Curds in the Way: Establishing Normal Ultrasound Appearances of the Contents of Newborn Bowel when Babies are Fed Fortified Breastmilk.

Curds in the Way: Establishing Normal Sonographic Appearances of Neonatal Bowel on Fortified Breastmilk Feeds

Status

Completed

Phases

Unknown

Study type

Observational

Source

ANZCTR

Registry ID

ACTRN12619000616178

Enrollment

Registered

2019-04-24

Start date

2019-05-01

Completion date

2019-09-05

Last updated

2026-02-09

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

Premature babies receive fortified feeds to improve growth and optimal bone formation. However, this can lead to milk curd obstruction (MCO) in the bowel and, rarely, perforation of the bowel. Diagnosis of MCO is difficult as clinical findings and abdominal radiographs are often non-specific. As a result, a baby may undergo surgery to explore the abdomen or may see their (fortified) feeds stop even though this leads to sub-optimal nutrition. Neonatal sonographic appearances of MCO in the bowel are not well-described; however, ultrasound has been suggested as the imaging choice for a milk curd in the stomach. This study aims to establish the ‘normal’ appearances of bowel contents on abdominal ultrasound in 20 asymptomatic babies admitted to the NICU born at <37 weeks’ gestation and fed on fortified breastmilk.

Interventions

2 abdominal ultrasounds in each of 20 neonates in the Auckland City Hospital Neonatal Intensive Care ward. The first will be when on regular breastmilk feeds but before the addition of fortifier. The second will be 10-14 days after initiation of regular fortified breastmilk feeds. These babies will have no known gastrointestinal pathology as the aim is to establish normal sonographic appearances of bowel contents before and after fortified feeds have commenced.

Eligibility

Sex/Gender

All

Age

No minimum to 1 Months

Healthy volunteers

Inclusion criteria

Babies will be eligible when they are born at <37 weeks’ gestation and/or of low birth weight (<1,800 g). They must be admitted to the NICU with the first abdominal ultrasound occurring before fortifier is added to the expressed breastmilk.

Exclusion criteria

Exclusion from recruitment: - Exclusive formula feeding (or > 50%) - Known chromosomal abnormality or heritable disease affecting gastrointestinal anatomy or function, or surgical gastrointestinal disease such as gastroschisis - Lack of guardian consent (verbal or written) Exclusion from analysis: - Development of clinical bowel obstruction of any cause, or development of necrotising enterocolitis - Abdominal or thoracic surgery - Administration of medications that reduce gastrointestinal motility

Outcome results