Healthy Infants
Conditions
Brief summary
The aim of this trial is to show that infants fed these new formulas, containing a blend of 5 Human Milk Oligosaccharides (HMOs), allow for growth in line with infants fed formulas without HMOs. There will be different groups in the trial: three formula-fed groups and a breastfed group.
Detailed description
These 5 HMOs are identical to the ones found naturally in human milk. They are natural prebiotics (or complex sugars) with potential health benefits. Prebiotics are natural compounds that help the establishment of beneficial gut bacteria (such as bifidobacteria), while preventing bad bacteria from doing harm. Supplementing diets with certain prebiotics has been shown to be well tolerated in adults and infants and to provide potential benefits.Therefore, the trial also aims to understand if consuming HMOs supplemented formulas could strengthen immunity and prevent common illnesses (for example, respiratory illnesses) in infants and toddlers. Furthermore, stool frequency and consistency will be monitored, so as to evaluate digestive tolerance to the formula.
Interventions
OTHERStarter Infant Formula, Follow-up Formula, and Growing-up Milk Supplemented With a Blend of Five Human Milk Oligosaccharides
Study formulas are administered orally, ad libitum, from enrollment until 15 months of age
OTHERBreast-feeding
Exclusive Breast-feeding up to 4 months of age
OTHERStandard Starter Infant Formula, Follow-up Formula, and Growing-up Milk
Standard Study formulas are administered orally, ad libitum, from enrollment until 15 months of age
Sponsors
Société des Produits Nestlé (SPN)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Masking description
Unique coding of the study products
Eligibility
Sex/Gender
ALL
Age
7 Days to 21 Days
Healthy volunteers
Yes
Inclusion criteria
1. Evidence of personally signed and dated informed consent document indicating that the infant's parent(s)/Legally Acceptable Representative has been informed of all pertinent aspects of the study. 2. Infants whose parent(s)/Legally Acceptable Representative have reached the legal age of majority in the countries where the study is conducted. 3. Infants whose parent(s)/Legally Acceptable Representative are willing and able to comply with scheduled visits, and the requirements of the study protocol. 4. Infants whose parent(s)/Legally Acceptable Representative are able to be contacted directly by telephone throughout the study. 5. Infants whose parent(s)/Legally Acceptable Representative have a working freezer. 6. Infants must meet all of the following inclusion criteria to be eligible for enrollment into the study: 1. Healthy term (37-42 weeks of gestation) infant at birth. 2. At enrollment visit, post-natal age ≥ 7 days and ≤ 21 days (date of birth = day 0, 0.25 - 0.75 months old). 3. At enrollment, birth weight ≥ 2500g and ≤ 4500g. 4. For formula-fed group, infants must be exclusively consuming and tolerating a cow's milk infant formula at time of enrollment and their parent(s)/Legally Acceptable Representative must have independently elected, before enrollment, not to breastfeed. 5. For breastfed group, infants must have been exclusively consuming breast milk since birth, and their parent(s)/Legally Acceptable Representative must have made the decision to continue exclusively breastfeeding until at least 4 month of age.
Exclusion criteria
1. Infants with conditions requiring infant feedings other than those specified in the protocol. 2. Infants receiving complementary foods or liquids defined as 4 or more teaspoons per day or approximately 20 g per day of complementary foods or liquids at or prior to enrollment. 3. Infants who have a medical condition or history that could increase the risk associated with study participation or interfere with the interpretation of study results, including: 1. Evidence of major congenital malformations (e.g., cleft palate, extremity malformation). 2. Suspected or documented systemic or congenital infections (e.g., human immunodeficiency virus, cytomegalovirus, syphilis). 3. History of admission to the Neonatal Intensive Care Unit (NICU), with the exception of admission for jaundice phototherapy. 4. Other severe medical or laboratory abnormality (acute or chronic) which, in the judgment of the investigator, would make the infant inappropriate for entry into the study. 4. Infants who are presently receiving or have received prior to enrollment any of the following: medication(s) or supplement(s) which are known or suspected to affect the following: fat digestion, absorption, and/or metabolism (e.g., pancreatic enzymes); stool characteristics (e.g., glycerin suppositories, bismuth-containing medications, docusate, Maltsupex, or lactulose); growth (e.g. insulin or growth hormone); gastric acid secretion; or any study outcomes. 5. Currently participating or having participated in another clinical trial since birth
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| To compare the growth of infants between the groups | From Study Day 1 to 4 months of age | To compare the growth (weight gain, g/day) of infants randomized to Test Groups (TG1 or TG2) versus Control Group (CG) |
| To compare recurrent incidences of illness of infants between the groups | From Study Day 1 to 15 months of age | To compare recurrent incidences of illness (specifically lower and upper respiratory tract illnesses including bronchitis/bronchiolitis), of infants randomized to Test Groups (TG1 or TG2) versus Control Group (CG) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Medication use (specifically antimicrobials and antipyretics) | From enrollment until 15 months of age | Medication type and duration of intake will be combined to report the medication use |
