It has been observed that target fortification on different schedules leads to meal to meal variation. It changes the ratio of protein to energy and the percentage of carbohydrate to non-protein energy which may, affect growth. In the past, the investigators have analyzed the outcomes of breast milk composition when target fortification is done with different analysis schedules. The investigators were able to measure the macronutrient intake for different milk analysis schedules via a theoretical model and show that the more frequent schedules reduce the variation of fortified-breast milk, whereas a reduced schedule leads to a high variation of macronutrients. It was observed that, in all the breast milk samples measured twice per week, infants achieved on average the recommended macronutrients in line with current recommendations. Nonetheless, the model only looks at the macronutrient intake and does not investigates the relationship between macronutrient variation and its effect on growth. The aim of the current study is to compare a frequent schedule of measurement of macronutrient analysis with a reduced schedule of measurement and to study its affect on growth, protein accretion and metabolic parameter.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
56
Modular product supplementation is based on most recent breast analysis done for the participant.
Modular product supplementation is based on most recent breast analysis done for the participant.
Modular product supplementation is based on most recent breast analysis done for the participant.
Faculty of Health Science, McMaster Children's Hospital
Hamilton, Ontario, Canada
Growth during first three weeks of intervention
Time frame: first three weeks during intervention before 36 weeks of gestation
Daily Nutrient intake (kcal, lactose, protein, fat) measured with conventional milk analysis
Time frame: from inclusion at postmenstrual age <30 weeks until 36 weeks of gestation
Weight Gain
Time frame: from inclusion at postmenstrual age <30 weeks until 36 weeks of gestation or discharge
Oxidative stress by 8-Oxo-2'-deoxyguanosine metabolites in urine
Measured by mass spectroscopy
Time frame: from inclusion at postmenstrual age <30 weeks until discharge
Protein synthesis analyzed by nitrogen excretion in urine [µmol/mL]
Time frame: first three weeks during intervention before 36 weeks of gestation
Feeding intolerance questionaire
volume of gastric residuals, color of gastric residuals, vomiting, abdominal girth, abdominal distention
Time frame: from inclusion at postmenstrual age <30 weeks until discharge
Fat mass [g]
Measured with bioelectrical impedance analysis
Time frame: from inclusion at postmenstrual age <30 weeks until discharge
Lean mass [g]
Measured with bioelectrical impedance analysis
Time frame: from inclusion at postmenstrual age <30 weeks until discharge
Head circumference [cm]
Measured by tape
Time frame: from inclusion at postmenstrual age <30 weeks until discharge
Body length [cm]
Measured by length board
Time frame: from inclusion at postmenstrual age <30 weeks until discharge
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