Preterm InfantNCT03443297
Early Versus Delayed Feeding in Preterm Growth-Restricted Infants
A study testing breast milk in people with Preterm Infant and IUGR, run by Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Trial summary
The introduction of enteral feeds for preterm, growth restricted infants are often delayed due to concern that early introduction may not be tolerated and may increase the risk of necrotizing enterocolitis. Read more about this study
- Who is it for?
- Ages 1 minute to 4 weeks
- Conditions the study is for
- Preterm Infant, IUGR
- What is being tested?
- breast milk
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 50 participants
- Where
- No sites listed yet
- Study dates
- 1 Mar 2018to 31 Dec 2018
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 1 minute to 4 weeks
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- All growth restricted preterm Infants of both sexes with gestational age 35 weeks or less and birth weight below 10th percentile for gestational age
Who cannot join
- • Hemodynamically unstable critically ill neonates.
- Newborn with severe perinatal asphyxia.
- Newborn with polycythemia requiring exchange transfusion
- Newborn with major congenital anomalies
- Syndromic manifestations or chromosomal malformations
- Suspected inborn errors of metabolism.
- Any baby who will have proven sepsis with shock or necrotizing enterocolitis will be excluded and will be replaced by new one in same category as per protocol analysis.
- Any baby who develop shock (due to sepsis, cardiogenic, hypovolemic etc.) will be excluded and will be replaced by new one in same category as per protocol analysis.
About this study
Official title: Early Versus Delayed Enteral Feeding for Achieving Full Feeding in Preterm Growth-Restricted Infants: A Randomized Clinical Trial
The introduction of enteral feeds for preterm, growth restricted infants are often delayed due to concern that early introduction may not be tolerated and may increase the risk of necrotizing enterocolitis. However, prolonged enteral fasting may diminish the functional adaptation of the immature gastrointestinal tract and extend the need for parenteral nutrition with its attendant infectious and metabolic risks. Early introduction of small volumes of milk in the form of Trophic feeding, promote intestinal maturation, may enhance feeding tolerance and decrease the time taken to reach full enteral feeding independently of parenteral nutrition.
A Randomized Trial will be carried out over a period of 12 months in Department of Neonatology of BSMMU. Sample size will be 50(25 in each group). Infants with gestation below 35 weeks, birth weight below the 10th percentile for gestational age, will be randomly allocated by web-based randomization to commence enteral feeds "early," whose feeding will be started from 24 to 48 hours of age or "late," whose feeding will be started from 48 to 72 hours of age. Gradually feeding will be increased. Rate of advancement of feeding will be same for both groups. Primary outcomes will be time to achieve full enteral feeding sustained for 72 hours. Statistical analyses will be performed by using Fisher Exact test and by Student's t test for categorical data and quantitative data respectively. Logistic regression analyses will be performed to determine the role of independent variable.
Read the detailed description
Eligible infants who will fulfill the inclusion criteria will be divided into two strata "Early feeding group" and " Late feeding group" by computer based randomization after taking informed written consent from parents or responsible caregivers. Feeding will be started in early feeding group from 24 to 48 hours of age or in late feeding group, from 48 to 72 hours of age. Initially 4 hourly feeding will be started with 0.5ml and 1 ml expressed breast milk in babies with birth weight <1200 grams and >1200 grams respectively. On the following day 3 hourly, thereafter 2 hourly feeding will be provided in both groups. Gradually amount of feeding will be increased after reaching 2 hourly feeding at the rate of 10 ml/kg/day for initial 10 days then 20ml/kg/day in 2 aliquots till full feeding(150ml/kg/day).For babies with birth weight <1200 gram, rate of feeding advancement 10 ml/kg/day till full feeds. Any baby who will develop shock (due to sepsis, cardiogenic, hypovolemic etc.) will be excluded and will be replaced by new one in same category as per protocol analysis. Follow up examinations will be done.
- Conditions
- Preterm Infant, IUGR
- Being tested
- breast milk
- Medical subject headings
- Premature Birth
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
breast milkOther
Feeding with breast milk will be started in early feeding group from 24 to 48 hours of age or in late feeding group, from 48 to 72 hours of age. Initially 4 hourly feeding will be started with 0.5ml and 1 ml expressed breast milk in babies with birth weight <1200 grams and >1200 grams respectively. gradually volume of milk should be increased
| Study group | Role | What they receive |
|---|---|---|
| Early Feeding group | Experimental | Active ingredient: maternal expressed breast milk Time of initiation of first feeding: 24 to 48 hours of age. Doses: Initially 4 hourly feeding will be started with 0.5 ml and 1 ml expressed breast milk in babies with birth weight <1200 grams and >1200 grams respectively. On the following day 3 hourly, thereafter 2 hourly feeding will be provided in both groups. Gradually amount of feeding will be increased after reaching 2 hourly feeding at the rate of 10 ml/kg/day for initial 10 days then 20ml/kg/day in 2 aliquots till full feeding(150ml/kg/day).For babies with birth weight <1200 gram, rate of feeding advancement 10 ml/kg/day till full feeds. Time of starting first feeding and time to reach full feeding, both will be documented in a questionnaire for each patient. Receives: Other: breast milk |
| Late Feeding group | No intervention | Feeding with maternal breast milk will be given in conventional way |
What is being measured
The primary outcome is the main question the study is designed to answer.
