This is a double-blind, randomized, placebo-controlled nutritional study of healthy term infants. The primary objective of the trial is to demonstrate a favorable change in fecal microbiome composition in infants receiving a dietary supplement compared to infants receiving a placebo supplement.
This is a double-blind, randomized, placebo-controlled nutritional study of healthy term infants, consisting of 2 randomized parallel arms: experimental group (EG) receiving a dietary supplement and a control group (CG) receiving a placebo supplement. The population under investigation is healthy infants aged 5 months +/- 1 week at the time of clinic visit 1. The planned sample size for this study is 172 infants (86 per study group). Each investigational product (EG and CG) will be provided in powder form and packaged in single dose stick packs. The powder will be dissolved in lukewarm formula or body temperature breastmilk and fed orally to the infants using a provided infant feeding beaker. The primary objective of the trial is to demonstrate a favorable change in fecal microbiome composition in infants receiving a dietary supplement compared to infants receiving a placebo supplement from enrolment until 5 months of intervention. In addition, fecal metabolic biomarkers, gastrointestinal (GI) related outcomes, blood markers of immune health, fecal markers of gut and immune health, bone quality, other anthropometric measurements, dietary pattern and infant illness and infection outcomes will be assessed/measured.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
QUADRUPLE
Enrollment
172
Dietary supplement in powder form
Placebo dietary supplement in powder form
Probiotic abundance
Fecal probiotic abundance
Time frame: At 5 months (V4) of intervention
Fecal metabolic biomarker
To assess changes in key fecal metabolic biomarkers such as fecal water-soluble vitamins, fecal organic acids, and other fecal metabolites.
Time frame: At baseline (V1), 3 months (V3), and 5 months (V4) of intervention.
Growth parameter: Weight
Weight in grams and corresponding weight-for-age Z-score according to WHO growth standards
Time frame: At baseline (V1), 1 month (V2), 3 months (V3), and 5 months (V4) of intervention.
Growth parameter: Length
Length in cm and corresponding weight-for-age Z-score according to WHO growth standards
Time frame: At baseline (V1), 1 month (V2), 3 months (V3) and 5 months (V4) of intervention.
Growth parameter: Head circumference
Head circumference in cm and corresponding head circumference-for-age Z-score according to WHO growth standards
Time frame: At baseline (V1), 1 month (V2), 3 months (V3) and 5 months (V4) of intervention.
GI-related Behavior: Infant Gastrointestinal Symptom Questionnaire (IGSQ)
The questionnaire is composed of 13 questions, categorized into 5 symptom domains of stooling, vomiting/spitting-up, crying, fussiness, and flatulence. The total score can range from 13 to 65 with lower scores indicating lower GI symptom burden.
Time frame: At baseline (V1), 1 month (V2), 3 months (V3) and 5 months (V4) of intervention.
GI-related behavior: Stool frequency
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Stool frequency recorded via the GI Symptom and Behavior Diary
Time frame: 1-day retrospective (V1) and 3-day prospective (V2, V3 and V4) of intervention
GI-related behavior: Stool consistency
Stool consistency recorded on a 5-point scale (1: watery, 5: hard) via the GI Symptom and Behavior Diary
Time frame: 1-day retrospective (V1) and 3-day prospective (V2, V3 and V4) of intervention
GI-related behavior: Crying and sleeping
Crying and sleeping time via the GI Symptom and Behavior Diary
Time frame: 1-day retrospective (V1) and 3-day prospective (V2, V3 and V4) of intervention
Fecal microbiota
Overall fecal microbiota composition, diversity, and function.
Time frame: At baseline (V1), 1 month (V2), 3 months (V3), and 5 months (V4) of intervention.
Bone quality
Tibia bone transmission time and speed of sound. Tibia length assessed using a measuring tape.
Time frame: At baseline (V1), 3 months (V3), and 5 months (V4) of intervention.
Dietary intake: Food record
Dietary intake using a 3-day food record completed at home
Time frame: 3 consecutive days prior to study visit 3 (age 8 months) and visit 4 (age 10 months)
Dietary intake: Complementary foods
Exact timing of the introduction of different types of complementary foods assessed using the Complementary Food Questionnaire
Time frame: Questionnaire to be completed prospectively starting at age 6 months
Dietary intake: Formula Composition
Key aspects of formula composition assessed using a questionnaire at each study visit for formula-fed infants (exclusively or mixed-fed).
Time frame: At baseline (V1), 1 month (V2), 3 months (V3), and 5 months (V4) of intervention.
Fecal markers of gut and immune health: Formula-fed infants only
Fecal markers of gut and immune health such as total secretory IgA (sIgA)
Time frame: At 1 month (V2), 3 months (V3), and 5 months (V4) of intervention in exclusively formula-fed infants only.
Fecal markers of gut and immune health: All infants
Fecal markers of gut and immune health such as fecal pH, fecal calprotectin, fecal α-1-antitrypsin, oral vaccine-specific fecal antibodies.
Time frame: At baseline (V1), 1 month (V2), 3 months (V3), and 5 months (V4) of intervention in all infants.
Blood biomarkers
Blood biomarkers such as immunotyping, plasma immune proteomics, metabolic and anabolic biomarkers, plasma metabolomics, vaccine-specific antibodies, plasma short-chain fatty acids.
Time frame: At baseline (V1), 3 months (V3), and 5 months (V4) of intervention.
Neurodevelopment: National Institute of Health (NIH) Baby Toolbox
To assess different aspects of infant neurodevelopment
Time frame: At 5 months (V4) of intervention
Neurodevelopment: Heart rate variability
Heart rate variability will be assessed using a simple, non-invasive sensor.
Time frame: Assessed for 24 hours at home after baseline (V1), 3 months (V3), and 5 months (V4) of intervention.