Recombinant Human Prolactin for Lactation Induction

Lactation Clinical Trial

Official title:

Recombinant Human Prolactin for Lactation Induction in Mothers of Premature Infants

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00181610
• Other study ID #: 2001P001475
• Status: Completed
• Phase: Phase 2
• First received: September 9, 2005
• Last updated: December 31, 2017
• Start date: September 2004
• Est. completion date: September 2010

Study information

• Verified date: December 2017
• Source: Massachusetts General Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of the study is to assess the safety and determine the effects of the hormone prolactin on lactation (breast milk production).

Description:

The study is a randomized, double blind, placebo controlled trial. Subjects will be admitted to the General Clinical Research Center (GCRC) as outpatients to undergo their baseline pumping study. One lactation consultant will educate all subjects in the proper technique for pumping on the first day of the study and will evaluate their technique on day 5 and day 8 of the study. The lactation consultant will also instruct patients to record the volume of milk pumped and the time of each pumping episode. Subjects will be encouraged to have direct contact with their infants prior to pumping. All infant contact, infant latching onto the breast and mother's stress level will also be recorded throughout the study. Starting at 8 am on day 1, a hospital grade breast pump will be used to drain both breasts as confirmed by the absence of milk flow for 2 min during each episode of pumping and by palpation. Pumping will be performed in this manner every 3 hours around the clock. Subjects will be allowed a 5 hour window to sleep, however, as long as the total number of pumping episodes equals 8 in 24 hours.

During the first episode of pumping, a baseline prolactin level will be drawn immediately before the start of a pumping and repeated at 10 min intervals for 60 min, and then every 30 min for a total of 3 hours to document the peak prolactin level. An intravenous line will be placed to draw blood. Subsequently, subjects will be randomized to receive prolactin or placebo. On the morning of days 2, 5 and 8, blood will be collected for a prolactin level before medication injection. Subsequently, prolactin 60 mg/kg or placebo will be injected subcutaneously by the study nurse 3 hrs after the last pumping episode. On days 2 and 8, additional blood will be collected every 10 min for the first hour, every 30 min for hour 2 and 3, then at 4, 6 and 8 hours after injection to determine the peak prolactin level during a pumping session. Subjects will then drain both breasts as confirmed by the absence of milk flow for 2 min during each episode of pumping and by palpation and milk volume recorded. The subjects' vital signs will be monitored immediately before and every 15 minutes for 1 hr, every 30 min for hours 2 and 3, and then at 4, 6 and 8 hours after injection of prolactin/placebo. Temperature will be measured before the injection, every hour for hours 2 and 3, and then at 4, 6 and 8 hours after injection of placebo/prolactin. If there are no changes in vital signs, on days 5 and 8 vital signs will be monitored at baseline, only. Subjects will be taught to do SC injections on their own and will administer their second dose of SC r-hPRL or placebo 12 hours after the first dose. Subjects will continue every 12 hour SC r-hPRL or placebo administration for the next 7 days. Subjects will be asked to refrigerate all milk and bring it in to GCRC visits so that the volume that is recorded can be confirmed and for testing the milk composition and prolactin level before it is given to the infants. The final prolactin injection will be given on the evening of study day 8. All side effects in the mother and baby will be recorded daily throughout the study. Subjects will return for a final outpatient visit on day 16, to determine if any treatment effect persists. During this visit, milk will be pumped at baseline and volume recorded. In addition, blood will be drawn at 10 min intervals for 60 min, and then every 30 min for a total of 3 hours to document the peak prolactin level. Subjects will turn in their pumping diary the next day.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 11
• Est. completion date: September 2010
• Est. primary completion date: September 2010
• Accepts healthy volunteers: No
• Gender: Female
• Age group: 18 Years to 45 Years

Eligibility

Inclusion Criteria:

• Healthy women, aged 18-45 years

• Lactation insufficiency postpartum

• Subjects will be women with children in the neonatal Intensive Care Unit (ICU) who are pumping breast milk for their infant's nutritional support and to maintain their milk supply.

• Subjects will have given birth at a gestational age of at least 24 weeks, and will generally be recruited 4-8 weeks postpartum.

Exclusion Criteria:

• Medications known to increase prolactin

• Anatomical breast abnormalities

• Use of medication contraindicated in breastfeeding mothers

• Allergies to mannitol

• Current use of hormonal contraception

• Previous mammoplasty or breast augmentation, unless they have successfully nursed an infant for 3 months in the past without requiring supplemental formula.

Related Conditions & MeSH terms

• Lactation

Intervention

Drug:
• Recombinant Human Prolactin
60 mcg/kg every 12 hours

Biological:
• Recombinant human prolactin
60 mcg/kg given every 12 hours or every 24 hours
• Normal Saline
twice per day

Locations

Country	Name	City	State
United States	Massachusetts General Hospital	Boston	Massachusetts

Sponsors (1)

Lead Sponsor	Collaborator
Massachusetts General Hospital

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in Breast Milk Volume Baseline to 7 Days		7 days
Secondary	Breast Milk Prolactin Levels		7 days