Clinical Research Directory

The Use of Early Fortification in Preterm Infants

Very premature or very low birth weight (VLBW) infants are at risk of suboptimal growth after birth, making adequate nutrition essential. Breast milk alone is insufficient to meet the nutritional needs of premature infants, so fortification is added to breast milk to support catch-up growth. Standard human milk fortification (HMF) is typically started when the feeding volume reaches 100 ml/kg/day, but research suggests that early HMF administration can increase protein intake sooner without negative effects on the infant. Early HMF administration didn't increase the incidence of food intolerance and necrotizing enterocolitis (NEC). Other studies have shown that early fortification increases the rate of early weight gain without increasing the incidence of complications. There is no research in Indonesia comparing the duration of regaining birth weight between early HMF and standard HMF. This study aims to determine the difference in the duration of regaining birth weight in very premature or VLBW infants given early HMF versus standard HMF. The research method is a prospective, randomized, double-blind preliminary study comparing early HMF administration (when feeding volume reached 30 ml/kg/day) with standard HMF (when feeding volume reached 100 ml/kg/day).

The Video System to Provide a Developmental Training Guide for Preterm Infants

This study aimed to establish a systematic developmental training guide protocol for parent-centered early intervention and verify the concept and feasibility of a video system for parent-centered in-home developmental therapy under the monitoring of a therapist. The target group is premature infants under 32 weeks of gestation or very low birth weight infants under 1500 g with brain damage. A single-arm intervention group of 10 people was recruited, and considering a dropout rate of 20%, the total number of participants was calculated to be 12. 1:1 monitoring to provide parent-centered early intervention at home after discharge from the neonatal intensive care unit is conducted twice a week for 30 minutes per session using a video platform (Zoom) until the corrected age of 6 months. Parents record the developmental training process using a smartphone and transmit it to the therapist, who analyzes the video data to provide new treatment goals and guidelines. Feasibility assessment included: 1) Exercise diary: Number of total and average sessions performed (N) and percentage (%), number of total and average sessions completed (N) and percentage (%) 2) Parent questionnaire 3) Video analysis: Periodic video education and developmental training video acquisition and analysis 4) Heart rate analysis: Analysis of average heart rate during and after rest and developmental training 5) Safety analysis: Number of times (N) and reasons for exercise interruption during developmental training 6) Developmental assessment: Implementation of developmental assessments such as GMOS, MOS-R, HINE, GMFM, and BSID. For safety assessment, if the following symptoms appear during development training, stop exercising and rest until stable. If oxygen saturation drops by more than 10% compared to resting, causing cyanosis and dyspnea, or if heart rate increases by more than 150 beats/min.