Fact-based Nutrition for Infants and Lactating Mothers

Prematurity Clinical Trial

— NUTRISHIELD  

Official title:

Fact-based Nutrition for Infants and Lactating Mothers - The NUTRISHIELD Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05646940
• Other study ID #: 818110
• Status: Completed
• Start date: October 1, 2020
• Est. completion date: December 31, 2023

Study information

• Verified date: March 2024
• Source: Instituto de Investigacion Sanitaria La Fe
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Human milk (HM) is the ideal source of nutrients for infants, but its composition is highly variable. When not enough own mother's milk (OMM) is available, the administration of pasteurized donor human milk (DHM) is considered the best alternative for feeding preterm infants (PI). The aim of this study is to evaluate the influence of diet, lifestyle habits, psychological stress, and pasteurization on the milk composition, and how it modulates infant's growth, health, and development. NUTRISHIELD is a prospective mother-infant birth cohort in the Spanish-Mediterranean area including three groups: PI <32 weeks of gestation (i) exclusively receiving OMM (i.e., >80% v/v of total intake), and (ii) exclusively receiving DHM, and (iii) term infants (TI) exclusively receiving OMM, as well as their mothers, and HM donors. Biological samples and nutritional, clinical, and anthropometric characteristics are collected at six time points covering the period from birth and until six months of infant's age (complete enteral nutrition (CEN) / recovery birth weight (RBW), and one, two, three, and six months). An additional assessment at two years (corrected age for PI) is conducted, in order to study long-term effects on neurodevelopment.

Description:

The genotype, metabolome, and microbiota as well as the HM composition (i.e., macronutrients, fatty acids, vitamins, human milk oligosaccharides, and steroids) are characterized. Portable sensor prototypes for the analysis of HM and urine are benchmarked. Additionally, maternal psychosocial status is measured at the beginning of the study and at month six, including social support, family functioning, perceived stress, anxiety, and depression symptoms, and traumatic life events. Mother-infant postpartum bonding and parental stress is also examined. At six months (corrected age for preterm groups), infant neurodevelopment scales are applied. Mother's concerns and attitudes to breastfeeding are also registered through a specific questionnaire at CEN/RBW and six months. An additional assessment at two years (corrected age for PI) is conducted, in order to study long-term effects on neurodevelopment. Current knowledge on the importance of diet and other environmental factors for infant growth, health, and development is limited and donor-matching at HM banks is frequently only based on gestational age and total protein content of HM. NUTRISHIELD provides an in-depth longitudinal study of the mother-infant-microbiota triad combining multiple biological matrices, newly developed analytical methods, and ad-hoc designed sensor prototypes with a wide range of clinical outcome measures. Data obtained from this study will be used to train a machine-learning algorithm for providing dietary advice to lactating mothers and will be implemented in a user-friendly platform based on a combination of user-provided information and biomarker analysis. A better understanding of the factors affecting the milk's composition, together with the health implications for infants plays an important role in developing improved strategies of nutraceutical management in infant care.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 86
• Est. completion date: December 31, 2023
• Est. primary completion date: July 31, 2022
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• Acceptance of the mother to participate and sign an informed consent form
• A gestational age < 32 weeks for the group of PI and > 37 weeks for the group of TI
• Exclusive consumption (i.e., >80% v/v of total intake) of either OMM or DHM.

Exclusion Criteria:

• Non-compliance with any of the inclusion criteria
• The requirement of a special diet for the mother (e.g., celiac disease, diabetes) or maternal consumption of probiotics
• The need of intestinal surgery, severe congenital malformations, or chromosomopathies of the infant
• Mother's residence outside the Valencian Community
• Severe language barriers hampering the collection of necessary data from mothers not speaking Spanish and/or English

Related Conditions & MeSH terms

• Premature Birth
• Prematurity

Locations

Country	Name	City	State
Spain	Instituto de Investigación Sanitaria La Fe	Valencia

Sponsors (1)

Lead Sponsor	Collaborator
Instituto de Investigacion Sanitaria La Fe

Country where clinical trial is conducted

Spain, 

References & Publications (10)

Akhgar CK, Nurnberger V, Nadvornik M, Ramos-Garcia V, Ten-Domenech I, Kuligowski J, Schwaighofer A, Rosenberg E, Lendl B. Fatty Acid Determination in Human Milk Using Attenuated Total Reflection Infrared Spectroscopy and Solvent-Free Lipid Separation. App — View Citation

