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Lay Description

A randomized, blinded, controlled trial to evaluate growth velocity and clinical outcomes in infants with single ventricle physiology fed an exclusive human milk diet prior to, and throughout the post-operative period following, surgical repair. Human milk is defined as expressed human milk or donor milk and its derivatives, human milk-based fortifier and human milk caloric fortifier.

The study hypothesis is that infants fed an exclusive human milk diet will have short and long term benefits, with improved wound healing, growth, and neurodevelopmental outcomes while reducing episodes of feeding intolerance and necrotizing enterocolitis (NEC).

Category

  • Child Health
  • Nutrition
IRB Number
20150779HU
NCT Number
NCT02860702
Open to Enrollment
Yes

Eligibility

Eligible Ages
Under7 Days
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  1. Term infants (≥37 and 0/7 weeks gestational age) ≤ 7 days old with a diagnosis of single ventricle physiology who are thought to require a single ventricle repair at the time of enrollment.
  2. Infant feeding was NPO or consisted of 100% human milk diet prior to enrollment
  3. Parent(s) willing to sign informed consent.
  4. Parent(s) willing to comply with study follow-up procedures.
  5. Require surgical palliation within the first 1 month of life.

Exclusion Criteria

  1. Term infants >7 days old at the time of diagnosis.
  2. <37 weeks gestation
  3. Infants requiring cardio-pulmonary resuscitation prior to surgical repair.
  4. Outborn infants who received enteral nutrition at the other institution prior to surgical repair. If it is uncertain if infant received even 1 bottle or a small amount of formula, infants will be excluded.
  5. Major congenital abnormalities that could significantly affect survival such as:

    1. Confirmed or suspected major genetic abnormalities (lethal or with extremely low probability for survival).
    2. Chromosomal abnormalities: Trisomies (13, 18, 21 etc.) deletions or translocations (Turner/Williams Syndrome, DiGeorge, to name a few)
    3. Major organ system abnormalities not related to a genetic syndrome that are lethal or have extremely low probability for survival (i.e, bilateral kidney intrinsic disease, pulmonary hypoplasia, Central Nervous System (CNS) malformations: Arnold Chiari, myelomeningoceles, hydranencephaly, schizencephaly, holoprosencephaly))
    4. Heterotaxia
    5. Metabolic disorders affecting growth: homocystinuria, methylmalonic acidemias, propionic acidemias, urea cycle defects
  6. Evidence of intracerebral hemorrhage (IVH) ≥ Grade 3
  7. Any comorbidity or significant clinical event prior to enrollment, deemed by the Investigator as likely to affect survival.
  8. Requires Extracorporeal Membrane Oxygenation (ECMO) pre-operatively
  9. Legally Authorized Representative(s) unwilling to comply with an exclusive human milk diet either in the form of mother's milk, human milk-based human milk fortifier, human milk based caloric fortifier or donor human milk during the initial hospitalization period and through the 30 day feeding period after surgical repair or hospital discharge, whichever comes first.

Study Design

Arm Groups

Study Contact


Diana Anzueto Guerra
(210) 567-5225
anzuetod@uthscsa.edu

Principal Investigator
Cynthia Blanco