Human milk oligosaccharides (HMOs) represent the third largest solid component of breast milk. Technology advancements made it possible to supplement infant formulas with HMOs (2'FL, LNnT). Two published RCTs have demonstrated that infant formulas supplemented with 2'FL or 2'FL+LNnT are safe, well-tolerated, support normal grow, and may support healthy GI function and confer immune benefits. The performance of HMOs-supplemented formulas assessed in a real-world setting is complementary to previously conducted RCTs conducted in highly controlled clinical settings. Main objectives will be to monitor the safety \& tolerance of HMOs-supplemented formulas in larger and diverse infant populations; to assess the performance of HMOs-supplemented formulas in mixed-fed infants, a population that was not studied in previous RCTs but likely represents a relatively common feeding regimen. Finally, considering the potential health/immune benefits of HMOs, it is also important explore the incidences of illnesses (i.e., respiratory illnesses, GI illnesses, and fever) associated with consuming HMOs-supplemented formulas and compare with breastfed infants data.
Objectives: The main objective of this study is to document the growth and feeding tolerance of healthy term infants consuming an infant formula supplemented with HMOs for 8 weeks (56 days), in a real-world setting. Main endpoints: 1. Growth documented via monitoring the anthropometric parameters including weight, length, head circumference, BMI and their corresponding z-scores (i.e., z-scores for weight-for-age, length-for-age, weight-for-length, head circumference-for-age, and BMI-for-age) calculated using the 2006 WHO Growth Standards 2. Feeding tolerance assessed via monitoring parent-reported overall GI symptom burden measured by the Infant Gastrointestinal Symptom Questionnaire (IGSQ) index score (13-item summary score) Additional objectives: To describe the following outcomes in infants fed an infant formula supplemented with HMOs: 1. Formula acceptability 2. Despite there are no expected safety concerns, standard Adverse Events (AEs) monitoring will be implemented during the study Additional endpoints: 1. Formula acceptability assessed by the Study Formula Satisfaction Questionnaire 2. Reported AEs and Serious Adverse Events (SAEs) including type, incidence, severity, seriousness and relation to study formula consumption as well as concomitant medications and non-pharmacological treatments. * Select morbidities of interest (i.e., respiratory illnesses, GI illnesses, and fever) will be collected as part of AE reporting and specific corresponding AE guidance forms will be used to standardize reporting of such AEs Trial design: Uncontrolled, single arm, open-label, prospective study in infants (enrolled at postnatal age 7 days to 2 months) fed the study formula for 8 weeks (56 days) A group of exclusively breastfed infants (BF) will serve as a reference group in parallel to the study arm. For the BF group, Infants must have been exclusively consuming breast milk since birth, and their parent(s) must have made the decision to continue exclusively breastfeeding until at least 4 month of age Trial population: Healthy, male and female, term infants, 7 days postnatal age to 2 months of age at the enrollment Treatment duration: Total study participation/intervention up to approximately 8 weeks
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
207
Starter Infant Formula supplemented with 1.5g/L of Human Milk Oligosaccharides
Vitha Santa Catalina Hospital
Las Palmas de Gran Canaria, Canary Islands, Spain
Hospital Maternal MH Belén
A Coruña, Galicia, Spain
Universitary Hospital Quirón-Dexeus
Barcelona, Spain
Ruber Internacional Clinic
Madrid, Spain
Hispalense Group
Seville, Spain
Casa de la Salud, Hospital
Valencia, Spain
World Health Organization (WHO) based weight-for-age z-scores
Weight-for-age z-scores using WHO growth standards
Time frame: 8 weeks (study end)
World Health Organization (WHO) based length-for-age z-scores
Length-for-age z-scores using WHO growth standards
Time frame: 8 weeks (study end)
World Health Organization (WHO) weight-for-length z-scores
Weight-for-length z-scores using WHO growth standards
Time frame: 8 weeks (study end)
World Health Organization (WHO) head-circumference-for-age z-scores
head-circumference-for-age z-scores using WHO growth standards
Time frame: 8 weeks (study end)
World Health Organization (WHO) based body-mass-index (BMI)-for-age z-scores
Weight and height will be combined to calculate BMI in kg/m\^2, then BMI-for-age z-scores will be derived using WHO growth standards
Time frame: 8 weeks (study end)
Feeding tolerance
The Infant Gastrointestinal Symptom Questionnaire (IGSQ) index score will be used to assess GI distress. This is a validated 13-item questionnaire where each item is scored on a scale of 1 to 5 with higher values indicating greater GI distress. A composite IGSQ score is derived from summing the individual scores with a possible range of 13 to 65 where higher values indicate greater GI distress and values ≤23 indicate no digestive distress.
Time frame: 4 weeks (study midpoint)
Feeding tolerance
The Infant Gastrointestinal Symptom Questionnaire (IGSQ) index score will be used to assess GI distress. This is a validated 13-item questionnaire where each item is scored on a scale of 1 to 5 with higher values indicating greater GI distress. A composite IGSQ score is derived from summing the individual scores with a possible range of 13 to 65 where higher values indicate greater GI distress and values ≤23 indicate no digestive distress.
Time frame: 8 weeks (study end)
Formula acceptability
Study Formula Satisfaction Questionnaire
Time frame: 4 weeks (study midpoint), 8 weeks (study end)
Standard adverse events (AEs) reporting for safety assessment
Reported adverse events (AEs) and Serious Adverse Events (SAEs) include type, incidence, severity, seriousness and relation to feeding
Time frame: From the time the informed consent form has been signed at enrollment infant age less than 7 days to 2 months through the 8 weeks of intervention
Weight
Weight measurements in grams
Time frame: 8 weeks (study end)
Length
Length measurements in centimeters
Time frame: 8 weeks (study end)
Head circumference
Head circumference measurements in centimeters
Time frame: 8 weeks (study end)
Body-mass-index (BMI)
Weight and height will be combined to report BMI in kg/m\^2
Time frame: 8 weeks (study end)
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