NCT06870981

Brief Summary

Early nutrition critically influences growth, neurodevelopment and morbidity among infants born of very low birth weight (VLBW), but current one-size-fits-all feeding regimes do not optimally support these vulnerable infants. There is increasing interest in "precision nutrition" approaches, but it is unclear which Human Milk (HM) components require personalized adjustment of doses. Previous efforts have focused on macronutrients, but HM also contains essential micronutrients as well as non-nutrient bioactive components that shape the gut microbiome. Further, it is unclear if or how parental factors (e.g. body mass index, diet) and infant factors (e.g. genetics, gut microbiota, sex, acuity) influence relationships between early nutrition and growth, neurodevelopment and morbidity. Understanding these complex relationships is paramount to developing effective personalized HM feeding strategies for VLBW infants. This is the overarching goal of the proposed Optimizing Nutrition and Milk (Opti-NuM) Project. The Opti-NuM Project brings together two established research platforms with complementary expertise and resources: 1) the MaxiMoM Program\* with its clinically embedded translational neonatal feeding trial network in Toronto (Dr. Deborah O'Connor, Dr. Sharon Unger) and 2) the International Milk Composition (IMiC) Consortium, a world-renowned multidisciplinary network of HM researchers and data scientists collaborating to understand how the myriad of HM components contribute "as a whole" to infant growth and development, using systems biology and machine learning approaches. Members of the IMiC Corsortium that will work with on this study are located at the University of Manitoba (Dr. Meghan Azad), University of California (Dr. Lars Bode) and Stanford (Dr. Nima Aghaeepour).

Trial Health

80
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,100

participants targeted

Target at P75+ for all trials

Timeline
19mo left

Started Oct 2010

Longer than P75 for all trials

Geographic Reach
2 countries

6 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress91%
Oct 2010Dec 2027

Study Start

First participant enrolled

October 1, 2010

Completed
14.4 years until next milestone

First Submitted

Initial submission to the registry

February 3, 2025

Completed
1 month until next milestone

First Posted

Study publicly available on registry

March 11, 2025

Completed
1.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2026

Expected
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2027

Last Updated

March 11, 2025

Status Verified

March 1, 2025

Enrollment Period

16.2 years

First QC Date

February 3, 2025

Last Update Submit

March 6, 2025

Conditions

Keywords

Very Low Birth Weight InfantsEarly nutrition and the preterm infantHuman milk feeding

Outcome Measures

Primary Outcomes (1)

  • Cognitive composite score on the Bayley Scales of Infant and Toddler Development.

    Our primary outcome is the cognitive composite score on the Bayley Scales of Infant and Toddler Development collected from the medical record or by home-visit by our research staff. The Bayley is the most widely used instrument globally by clinicians and researchers to assess developmental functioning of infants, toddlers and young children across cognitive, language (receptive, expressive) and motor (fine, gross) domains. Cognitive, language and motor composite scores will be standardized to a mean of 100 with a standard deviation of 15. The range on the composite Bayle Scores is from less than 0.1 to more than 99.9 percentile. A score lower than the 10th percentile indicates developmental delay.

    At 18-24 months CA

Secondary Outcomes (6)

  • Language composite score from the Bayley Scales of Infant and Toddler Development

    At 18-24 months CA

  • Motor composite score from the Bayley Scales of Infant and Toddler Development

    At 18-24 months CA

  • Weight (g)

    Initial hospitalization, approximately 50 days; at 4 months and 18-24 months CA clinic visit.

  • Length (cm)

    Initial hospitalization, approximately 50 days; at 4 months and 18-24 months CA clinic visit.

  • Head circumference (cm)

    Initial hospitalization, approximately 50 days; at 4 months and 18-24 months CA clinic visit.

  • +1 more secondary outcomes

Study Arms (1)

Participants of the MaxiMoM Platform Trials

Secondary data use and biospecimens from participants of the MaxiMoM Platform Trials are infants born 1500g or less (infant weight), born in the Greater Toronto Area.

