthcare Hospital (SBMCH)
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Very preterm infants born between gestational age 26 + 0 and 30 + 6 weeks (from the first day of the mother's last menstrual period and/or based on fetal ultrasound)
- DM is given at the unit when MM is absent (or insufficient in amount)
- Infants judged by the attending physician to be in need of nutrient fortification, as added in the form of HMF to MM and/or DM
- Signed parental consent
Exclusion Criteria:
- Major congenital anomalies and birth defects
- Infants who have had gastrointestinal surgery prior to randomization
- Infants who have received IF prior to randomization
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: Bovine Colostrum / intervention group
Preterm infants are supplemented with bovine colostrum (BC) as a fortifier to human milk.
BC is the first milk from cows after parturition and is a rich source of protein (80-150 g/L) and bioactive components, including lactoferrin, lysozyme, lactoperoxidase, immunoglobulins, and growth factors.
The product is supplied in a sterile, powdered form and consists of unmodified, intact BC.
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Infants randomized to the intervention group will receive a maximum of 2.8 g bovine colostrum (BC, Biofiber, Gesten, Denmark), as the HMF added to 100 ml of MM and/or DM, when EN has reached a dose of 80-100 ml/kg/d.
The infants start with 1 g (0.5 g protein) BC per 100 ml human milk on the first day, increased to 2 g (1.0 g protein) on day 3, and finally 2.8 g (1.4 g protein) on day 5 if the infants only receive DM.
The intervention lasts until the infants reach postmenstrual age (PMA) 35+6 weeks or in no-need of fortification due to sufficient growth, whichever comes first.
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Active Comparator: FM85 / control group
Preterm infants are supplemented with PreNAN FM85 as fortifier to human milk.
PreNAN FM85 contains partially hydrolyzed protein and maltodextrin including vitamins and minerals.
The product is supplied in a powdered form.
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Infants randomized to the control group will receive a maximum of 4 g PreNAN FM85 (Nestlé, Vevey, Switzerland) as HMF, added to 100 ml MM and/or DM, when EN has reached a dose of 80-100 ml/kg/d.
The infants starts with 1 g (0.35 g protein) FM85 per 100 ml human milk on the first day, which will be increased to 3 g (1.05 g protein) on day 3 and finally 4 g (1.4 g protein) on day 5, if the infants only receive DM.
The infants will receive FM85 as the HMF as long as additional protein in the milk is needed until discharge.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of feeding intolerance
Time Frame: From start of intervention until the infants reach PMA 35+6 weeks or are not in need of fortification due to sufficient growth, whichever comes first
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Number of infants in each group diagnosed with feeding intolerance for at least once.
Feeding intolerance is defined as any pause of fortification or withhold of enteral feeding.
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From start of intervention until the infants reach PMA 35+6 weeks or are not in need of fortification due to sufficient growth, whichever comes first
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Body weight
Time Frame: Measured weekly from the start of intervention until hospital discharge, or up to 14 weeks
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Weight gain in grams per kg body weight from birth to discharge.
Weight at different time points will be calculated into z-scores according to a reference.
Delta z-scores will be used to evaluate growth and for comparison between groups.
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Measured weekly from the start of intervention until hospital discharge, or up to 14 weeks
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Body length
Time Frame: Measured weekly from the start of intervention until hospital discharge, or up to 14 weeks
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Recorded as a measure of growth in cm by standardized measuring procedures
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Measured weekly from the start of intervention until hospital discharge, or up to 14 weeks
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Head circumference
Time Frame: Measured weekly from the start of intervention until hospital discharge, or up to 14 weeks
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Recorded as a measure of head growth in cm by standardized measuring procedures
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Measured weekly from the start of intervention until hospital discharge, or up to 14 weeks
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Incidence of necrotizing entercolitis (NEC)
Time Frame: From the start of intervention to hospital discharge, or up to 14 weeks
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Number of infants in each group diagnosed with necrotizing enterocolitis (NEC) defined as Bell's stage II or above (Kliegman & Walsh 1987)
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From the start of intervention to hospital discharge, or up to 14 weeks
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Incidence of late-onset sepsis (LOS)
Time Frame: From the start of intervention to hospital discharge, or up to 14 weeks
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Number of infants in each group diagnosed with late-onset sepsis defined as clinical signs of infection >2 days after birth with antibiotic treatment for ≥5 days (or shorter than 5 days if the participant died) with or without one positive bacterial culture in blood or cerebral spinal fluid (CSF)
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From the start of intervention to hospital discharge, or up to 14 weeks
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Time to reach full enteral feeding
Time Frame: From birth to hospital discharge, or up to 14 weeks
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Number of days to full enteral feeding is reached - defined as the time when >150 ml/kg/d is reached and parenteral nutrition has been discontinued
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From birth to hospital discharge, or up to 14 weeks
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Days on parenteral nutrition
Time Frame: From birth to hospital discharge, or up to 14 weeks
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Number of days that the infant receives intravenous intakes of protein and/or lipid and/or glucose
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From birth to hospital discharge, or up to 14 weeks
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Length of hospital stay
Time Frame: From birth to hospital discharge, or up to 14 weeks
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Number of days in hospital, defined as days from birth until final discharge
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From birth to hospital discharge, or up to 14 weeks
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Volume of gastric residual
Time Frame: From birth to hospital discharge, or up to 14 weeks
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Volume of aspirated gastric residuals in ml
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From birth to hospital discharge, or up to 14 weeks
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Color of gastric residual
Time Frame: From birth to hospital discharge, or up to 14 weeks
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The color of aspirated gastric residuals categorized into 7 colours
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From birth to hospital discharge, or up to 14 weeks
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Incidence of bloody gastric residual
Time Frame: From birth to hospital discharge, or up to 14 weeks
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Number of infants in each group have had blood in the gastric residual
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From birth to hospital discharge, or up to 14 weeks
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Frequency of stool per day
Time Frame: From birth to hospital discharge, or up to 14 weeks
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Frequency of stool passed each day
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From birth to hospital discharge, or up to 14 weeks
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Amount of the stool
Time Frame: From birth to hospital discharge, or up to 14 weeks
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Using a 4-level pre-defined scale Amount of stool on the diaper: the percentage of area covered by stool on the diaper.
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From birth to hospital discharge, or up to 14 weeks
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Color of the stool
Time Frame: From birth to hospital discharge, or up to 14 weeks
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The color of stools categorized into 6 colors
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From birth to hospital discharge, or up to 14 weeks
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Consistency of the stool
Time Frame: From birth to hospital discharge, or up to 14 weeks
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Using a 4-level pre-defined scale
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From birth to hospital discharge, or up to 14 weeks
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Total daily volume of enteral nutrition (EN) and parenteral nutrition (PN)
Time Frame: From birth to hospital discharge, or up to 14 weeks
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Volume of EN (including MM, DM, infant formula, and fortification) and PN in take
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From birth to hospital discharge, or up to 14 weeks
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Levels of macronutrients intake from EN and PN
Time Frame: From birth to hospital discharge, or up to 14 weeks
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Calculated based on the volume and composition of EN and PN
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From birth to hospital discharge, or up to 14 weeks
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Collaborators and Investigators
Sponsor
Investigators
- Study Chair: Per T Sangild, Rigshospitalet, Denmark
- Principal Investigator: Ping Zhou, Shenzheng Baoan Maternity and Child Healthcare Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- FortiColos-CN
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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