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The Use of Early Fortification in Preterm Infants

1. oktober 2026 opdateret af: Putri Maharani Tristanita Marsubrin, MD, PhD, Universitas Indonesia

Early Fortification to Shorten Birth Weight Recovery Time in Very Preterm or Very Low Birth Weight Infants

Very premature or very low birth weight (VLBW) infants are at risk of suboptimal growth after birth, making adequate nutrition essential. Breast milk alone is insufficient to meet the nutritional needs of premature infants, so fortification is added to breast milk to support catch-up growth. Standard human milk fortification (HMF) is typically started when the feeding volume reaches 100 ml/kg/day, but research suggests that early HMF administration can increase protein intake sooner without negative effects on the infant. Early HMF administration didn't increase the incidence of food intolerance and necrotizing enterocolitis (NEC). Other studies have shown that early fortification increases the rate of early weight gain without increasing the incidence of complications. There is no research in Indonesia comparing the duration of regaining birth weight between early HMF and standard HMF. This study aims to determine the difference in the duration of regaining birth weight in very premature or VLBW infants given early HMF versus standard HMF. The research method is a prospective, randomized, double-blind preliminary study comparing early HMF administration (when feeding volume reached 30 ml/kg/day) with standard HMF (when feeding volume reached 100 ml/kg/day).

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

44

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • DKI Jakarta
      • Jakarta Pusat, DKI Jakarta, Indonesien, 10430
        • Cipto Mangunkusumo Hospital

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

6 måneder til 7 måneder (Barn)

Tager imod sunde frivillige

Ja

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Very preterm infants (gestational age 28 to <32 weeks) or very low birth weight infants (birth weight 1000 to <1500 grams)
  • Infants receiving at least 50% of their daily enteral needs from breast milk
  • Infants whose parents provided written informed consent to participate in the study

Exclusion Criteria:

  • Infants with major congenital abnormalities
  • Infants with grade 2 or grade 3 NEC or spontaneous intestinal perforation (SIP) before the intervention
  • Infants who had already achieved return to birth weight (RTBW) before initiation of the intervention
  • Infants with insufficient breast milk availability to provide ≥50% of their daily enteral requirements before enrollment
  • Infants born to mothers with medical conditions that precluded breastfeeding
  • Infants with known cow's milk protein allergy before initiation of the intervention
  • Infants who died before initiation of the intervention
  • Parents who withdrew informed consent

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Støttende pleje
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Early Fortification Group

Participants were given early fortification when the feeding volume reached 30 ml/kg/day

In the early fortification group, 1 sachet of HMF was added to 30 ml of breast milk for the first 24 hours. If the feeding tolerance was good, 1 sachet of HMF was then mixed into 25 ml of breast milk.

Eksperimentel: Standard Fortification Group

Participants were given standard fortification when the feeding volume reached 100 ml/kg/day

In the standard fortification group, 1 sachet of HMF was mixed into 25 ml of breast milk starting from the first day of HMF administration.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Return to birth weight
Tidsramme: Body weight will be measured daily from birth until the day the infant first reaches their birth weight. The assessment period is expected to last up to 3 weeks after birth.

The first day the infants reached their birth weight again

Body weight will be measured daily from birth until the day the infant first reaches their birth weight. The assessment period is expected to last up to 3 weeks after birth.

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Number of Participants with Feeding Intolerance
Tidsramme: Feeding intolerance will be monitored from the initiation of HMF administration until the day the infant first reaches their birth weight. The monitoring period is expected to last up to 3 weeks after birth.

Feeding intolerance was defined as inability to tolerate enteral feeding, characterized by a gastric residual volume greater than 50% (with or without regurgitation), vomiting, abdominal distension, decreased frequency of bowel movements, and disruption of the feeding plan.

Feeding intolerance will be monitored from the initiation of HMF administration until the day the infant first reaches their birth weight. The monitoring period is expected to last up to 3 weeks after birth.
Number of Participants with Electrolyte Imbalances
Tidsramme: Electrolytes will be assessed once during intervention. Blood sampling will be scheduled by the attending physician. The intervention period starts with HMF administration and ends when birth weight is regained, expected within 3 weeks after birth.

Electrolyte imbalance was identified when serum levels fell below institutional laboratory reference ranges, with assessments performed for all study subjects.

Electrolytes will be assessed once during intervention. Blood sampling will be scheduled by the attending physician. The intervention period starts with HMF administration and ends when birth weight is regained, expected within 3 weeks after birth.
Number of Participants with Necrotizing Enterocolitis
Tidsramme: Necrotizing enterocolitis will be monitored from the initiation of HMF administration until the day the infant first reaches their birth weight. The monitoring period is expected to last up to 3 weeks after birth.

Necrotizing enterocolitis was defined as a disorder of the intestinal mucosa, clinically manifested by feeding intolerance, bloody stools, and possibly accompanied by changes in abdominal skin color, supported by abdominal X-ray findings consistent with necrotizing enterocolitis.

Necrotizing enterocolitis will be monitored from the initiation of HMF administration until the day the infant first reaches their birth weight. The monitoring period is expected to last up to 3 weeks after birth.

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Ledende efterforsker: Putri MT Marsubrin, MD, PhD, FKUI RSCM

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

10. november 2024

Primær færdiggørelse (Faktiske)

30. juni 2025

Studieafslutning (Faktiske)

30. juni 2025

Datoer for studieregistrering

Først indsendt

27. august 2026

Først indsendt, der opfyldte QC-kriterier

1. oktober 2026

Først opslået (Faktiske)

6. oktober 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

6. oktober 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

1. oktober 2026

Sidst verificeret

1. august 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 24-06-0986

Plan for individuelle deltagerdata (IPD)

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INGEN

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