Synbiotic Extensively Hydrolysed Feed Study

Nutricia UK Ltd35 enrolled

Overview

This study of the tolerance and acceptability of a extensively hydrolysed formula (eHF) containing pre- and probiotics will assess gastrointestinal (GI) tolerance, product intake and acceptability in 40 infants (aged \<13 months) currently using or requiring an extensively hydrolysed formula for the dietary management of CMA. Patients already prescribed an eHF (or other appropriate feed for CMA) at time of recruitment will undertake a 3 day baseline period in which their current symptoms, compliance, GI tolerance and acceptability towards their current feed is assessed, before introducing the study product for a period of 4 weeks. Patients who are not on an eHF (or other appropriate feed for CMA) at baseline will forgo this 3 day baseline period and immediately introduce the study product for 4 weeks.

Study Type

INTERVENTIONAL

Allocation

Purpose

SUPPORTIVE_CARE

Masking

NONE

Enrollment

Conditions

Cow Milk Allergy

Interventions

Eligibility

Sex: ALLMax age: 13 Months

Medical Language ↔ Plain English

Inclusion Criteria: * Aged \<13 months * Currently using or requiring an extensively hydrolysed formula for the dietary management of cows' milk allergy * Expected to receive at least 25% of their energy intake from the study feed * Already fed with infant formula or hypoallergenic formula (either partially or fully) * Written, informed consent from parent/carer Exclusion Criteria: * "Severe" cows' milk allergy (clinically judged to require an amino acid formula) or any other contraindications to the use of an extensively hydrolysed formula * Exclusively breastfed infants * Primary lactose intolerance * History of poor tolerance to whey based EHFs * Immunocompromised infants * Premature infants (born \<37 weeks) * Major hepatic or renal dysfunction * Requirement for any parenteral nutrition * Tube-fed via a post-pyloric route * Participation in other clinical intervention studies within 1 month of recruitment to this study * Investigator concern around the ability of family to comply with protocol and requirements of study

Locations (8)

Brighton and Sussex University Hospital NHS Foundation Trust

Brighton, United Kingdom

University Hospitals Bristol NHS Foundation Trust

Bristol, United Kingdom

Ashford and St Peter's Hospital NHS Foundation Trust

Chertsey, United Kingdom

Royal Surrey County Hospital NHS Foundation Trust

Guildford, United Kingdom

Guy's and St Thomas' NHS Foundation Trust

London, United Kingdom

The Rotherham NHS Foundation Trust

Rotherham, United Kingdom

university Hospitals Southampton NHS Foundation Trust

Southampton, United Kingdom

West Hertfordshire NHS Foundation Trust

Watford, United Kingdom

Outcomes

Primary Outcomes

Change in gastrointestinal tolerance from baseline to intervention day 28: questionnaire

Gastro-intestinal tolerance will be recorded by the parent on Baseline Days 1-3 (where this period is undertaken by the patient) and on Intervention Days 1, 2, 3, 7, 14, 21, 26, 27, and 28. Tolerance will be recorded using a standardised gastro-intestinal tolerance questionnaire, to be completed by the parents/carer

Time frame: 31 days

Secondary Outcomes

Compliance

Compliance with feed prescription will be assessed daily throughout the study by recording how much feed was received. The amount prescribed by the Dietitian will be recorded at the start of the study, and any changes to this prescription also noted. During the baseline period (where this is undertaken) the compliance of the patient's usual feed will be assessed.

Time frame: 31 days

Parent-reported Atopic Symptoms

Recorded via visual analogue scales at baseline and at the end of each week. Parents will record on a 100mm line the severity of a number of common atopic symtpoms, with the scale running from "not at all/none" at 0mm and "as bad as possible/

Time frame: 31 days

Food Allergy QOL - Parental burden questionnaire

Measured at baseline and at the end of study via a Food Allergy QOL - Parental Burden Questionnaire

Time frame: 31 days

Formula acceptability: Likert-style questionnaire

Feed acceptability will be assessed on Baseline Day 3 (for current feed, where applicable) and on the final day of the intervention period (Intervention day 28) via a Likert-style questionnaire

Time frame: 31 days

Nutrient intake

Nutrient intake, including the intake of all nutrition provided (including the study product, any other enteral tube feeding, foods, drinks etc.) will be recorded via a 24hr dietary recall, conducted by the Dietitian at the Baseline Visit and at the End of Study Visit.

Time frame: 31 days

Atopic dermatitis severity

Measured via Patient Orientated SCORing Atopic Dermatitis (PO-SCORAD) tool at Baseline, Intervention Day 7 and the final dat of the study

Time frame: 31 days

Change in weight

Weight will be measured at the start and end of the study in kg

Time frame: 31 days

Safety (Adverse Events)

Adverse events captured throughout entire study

Time frame: 31 days

Change in length (cm)

Length will be measured at the start and end of the study

Time frame: 31 days

Change in head circumference (cm)

Head circumference will be measured at the start and end of the study

Time frame: 31 days