Other: Opti-NuM is an observational secondary use of data/samples study, the investigators will analyze information and specimens from the MaxiMoM platform RCTs. No interventions form part of this study.

Interventions

Eligibility Criteria

Age1 Hour - 21 Days
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)
Sampling MethodNon-Probability Sample
Study Population

Very Low Birth Weight infants

You may qualify if:

  • Secondary data and biospecimens from participants of the MaxiMoM Platform RCTs

You may not qualify if:

  • Data and biospecimens from infants who are not enrolled in the three trials are eligible for this project.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (6)

Stanford University

Palo Alto, California, 94304-1212, United States

ACTIVE NOT RECRUITING

University of California - San Diego

San Diego, California, 92093-0715, United States

ACTIVE NOT RECRUITING

University of Manitoba

Winnipeg, Manitoba, R3E 3P4, Canada

ACTIVE NOT RECRUITING

Sunnybrook Health Sciences Centre

Toronto, Ontario, M4N 3M5, Canada

RECRUITING

The Hospital for Sick Children

Toronto, Ontario, M5G 0A4, Canada

ACTIVE NOT RECRUITING

Mount Sinai Hospital

Toronto, Ontario, M5G 1X5, Canada

RECRUITING

Related Publications (2)

  • O'Connor DL, Kiss A, Tomlinson C, Bando N, Bayliss A, Campbell DM, Daneman A, Francis J, Kotsopoulos K, Shah PS, Vaz S, Williams B, Unger S; OptiMoM Feeding Group. Nutrient enrichment of human milk with human and bovine milk-based fortifiers for infants born weighing <1250 g: a randomized clinical trial. Am J Clin Nutr. 2018 Jul 1;108(1):108-116. doi: 10.1093/ajcn/nqy067.

    PMID: 29878061BACKGROUND
  • O'Connor DL, Gibbins S, Kiss A, Bando N, Brennan-Donnan J, Ng E, Campbell DM, Vaz S, Fusch C, Asztalos E, Church P, Kelly E, Ly L, Daneman A, Unger S; GTA DoMINO Feeding Group. Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial. JAMA. 2016 Nov 8;316(18):1897-1905. doi: 10.1001/jama.2016.16144.

    PMID: 27825008BACKGROUND

Related Links

Biospecimen

Retention: SAMPLES WITH DNA

1. Human milk 2. Stool 3. Residual plasma 4. Buccal cells

Study Officials

  • Deborah L O'Connor, PhD, RN

    The Hospital for Sick Children

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Dubraiicka Pichardo, MSc

CONTACT

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
RETROSPECTIVE
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Senior Associate Scientist

Study Record Dates

First Submitted

February 3, 2025

First Posted

March 11, 2025

Study Start

October 1, 2010

Primary Completion (Estimated)

December 1, 2026

Study Completion (Estimated)

December 1, 2027

Last Updated

March 11, 2025

Record last verified: 2025-03

Data Sharing

IPD Sharing
Will share

Data transfer will take place via Secure File Transfer Protocol (SFTP). Sub-agreements which cover data and sample sharing and confidentiality is in place.

Shared Documents
STUDY PROTOCOL, SAP, ANALYTIC CODE
Time Frame
December 2024 to December 2027
Access Criteria
During the Opti-NuM project the following institutions will be involved in data and sample analysis as indicated. Data sharing will take place through SFTP, bio specimens will be shipped for analyses. * The Hospital for Sick Children (Lead, Deborah O'Connor PhD RD): Both data and sample analysis * The University of Toronto (Lead, Deborah O'Connor PhD RD): Both data and sample analysis * The University of Manitoba (Lead, Meghan Azad PhD): Data analysis; No sample analysis * Stanford University (Lead, Nima Aghaeepour PhD): Data analysis; No sample analysis * University of California (Lead, Lars Bode PhD): Oligosaccharide analysis of human milk samples only. No data provided to this site.

Locations