Effect of Rectal Administration of Breast Milk on Gut Microbiota in Preterm Infants (premic)
Effect of Rectal Administration of Human Milk on Gut Microbiota and Clinical Outcomes in Preterm Infants: A Randomized Controlled Study
Studieoversikt
Status
Intervensjon / Behandling
Detaljert beskrivelse
Preterm infants are highly vulnerable to alterations in gut microbiota due to immaturity, delayed enteral feeding, antibiotic exposure, and environmental factors. Early-life dysbiosis has been associated with adverse outcomes including necrotizing enterocolitis, sepsis, and impaired immune development. Strategies to promote healthy microbiota colonization in preterm infants are therefore of significant clinical interest.
Breast milk contains beneficial bacteria, prebiotics, and bioactive components that play a critical role in shaping neonatal gut microbiota. However, in the early postnatal period, especially in very preterm infants, enteral feeding may be limited or delayed. Alternative routes of exposure to breast milk components may offer a potential strategy to influence microbiota development.
This randomized controlled study aims to investigate the effects of rectal administration of maternal breast milk on gut microbiota in preterm infants. Participants will be randomly assigned to receive either rectal maternal breast milk or normal saline. Stool samples will be collected at predefined time points to assess microbiota composition.
The study is designed to explore whether rectal exposure to breast milk can modulate early microbial colonization and provide a feasible, safe, and innovative approach to support gut microbiota development in preterm infants.
Studietype
Registrering (Antatt)
Fase
- Ikke aktuelt
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Barn
Tar imot friske frivillige
Beskrivelse
Inclusion Criteria:
Preterm infants with a gestational age ≤32 weeks and birth weight ≤1500 g
Infants without meconium passage within the first 48 hours of life
Infants whose parents have provided written informed consent
Exclusion Criteria:
nfants with major congenital anomalies
Infants with gastrointestinal system anomalies
Infants in whom administration of maternal breast milk is contraindicated
Infants whose parents do not provide consent for participation
Infants who die within the first 72 hours of life
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Støttende omsorg
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Enkelt
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
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Eksperimentell: Rectal irrigation with maternal breast milk
Rectal irrigation will be performed starting 48 hours after birth, twice daily for 5 consecutive days at 09:00 and 21:00.
A 6 Fr feeding tube, 5 mL syringe, thermostatically controlled water bath (set at 37°C), sterile water-based lubricant, and sterile gloves will be used.
The enema volume will be calculated as 5 mL/kg and warmed to 37°C.
One end of the feeding tube will be connected to the syringe, and the other end will be gently inserted into the rectum after lubrication.
The solution will be administered slowly over approximately 3 minutes, and the tube will then be carefully removed.
Maternal breast milk will be used for rectal irrigation.
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Maternal breast milk will be used for rectal irrigation .
Rectal irrigation will be performed starting 48 hours after birth, twice daily for 5 consecutive days at 09:00 and 21:00.
A 6 Fr feeding tube, 5 mL syringe, thermostatically controlled water bath (set at 37°C), sterile water-based lubricant, and sterile gloves will be used.
The enema volume will be calculated as 5 mL/kg and warmed to 37°C.
One end of the feeding tube will be connected to the syringe, and the other end will be gently inserted into the rectum after lubrication.
The solution will be administered slowly over approximately 3 minutes, and the tube will then be carefully removed.
|
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Aktiv komparator: Rectal irrigation with normal saline
Rectal irrigation will be performed starting 48 hours after birth, twice daily for 5 consecutive days at 09:00 and 21:00.
A 6 Fr feeding tube, 5 mL syringe, thermostatically controlled water bath (set at 37°C), sterile water-based lubricant, and sterile gloves will be used.
The enema volume will be calculated as 5 mL/kg and warmed to 37°C.
One end of the feeding tube will be connected to the syringe, and the other end will be gently inserted into the rectum after lubrication.
The solution will be administered slowly over approximately 3 minutes, and the tube will then be carefully removed.Normal saline will be used for rectal irrigation as an active comparator.
|
Rectal irrigation will be performed starting 48 hours after birth, twice daily for 5 consecutive days at 09:00 and 21:00.
A 6 Fr feeding tube, 5 mL syringe, thermostatically controlled water bath (set at 37°C), sterile water-based lubricant, and sterile gloves will be used.
The enema volume will be calculated as 5 mL/kg and warmed to 37°C.
One end of the feeding tube will be connected to the syringe, and the other end will be gently inserted into the rectum after lubrication.
The solution will be administered slowly over approximately 3 minutes, and the tube will then be carefully removed.
Normal saline will be used for rectal irrigation as an active comparator.
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Gut microbiota composition in preterm infants
Tidsramme: 1 year
|
Gut microbiota composition will be analyzed using stool samples collected from preterm infants at 7 days and 1 month of life, including assessment of microbial diversity and relative abundance of bacterial taxa, to evaluate differences between study groups.
|
1 year
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Time to full enteral feeding
Tidsramme: 1 year
|
Time to achieve full enteral feeding will be defined as the number of days from birth until the infant tolerates full enteral nutrition without the need for parenteral nutrition.
|
1 year
|
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Feeding intolerance
Tidsramme: 1 year
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Feeding intolerance will be defined as the occurrence of bilious emesis, gastric residuals, visibly bloody stools, abdominal distension or tenderness, abdominal discoloration, gastric residual volume exceeding 50% of the previous feeding volume, emesis occurring three or more times within a 24-hour period, or clinical or radiological evidence of necrotizing enterocolitis (NEC).
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1 year
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Necrotizing enterocolitis
Tidsramme: 1 year
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Necrotizing enterocolitis will be diagnosed according to modified Bell's criteria stage II or higher.
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1 year
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Samarbeidspartnere og etterforskere
Studierekorddatoer
Studer hoveddatoer
Studiestart (Antatt)
Primær fullføring (Antatt)
Studiet fullført (Antatt)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
- Urogenitale sykdommer
- Kvinnelige urogenitale sykdommer og graviditetskomplikasjoner
- Tarmsykdommer
- Obstetrisk arbeid, prematur
- Obstetriske arbeidskomplikasjoner
- Graviditetskomplikasjoner
- Sykdommer i fordøyelsessystemet
- Gastrointestinale sykdommer
- Gastroenteritt
- Enterokolitt
- For tidlig fødsel
- Enterokolitt, nekrotiserende
Andre studie-ID-numre
- PREMIC-2026
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