| Absenteeism: Time away from daycare (infant) or work (parent) | From enrollment until 15 months of age | Time away from daycare (infant) or work (parent) |
| Fecal microbiome composition, diversity, community type | Stool sample collected at infant age less than 0.75, 3, 6, 12, and 15 months of age (a subset of 105 infants per formula group; 90 breastfed infants) | Fecal microbiota composition, diversity, and microbiota community type will be assessed using cutting-edge next generation sequencing technology and combined to report the Fecal microbiome |
| Fecal metabolic profile | Stool sample collected at infant age less than 0.75, 3, 6, 12, and 15 months of age (a subset of 105 infants per formula group; 90 breastfed infants) | Measures of fecal metabolism will be combined to report fecal metabolic profile (fecal pH, fecal organic acids, as well as additional targeted/untargeted metabolomics and cell-based functional assays) |
| Markers of immune and gut health | Stool sample collected at infant age less than 0.75, 3, 6, 12, and 15 months of age (a subset of 105 infants per formula group; 90 breastfed infants) | Fecal markers of immune and gut health will include secretory immunoglobulin A IgA \[total\], alpha-1 antitrypsin, and calprotectin. |
| Blood Markers of immune health | At 6 months of age | Plasma and peripheral blood mononuclear cells, Extracellular in vivo and ex vivo circulating cytokine levels will be measured in plasma |
| Gastrointestinal tolerance | Stool sample collected at infant age less than 0.75, 3, 6, 12, and 15 months of age (a subset of 105 infants per formula group; 90 breastfed infants) | Stool patterns (stool frequency and consistency), Gastrointestinal symptoms, Gastrointestinal-related behaviors, and milk intake will be combined to report the gastrointestinal tolerance |
| Cognitive and behavioral outcomes | At 15 months of age | Assessment at 15 months through the use of the MacArthur-Bates Communicative Development Inventories (MCDI) and the Early Childhood Behavior Questionnaire (ECBQ), two parent-reported questionnaires that evaluate early language/vocabulary and development of communication skills, that will be combined to report the cognitive and behavioral outcomes |
| DNA Genotyping of fucosyltransferase 2 and 3 (secretor status) | At Study Day 60 +/- 5 days | Association between secretor status and illnesses/infections via microbiome modulation will be evaluated. |
| Breastmilk collection for Human Milk Oligosaccharides profile analysis (breastfeeding mothers only) | At Study Day 90 +/- 5 days | A small sample of milk (1ml) will be hand pumped, collected in an Eppendorf tube and stored frozen |
| Vital signs: Body temperature | From enrollment until 15 months of age | Body temperature in Celsius degree will also be measured to report vital signs |
| Anthropometric measurements: Length | From enrollment until 15 months of age | Length measurements in centimeters to report anthropometric measurements. |
| Anthropometric measurements: Head circumference | From enrollment until 15 months of age | Head circumference measurements in centimeters to report anthropometric measurements. |
| Anthropometric measurements: BMI | From enrollment until 15 months of age | BMI measurements in kg/m\^2 to report anthropometric measurements. |
| Anthropometric measurements: World Health Organization (WHO) growth standard calculated z-scores | From enrollment until 15 months of age | WHO growth standard z-scores including weight-for-age, length-for-age, weight-for-length, head-circumference-for-age, BMI-for-age and weight velocity will be calculated and combined to report anthropometric measurements. |
| Vital signs: Infant respiration | From enrollment until 15 months of age | Infant respiration in breaths per minute will also be measured to report vital signs |
| Vital signs: Heart rate | From enrollment until 15 months of age | Heart rate in beasts per minute will also be measured to report vital signs |
| Standard adverse events (AEs) reporting for safety assessment | From the time the informed consent form has been signed at enrollment infant age less than 21 days or 0.75 months through the 2 weeks post-study telephone contact at infant age 464 days | Reported adverse events (AEs) and Serious Adverse Events (SAEs) include type, incidence, severity, seriousness and relation to feeding |
| Bone index measurement | From enrollment until 15 months of age | Bone index measurement will be conducted using a non-invasive and radiation-free ultra-sound sonometer measuring bone transmission time and speed of sound at the radius and tibia site, including also the measurement of the femur and radius length |
| Dietary pattern | From 6 months of age until 15 months of age | Dietary pattern will be evaluated using a Food frequency questionnaire including sixteen key food groups for infants and young children |
| Anthropometric measurements: Weight | From enrollment until 15 months of age | Weight measurements in grams to report anthropometric measurements. |
| Infant illness and infection outcomes | at different stages of feeding 1st age Infant Formula, 2nd age Follow-up Formula, and 3rd age Growing-up Milk when applicable | Specific parent-reported infant illness symptoms and physician confirmed diagnoses of lower respiratory tract infection (LRTI), upper respiratory tract infection (URTI), total respiratory tract infection (TRTI), gastrointestinal infection (GII), ear illness \[including: otitis media (OM), ear infection, ear inflammation, and ear pain\], and fever will be combined to report infant illness and infection outcomes (Episode, incidence, duration, severity, and recurrence) |
Countries
Bulgaria, Hungary, Poland
Outcome results
None listed