Association of feeding with weight gain pattern
Early achievement of acceptable weight gain 20-25 gram per day
Measured: 1 year
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Feb 2018
- Study start1 Mar 2018 (estimated)
- Primary completion31 Dec 2018 (estimated)
- Study completion31 Dec 2018 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Preterm InfantStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 50 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Farzana Ahmed, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03443297
- Sponsor's protocol ID
- U1111-1203-7088
- Status last verified
- Feb 2018
- First submitted
- 6 Feb 2018
- Last updated
- 23 Feb 2018
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 23 Feb 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Early Versus Delayed Enteral Feeding for Achieving Full Feeding in Preterm Growth-Restricted Infants: A Randomized Clinical Trial
- ClinicalTrials.gov ID
- NCT03443297
- Acronym / sponsor ID
- U1111-1203-7088
- Conditions
- Preterm Infant, IUGR
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 50 participants (estimated)
- Lead sponsor
- Bangabandhu Sheikh Mujib Medical University, Dhaka, BangladeshUniversity, hospital or other
- Study start
- 1 Mar 2018 (estimated)
- Primary completion
- 31 Dec 2018 (estimated)
- Study completion
- 31 Dec 2018 (estimated)
- First posted
- 23 Feb 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The introduction of enteral feeds for preterm, growth restricted infants are often delayed due to concern that early introduction may not be tolerated and may increase the risk of necrotizing enterocolitis. However, prolonged enteral fasting may diminish the functional adaptation of the immature gastrointestinal tract and extend the need for parenteral nutrition with its attendant infectious and metabolic risks. Early introduction of small volumes of milk in the form of Trophic feeding, promote intestinal maturation, may enhance feeding tolerance and decrease the time taken to reach full enteral feeding independently of parenteral nutrition.
A Randomized Trial will be carried out over a period of 12 months in Department of Neonatology of BSMMU. Sample size will be 50(25 in each group). Infants with gestation below 35 weeks, birth weight below the 10th percentile for gestational age, will be randomly allocated by web-based randomization to commence enteral feeds "early," whose feeding will be started from 24 to 48 hours of age or "late," whose feeding will be started from 48 to 72 hours of age. Gradually feeding will be increased. Rate of advancement of feeding will be same for both groups. Primary outcomes will be time to achieve full enteral feeding sustained for 72 hours. Statistical analyses will be performed by using Fisher Exact test and by Student's t test for categorical data and quantitative data respectively. Logistic regression analyses will be performed to determine the role of independent variable.
Detailed description
Eligible infants who will fulfill the inclusion criteria will be divided into two strata "Early feeding group" and " Late feeding group" by computer based randomization after taking informed written consent from parents or responsible caregivers. Feeding will be started in early feeding group from 24 to 48 hours of age or in late feeding group, from 48 to 72 hours of age. Initially 4 hourly feeding will be started with 0.5ml and 1 ml expressed breast milk in babies with birth weight <1200 grams and >1200 grams respectively. On the following day 3 hourly, thereafter 2 hourly feeding will be provided in both groups. Gradually amount of feeding will be increased after reaching 2 hourly feeding at the rate of 10 ml/kg/day for initial 10 days then 20ml/kg/day in 2 aliquots till full feeding(150ml/kg/day).For babies with birth weight <1200 gram, rate of feeding advancement 10 ml/kg/day till full feeds. Any baby who will develop shock (due to sepsis, cardiogenic, hypovolemic etc.) will be excluded and will be replaced by new one in same category as per protocol analysis. Follow up examinations will be done.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Early Feeding group | Experimental | Other: breast milkActive ingredient: maternal expressed breast milk Time of initiation of first feeding: 24 to 48 hours of age. Doses: Initially 4 hourly feeding will be started with 0.5 ml and 1 ml expressed breast milk in babies with birth weight <1200 grams and >1200 grams respectively. On the following day 3 hourly, thereafter 2 hourly feeding will be provided in both groups. Gradually amount of feeding will be increased after reaching 2 hourly feeding at the rate of 10 ml/kg/day for initial 10 days then 20ml/kg/day in 2 aliquots till full feeding(150ml/kg/day).For babies with birth weight <1200 gram, rate of feeding advancement 10 ml/kg/day till full feeds. Time of starting first feeding and time to reach full feeding, both will be documented in a questionnaire for each patient. |
| Late Feeding group | No intervention | –Feeding with maternal breast milk will be given in conventional way |
Who may qualify
- Ages
- 1 minute to 4 weeks
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (1 listed)
- All growth restricted preterm Infants of both sexes with gestational age 35 weeks or less and birth weight below 10th percentile for gestational age
Key exclusion criteria (8 listed)
- • Hemodynamically unstable critically ill neonates.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| breast milkFeeding with breast milk will be started in early feeding group from 24 to 48 hours of age or in late feeding group, from 48 to 72 hours of age. Initially 4 hourly feeding will be started with 0.5ml and 1 ml expressed breast milk in babies with birth weight <1200 grams and >1200 grams respectively. gradually volume of milk should be increased | Other | Early Feeding group |
Primary outcome
Association of feeding with weight gain pattern
Time frame: 1 year
Early achievement of acceptable weight gain 20-25 gram per day
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 23 Feb 2018.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
Questions about this trial
What is this clinical trial studying?
A study testing breast milk in people with Preterm Infant and IUGR, run by Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 23 Feb 2018. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Association of feeding with weight gain pattern (time frame: 1 year). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Feb 2018.