Pineiro-Ramos JD, Parra-Llorca A, Ten-Domenech I, Gormaz M, Ramon-Beltran A, Cernada M, Quintas G, Collado MC, Kuligowski J, Vento M. Effect of donor human milk on host-gut microbiota and metabolic interactions in preterm infants. Clin Nutr. 2021 Mar;40(3):1296-1309. doi: 10.1016/j.clnu.2020.08.013. Epub 2020 Aug 19. — View Citation

Poulimeneas D, Bathrellou E, Antonogeorgos G, Mamalaki E, Kouvari M, Kuligowski J, Gormaz M, Panagiotakos DB, Yannakoulia M; NUTRISHIELD Consortium. Feeding the preterm infant: an overview of the evidence. Int J Food Sci Nutr. 2021 Feb;72(1):4-13. doi: 10.1080/09637486.2020.1754352. Epub 2020 Apr 27. — View Citation

Ramos-Garcia V, Ten-Domenech I, Albiach-Delgado A, Gomez-Ferrer M, Sepulveda P, Parra-Llorca A, Campos-Berga L, Moreno-Gimenez A, Quintas G, Kuligowski J. Isolation and Lipidomic Screening of Human Milk Extracellular Vesicles. Methods Mol Biol. 2023;2571:177-188. doi: 10.1007/978-1-0716-2699-3_18. — View Citation

Ramos-Garcia V, Ten-Domenech I, Moreno-Gimenez A, Campos-Berga L, Parra-Llorca A, Gormaz M, Vento M, Karipidou M, Poulimeneas D, Mamalaki E, Bathrellou E, Kuligowski J. Joint Microbiota Activity and Dietary Assessment through Urinary Biomarkers by LC-MS/M — View Citation

Ramos-Garcia V, Ten-Domenech I, Moreno-Gimenez A, Campos-Berga L, Parra-Llorca A, Ramon-Beltran A, Vaya MJ, Mohareb F, Molitor C, Refinetti P, Silva A, Rodrigues LA, Rezzi S, Hodgson ACC, Canarelli S, Bathrellou E, Mamalaki E, Karipidou M, Poulimeneas D, — View Citation

Ramos-Garcia V, Ten-Domenech I, Moreno-Gimenez A, Campos-Berga L, Parra-Llorca A, Solaz-Garcia A, Lara-Canton I, Pinilla-Gonzalez A, Gormaz M, Vento M, Kuligowski J, Quintas G. GC-MS analysis of short chain fatty acids and branched chain amino acids in ur — View Citation

Ramos-Garcia V, Ten-Domenech I, Vento M, Bullich-Vilarrubias C, Romani-Perez M, Sanz Y, Nobili A, Falcone M, Di Stefano M, Quintas G, Kuligowski J. Fast profiling of primary, secondary, conjugated, and sulfated bile acids in human urine and murine feces samples. Anal Bioanal Chem. 2023 Aug;415(20):4961-4971. doi: 10.1007/s00216-023-04802-8. Epub 2023 Jun 20. — View Citation

Ten-Domenech I, Ramos-Garcia V, Moreno-Torres M, Parra-Llorca A, Gormaz M, Vento M, Kuligowski J, Quintas G. The effect of Holder pasteurization on the lipid and metabolite composition of human milk. Food Chem. 2022 Aug 1;384:132581. doi: 10.1016/j.foodchem.2022.132581. Epub 2022 Feb 26. — View Citation

Ten-Domenech I, Ramos-Garcia V, Pineiro-Ramos JD, Gormaz M, Parra-Llorca A, Vento M, Kuligowski J, Quintas G. Current Practice in Untargeted Human Milk Metabolomics. Metabolites. 2020 Jan 22;10(2):43. doi: 10.3390/metabo10020043. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Maternal nutrition and HM composition	Evaluate associations between the mother's diet and HM composition in PI and TI (i.e., how the potential association between mother's diet and HM nutrient composition is affected by prematurity), and between HM composition and mother's physical and psychosocial status (e.g., lifestyle, perceived stress, anxiety and depression)	From birth to 6 months
Primary	HM pasteurization	To evaluate the effect of pasteurization/storage on DHM composition	Up to 6 months
Primary	Infants' health	To evaluate associations between HM composition (OMM or DHM) on growth and other health parameters in PI and TI	From birth to month 24