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Trial registered on ANZCTR
Registration number
ACTRN12606000525583
Ethics application status
Approved
Date submitted
19/12/2006
Date registered
20/12/2006
Date last updated
16/11/2015
Type of registration
Retrospectively registered
Titles & IDs
Public title
Protein in Preterm Infant Nutrition (PiPIN)
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Scientific title
A randomised controlled trial on the effects of increasing the protein content of Human Milk Fortifier on growth in preterm infants <31 weeks.
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Secondary ID [1]
287898
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nil known
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Universal Trial Number (UTN)
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Trial acronym
PiPIN
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Preterm infant < 31 weeks
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Condition category
Condition code
Reproductive Health and Childbirth
1597
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0
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Childbirth and postnatal care
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Both the intervention and control group will receive Human Milk Fortifier added to expressed breast milk (EBM) at the rate of 5g fortifier per 100ml EBM. This dose is added to all their breast milk feeds which may be administered as continuous perfusion feeds or one, two or three hourly bolus feeds. The route of administration is oral, usual via a nasogastric tube or sometimes by bottle. The intervention group receives fortifier containing 1.4g protein per 5g. Duration of the treatment is the length of time that fortified human milk is clinically indicated and varies between participants depending on their clinical course. The usual length of the intervention is from the time the infant achieves an enteral intake of 80 - 100ml/kg to the time the infant is graded onto direct sucking feeds from the breast.
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Intervention code [1]
1326
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Treatment: Other
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Comparator / control treatment
The control group receives standard fortifier containing 1g protein per 5g
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Control group
Dose comparison
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Outcomes
Primary outcome [1]
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Linear growth (increase in recumbent length)
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Assessment method [1]
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Timepoint [1]
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Weekly, & Discharge (D/C) or Estimated Date of Delivery (EDD)
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Secondary outcome [1]
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Weight gain: grams
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Assessment method [1]
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Timepoint [1]
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Daily, D/C or EDD
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Secondary outcome [2]
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Head circumference: centimetres
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Assessment method [2]
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Timepoint [2]
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Weekly, D/C or EDD
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Secondary outcome [3]
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Body composition: Bioelectrical Impedance Spectroscopy
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Assessment method [3]
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Timepoint [3]
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Fortnightly D/C or EDD
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Secondary outcome [4]
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Serum albumin, Urea, total protein, electrolytes, acid base
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Assessment method [4]
3843
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Timepoint [4]
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Weekly, D/C or EDD
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Secondary outcome [5]
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Amino acid profile (blood & urine): tandem mass spectroscopy
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Assessment method [5]
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Timepoint [5]
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Weekly, weekly & D/C or EDD
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Eligibility
Key inclusion criteria
Infants born <31 weeks gestation at Women's & Children's Hospital Adelaide who are receiving breast milk.
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Minimum age
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Years
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Maximum age
3
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Infants with major congenital or chromosomal abnormalities which are known to affect growth such as major heart defects, cystic fibrosis.Infants where a high protein intake is contraindicated such as Phenylketonuria, disorders of the urea cycle.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Randomisation done by an independent researcher at CNRC using blocked computer generated random numbers. Stratified for gender and gestational age (<28 week, 28 - 30 weeks). Randomisation was implanted via the study product. Tins of fortifier were assigned a number (as above) and placed in 1 of 4 boxes according to stratification. ON recruitment, the researcher went to the appropriate box and took the next sequentially numbered tins.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Blocked computer generated random numbers. Stratified for gender and gestational age (<28 weeks, 28 - 30 weeks)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
Partipants, clinicians, assessors and data analyst are blinded to the intervention
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Phase
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
25/10/2006
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Actual
25/10/2006
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Date of last participant enrolment
Anticipated
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Actual
3/03/2008
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
90
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Accrual to date
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Final
92
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Recruitment in Australia
Recruitment state(s)
SA
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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MS McLeod PhD Scholarship, Women's and Children's Hospital, Adelaide University PhD Divisional Scholarship
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Address [1]
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Women's and Children's Hospital, King William St North Adelaide & The University of Adelaide, North Terrace Adelaide
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Country [1]
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Australia
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Funding source category [2]
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Other
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Name [2]
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Denis Harwood Grant-in-Aid
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Address [2]
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C/- Women's and Children's Health Research Institute, Women's and Children's Hospital, North Adelaide
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Country [2]
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Australia
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Primary sponsor type
Individual
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Name
Associate Professor Maria Makrides, Child Nutrition Research Centre
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Address
Child Nutrition Research Centre
Children's Youth and Women's Health Service
King William St
North Adelaide South Australia
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Jacqueline Miller
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Address [1]
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Child Nutrition Research Centre,
L4, Flinders Medical Centre,
Bedford Park
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Women's and Children's Hospital
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Ethics committee address [1]
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Adelaide
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
3219
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Approval date [1]
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20/12/2005
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Ethics approval number [1]
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REC1774/12/08
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Summary
Brief summary
Breast milk is best for babies but is inadequate for very preterm infants without fortification with protein and some bone minerals. Currently, all breast milk for very preterm infants is fortified with a 'Human Milk Fortifier' but we're un-sure of the optimum level of protein that should be in the fortifier. This trial aims to determine if a higher level of protein added to fortifier will help preterm infants to grow better.
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Trial website
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Trial related presentations / publications
J Miller, M Makrides, RA Gibson, AJ McPhee, TE Stanford, S Morris, P Ryan, and CT Collins. Effect of increasing the protein content of human milk fortifier on growth in preterm infants born less than 31 wk gestation: a randomized controlled trial. Am J Clin Nutr 2012 95 (3)
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Public notes
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Contacts
Principal investigator
Name
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Dr Jacqui Miller
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Address
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Nutrition and dietetics, Flinders University
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Country
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Australia
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Phone
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+61 8 82045863
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Jacqueline Miller
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Address
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Child Nutrition Research Centre
Women's and Children's Hospital
72 King William Rd
North Adelaide SA 5051
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Country
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Australia
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Phone
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+61 8 81618224
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Fax
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+61 8 81618228
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Email
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[email protected]
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Contact person for scientific queries
Name
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Associate Professor Maria Makrides
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Address
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Child Nutrition Research Centre
Women's and Children's Hospital
72 King William Rd
North Adelaide SA 5051
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Country
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Australia
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Phone
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+61 8 81616067
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Fax
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+61 8 81618228
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
Effect of increasing protein content of human milk fortifier on growth in preterm infants born at <31 wk gestation: a randomized controlled trial
2012
https://doi.org/10.3945/ajcn.111.026351
N.B. These documents automatically identified may not have been verified by the study sponsor.
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