Adverse Event, Disorder Lung, Disorder of Intestine, Growth, Tolerance
Conditions
Keywords
Growth, Tolerance, Adverse Event, Gastrointestinal disorder, Respiratory infection, Gastrointestinal infection
Brief summary
Human milk oligosaccharides (HMOs) represent the third largest solid component of breast milk. Technology advancements made it possible to supplement infant formulas with HMOs (2'FL, LNnT). Two published RCTs have demonstrated that infant formulas supplemented with 2'FL or 2'FL+LNnT are safe, well-tolerated, support normal grow, and may support healthy GI function and confer immune benefits. The performance of HMOs-supplemented formulas assessed in a real-world setting is complementary to previously conducted RCTs conducted in highly controlled clinical settings. Main objectives will be to monitor the safety & tolerance of HMOs-supplemented formulas in larger and diverse infant populations; to assess the performance of HMOs-supplemented formulas in mixed-fed infants, a population that was not studied in previous RCTs but likely represents a relatively common feeding regimen. Finally, considering the potential health/immune benefits of HMOs, it is also important explore the incidences of illnesses (i.e., respiratory illnesses, GI illnesses, and fever) associated with consuming HMOs-supplemented formulas and compare with breastfed infants data.
Detailed description
Objectives: The main objective of this study is to document the growth and feeding tolerance of healthy term infants consuming an infant formula supplemented with HMOs for 8 weeks (56 days), in a real-world setting. Main endpoints: 1. Growth documented via monitoring the anthropometric parameters including weight, length, head circumference, BMI and their corresponding z-scores (i.e., z-scores for weight-for-age, length-for-age, weight-for-length, head circumference-for-age, and BMI-for-age) calculated using the 2006 WHO Growth Standards 2. Feeding tolerance assessed via monitoring parent-reported overall GI symptom burden measured by the Infant Gastrointestinal Symptom Questionnaire (IGSQ) index score (13-item summary score) Additional objectives: To describe the following outcomes in infants fed an infant formula supplemented with HMOs: 1. Formula acceptability 2. Despite there are no expected safety concerns, standard Adverse Events (AEs) monitoring will be implemented during the study Additional endpoints: 1. Formula acceptability assessed by the Study Formula Satisfaction Questionnaire 2. Reported AEs and Serious Adverse Events (SAEs) including type, incidence, severity, seriousness and relation to study formula consumption as well as concomitant medications and non-pharmacological treatments. * Select morbidities of interest (i.e., respiratory illnesses, GI illnesses, and fever) will be collected as part of AE reporting and specific corresponding AE guidance forms will be used to standardize reporting of such AEs Trial design: Uncontrolled, single arm, open-label, prospective study in infants (enrolled at postnatal age 7 days to 2 months) fed the study formula for 8 weeks (56 days) A group of exclusively breastfed infants (BF) will serve as a reference group in parallel to the study arm. For the BF group, Infants must have been exclusively consuming breast milk since birth, and their parent(s) must have made the decision to continue exclusively breastfeeding until at least 4 month of age Trial population: Healthy, male and female, term infants, 7 days postnatal age to 2 months of age at the enrollment Treatment duration: Total study participation/intervention up to approximately 8 weeks
Interventions
Starter Infant Formula supplemented with 1.5g/L of Human Milk Oligosaccharides
Sponsors
Puerta de Hierro University Hospital
University of Navarrra Hospital (Clinica Universitaria)
Grupo Pulso
Casa de la Salud Hospital
Vitha Santa Catalina Hospital
Quirón-Dexeus Universitary Hospital
Hospital Ruber Internacional
Grupo Hispalense de Pediatría Hospital
MH Belén Maternal Hospital
Société des Produits Nestlé (SPN)
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
7 Days to 2 Months
Healthy volunteers
Yes
Inclusion criteria
1. Evidence of personally signed and dated informed consent document indicating that the infant's parent(s) have been informed of all pertinent aspects of the study 2. Parent(s) are willing and able to fulfill the requirements of the study protocol 3. Healthy full term (37-42 weeks gestation) infant 4. Be between post-natal age (Date of Birth = Day 0) 7 days to 2 months 5. Parent(s) must have independently elected, before enrollment, to formula feed
Exclusion criteria
1. Evidence of personally signed and dated informed consent document indicating that the infant's parent(s) have been informed of all pertinent aspects of the study 2. Parent(s) are willing and able to fulfill the requirements of the study protocol 3. Healthy full term (37-42 weeks gestation) infant 4. Be between post-natal age (Date of Birth = Day 0) 7 days to 2 months 5. Infants must have been exclusively consuming breast milk since birth, and their parent(s) must have made the decision to continue exclusively breastfeeding until at least 4 month of age
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feeding tolerance | 4 weeks (study midpoint) | The Infant Gastrointestinal Symptom Questionnaire (IGSQ) index score will be used to assess GI distress. This is a validated 13-item questionnaire where each item is scored on a scale of 1 to 5 with higher values indicating greater GI distress. A composite IGSQ score is derived from summing the individual scores with a possible range of 13 to 65 where higher values indicate greater GI distress and values ≤23 indicate no digestive distress. |
| World Health Organization (WHO) based weight-for-age z-scores | 8 weeks (study end) | Weight-for-age z-scores using WHO growth standards |
| World Health Organization (WHO) based length-for-age z-scores | 8 weeks (study end) | Length-for-age z-scores using WHO growth standards |
| World Health Organization (WHO) weight-for-length z-scores | 8 weeks (study end) | Weight-for-length z-scores using WHO growth standards |
| World Health Organization (WHO) head-circumference-for-age z-scores | 8 weeks (study end) | head-circumference-for-age z-scores using WHO growth standards |
| World Health Organization (WHO) based body-mass-index (BMI)-for-age z-scores | 8 weeks (study end) | Weight and height will be combined to calculate BMI in kg/m\^2, then BMI-for-age z-scores will be derived using WHO growth standards |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Formula acceptability | 4 weeks (study midpoint), 8 weeks (study end) | Study Formula Satisfaction Questionnaire |
| Standard adverse events (AEs) reporting for safety assessment | From the time the informed consent form has been signed at enrollment infant age less than 7 days to 2 months through the 8 weeks of intervention | Reported adverse events (AEs) and Serious Adverse Events (SAEs) include type, incidence, severity, seriousness and relation to feeding |
| Weight | 8 weeks (study end) | Weight measurements in grams |
| Length | 8 weeks (study end) | Length measurements in centimeters |
| Head circumference | 8 weeks (study end) | Head circumference measurements in centimeters |
| Body-mass-index (BMI) | 8 weeks (study end) | Weight and height will be combined to report BMI in kg/m\^2 |
Countries
Spain
Outcome results
None listed