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Individualized Fortification of Human Milk for Infants Born ≤ 1250 g (MaxiMoM-InForM)
Sponsor: The Hospital for Sick Children
Summary
Very low birth weight infants have increased nutritional needs. Extra nutrients are added to their human milk feeds to help improve their nutritional status, growth and neurodevelopment. Standard fortification of human milk is routine in most neonatal units in North America, but despite the added nutrients, infants are often discharged from hospitals with poor growth, and their neurodevelopment remains suboptimal. Two individualized fortification methods, target and BUN adjustable, have been proposed to improve the nutrient supply to infants. However, there is currently insufficient evidence to support the implementation of individualized fortification or one method over the other. Therefore, this study will randomly assign very low birth weight infants to receive feeds fortified according to standard, target or BUN adjustable fortification methods until the end of the feeding intervention. Feedings will be prepared in milk preparation rooms to ensure caregivers and outcomes assessor remain blinded to feeding allocation. Growth, morbidities, and nutrient intakes will be determined throughout hospitalization and skinfolds assessed at 36 weeks. At 4 months CA, growth and body composition will be determined by air displacement plethysmography on a subset of infants. Neurodevelopment will be assessed using the Bayley Scales of Infant and Toddler Development, at 18-24 months CA.
Official title: MaxiMoM: Individualized Fortification of Human Milk for Infants Born ≤ 1250 g; a Three Arm Randomized Clinical Trial
Key Details
Gender
All
Age Range
Any - 21 Days
Study Type
INTERVENTIONAL
Enrollment
615
Start Date
2021-11-11
Completion Date
2026-07-01
Last Updated
2025-07-31
Healthy Volunteers
No
Conditions
Interventions
Standard fortification
Standard fortification assumes that the nutrient content of human milk is constant and involves use of a standard fixed dose of multi-nutrient fortifier and as appropriate nutrient modulars.
Target fortification
Target fortification involves use of a multi-nutrient fortifier as well as weekly analysis of energy and macronutrients of human milk and subsequent addition of fat and protein modulars if needed.
BUN adjustable fortification
BUN (blood urea nitrogen) adjustable fortification involves use of a multi-nutrient fortifier as well as weekly BUN tests and subsequent addition of a protein modular according to a prescribed algorithm.
Locations (20)
University of Alberta
Edmonton, Alberta, Canada
William Osler Health System-Brampton Civic Hospital
Brampton, Ontario, Canada
William Osler Health System-Etobicoke General Hospital
Etobicoke, Ontario, Canada
Markham Stouffville Hospital
Markham, Ontario, Canada
Trillium Health Partners-Missisauga Hospital
Mississauga, Ontario, Canada
Trillium Health Partners-Credit Valley Hospital
Mississauga, Ontario, Canada
Southlake Regional Health Centre
Newmarket, Ontario, Canada
North York General Hospital
North York, Ontario, Canada
Humber River Hospital
North York, Ontario, Canada
Lakeridge Health
Oshawa, Ontario, Canada
Mackenzie Health
Richmond Hill, Ontario, Canada
Scarborough Health Network-Centenary Hospital
Scarborough Village, Ontario, Canada
Scarborough Health Network-General Hospital
Scarborough Village, Ontario, Canada
Michael Garron Hospital
Toronto, Ontario, Canada
Sunnybrook Health Sciences Centre
Toronto, Ontario, Canada
Unity Health Toronto-St Michaels Hospital
Toronto, Ontario, Canada
Sinai Health System-Mount Sinai Hospital
Toronto, Ontario, Canada
The Hospital for Sick Children
Toronto, Ontario, Canada
University of Toronto
Toronto, Ontario, Canada
Unity Health Toronto-St Josephs Health Centre
Toronto, Ontario, Canada