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Vulnerable populations, who have deficient diets, may produce human milk (HML) that is not adequate in all nutrients and this will have consequences on the growth and development of the child. In 2021 at IDIP, a specific milk product for pregnant and lactating women Super Mil Mamá ( SMM, whole milk powder fortified with multiple vitamins, minerals and DHA ) has been designed and developed as part of a key strategy to incorporate in public policies for the first 1000 days of life. However, the potential benefits of this product have not yet been evaluated at the population level.
The main objective is to evaluate the effect of the consumption of a milk product (SMM) designed for lactating women on the composition of human milk and the nutritional status of iron and DHA in infant red blood cells in a vulnerable population through a randomized, triple-blind, controlled clinical trial.
Specific objectives To compare the concentrations of DHA, Vitamins A, E, and D, Iron, Iodine, Zinc and Calcium in human milk before and after dietary supplementation with SMM.
To compare the concentrations of DHA, Vitamins A, E, D and Zinc in blood and the nutritional status of maternal iron before and after dietary supplementation with SMM.
To analyze the relationship between micronutrients measured in maternal blood and human milk after dietary supplementation with SMM.
To compare the concentrations of micronutrients measured in blood and human milk in women who received SMM and those who received commercial milk (CM) at the end of supplementation.
To compare the iron nutritional status and DHA content in red blood cells of infants of mothers who consumed SMM or LC.
To evaluate the relationship between the concentration of micronutrients in human milk and infant growth during the first six months of life.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Super 1.000 Mamá | Experimental | Breastfeeding mothers who breastfeed their children during the first four months postpartum will receive a fortified powder milk product formulated and designed specifically for this population. |
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| Leche comercial | Sham Comparator | Breastfeeding mothers who breastfeed their children during the first four months postpartum will receive commercial powder milk. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fortified powder milk | Dietary Supplement | Super 1.000 Mamá It's made up of milk with added vegetable oils, fish oil, carbohydrates from corn, prebiotic fiber (inulin), vitamins, and minerals, with specifically defined proportions. It has medium energy content, is balanced in protein, fats, and carbohydrates, and provides a significant content of both polyunsaturated fatty acids, such as omega-6, and omega-3, and the added docosahexaenoic acid, as recommended by international organizations. The reconstituted 200 ml serving delivers between 20 and 40% of the Daily Reference Intake in critical nutrients for this particular group of people, which include minerals such as calcium, iron, zinc, iodine, and vitamins such as A, D, C, B12 and folic acid. The rest of the vitamins, and minerals are also at the same level, allowing those who consume it to incorporate a large amount of nutrients regularly. Addvance SA, an SME dairy company from the Province of Santa Fe, will carry out the production of this milk. |
| Measure | Description | Time Frame |
|---|---|---|
| breast milk DHA concentration | concentration of DHA in breast milk expressed as a percentage of DHA with respect to the total fatty acids contained in the analyzed sample | breast milk DHA concentration will assessed before starting the intervention (one month postpartum) and at the end of it (fourth month postpartum) |
| breast milk Vitamin A concentration | Retinol concentration in breast milk expressed in μmol/L and μg/g fat contained in the analyzed sample | breast milk Vitamin A concentration will assessed before starting the intervention (one month postpartum) and at the end of it (fourth month postpartum) |
| breast milk Vitamin E concentration | α-tocopherol concentration in breast milk expressed in μmol/L and μg/g fat contained in the analyzed sample | breast milk Vitamin E concentration will assessed before starting the intervention (one month postpartum) and at the end of it (fourth month postpartum) |
| breast milk Vitamin D concentration | 25-hidroxi vitamin D concentration in breast milk expressed in ng/ml | breast milk Vitamin D concentration will assessed before starting the intervention (one month postpartum) and at the end of it (fourth month postpartum) |
| breast milk Zinc concentration | Zinc concentration in breast milk expressed in mg/dl | breast milk Zinc concentration will assessed before starting the intervention (one month postpartum) and at the end of it (fourth month postpartum) |
| breast milk Calcium concentration | Calcium concentration in breast milk expressed in mg/dl |
| Measure | Description | Time Frame |
|---|---|---|
| mother red blood cell DHA concentration | concentration of DHA in mother red blood cell expressed as a percentage of DHA with respect to the total fatty acids contained in the analyzed sample | mother serum DHA concentration will assessed before starting the intervention (one month postpartum) and at the end of it (fourth month postpartum) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Maria Florencia Andreoli, PhD | Contact | 542214177324 | mfandreoli@gmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Instituto de Desarrollo e Investigaciones Pediátricas (IDIP) - HIAEP Sor María Ludovica | Recruiting | La Plata | Buenos Aires | 1900 | Argentina |
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| ID | Term |
|---|---|
| C057917 | Refit milk powder |
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The powder milk containers (both SMM and commercial milk) will be packaged by Addvance SA (in the Province of Santa Fe), each of the products will have a label that differentiates them but only the company Addvance SA will know that information. In this project, neither the participating mothers, researchers, and technical staff assigned to the project nor the professional who performs the data analysis knows what product each participant will receive.
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| Powder milk | Other | Commercial powder milk constitutes dehydrated commercially available cow's milk, which is fortified with Vitamins A and D by law. |
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| breast milk Calcium concentration will assessed before starting the intervention (one month postpartum) and at the end of it (fourth month postpartum) |
| breast milk Iron concentration | Calcium concentration in breast milk expressed in mg/dl | breast milk Iron concentration will assessed before starting the intervention (one month postpartum) and at the end of it (fourth month postpartum) |
| breast milk Iodine concentration | Iodine concentration in breast milk expressed in mg/dl | breast milk Iodine concentration will assessed before starting the intervention (one month postpartum) and at the end of it (fourth month postpartum) |
| mother Vit A concentration |
Retinol concentration in mother serum expressed in μmol/L |
| mother Vit A concentration will assessed before starting the intervention (one month postpartum) and at the end of it (fourth month postpartum) |
| mother Vit E concentration | α-tocopherol concentration in mother serum expressed in μmol/L | mother Vit E concentration will assessed before starting the intervention (one month postpartum) and at the end of it (fourth month postpartum) |
| mother Vit D concentration | 25-hidroxi vitamin D concentration in mother serum expressed in ng/ml | mother Vit D concentration will assessed before starting the intervention (one month postpartum) and at the end of it (fourth month postpartum) |
| mother Zinc concentration | Zinc concentration in mother serum expressed in mg/dl | mother Zinc concentration will assessed before starting the intervention (one month postpartum) and at the end of it (fourth month postpartum) |
| mother hemoglobin concentration | hemoglobin concentration in mother serum expressed in g/dL | mother hemoglobin concentration will assessed before starting the intervention (one month postpartum) and at the end of it (fourth month postpartum) |
| mother serum ferritin concentration | ferritin concentration in mother serum expressed in ng/ml | mother serum ferritin concentration will assessed before starting the intervention (one month postpartum) and at the end of it (fourth month postpartum) |
| child hemoglobin concentration | hemoglobin concentration in child serum expressed in g/dL | child hemoglobin concentration will assessed before starting the intervention (one month postpartum) and at the end of it (fourth month postpartum) |
| child serum ferritin concentration | ferritin concentration in child serum expressed in ng/ml | child serum ferritin concentration will assessed before starting the intervention (one month postpartum) and at the end of it (fourth month postpartum) |
| child red blood cell DHA concentration | concentration of DHA in child red blood cell expressed as a percentage of DHA with respect to the total fatty acids contained in the analyzed sample | child red blood cell DHA concentration concentration will assessed before starting the intervention (one month postpartum) and at the end of it (fourth month postpartum) |