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Very Preterm InfantNCT07045844

Effects of Enteral Feeding Regimens on NEC, Mortality, and Neurodevelopment in Very Preterm Infants

A study testing Pasteurized Donor Milk for Insufficient Breastfeeding, Preterm Formula for Insufficient Breastfeeding and Routine fortification in people with Very Preterm Infant and Necrotizing Enterocolitis (NEC), run by The Children's Hospital of Zhejiang University School of Medicine at 24 sites in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

The goal of this clinical trial is to evaluate whether supplementing with pasteurized donor human milk (pHDM) or preterm formula (PTF) when own mother's milk (OMM) is insufficient can improve outcomes in very preterm infants born before 29 weeks of gestation. Read more about this study

Who is it for?
Ages 1 day to 90 days
What is being tested?
Pasteurized Donor Milk for Insufficient Breastfeeding, Preterm Formula for Insufficient Breastfeeding and Routine fortification
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2,324 participants
Where
24 sitesChina
Study dates
23 Jan 2026to 31 Jul 2030
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 1 day to 90 days
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Gestational age at birth less than 29 weeks;
  • No contraindications to enteral feeding;
  • Mother is willing to breastfeed.

Who cannot join

  • For Randomization Group 1: If the infant has already received pasteurized human donor milk (pHDM), preterm formula (PTF), or nutritional fortifiers;
  • For Randomization Group 2: If the infant is exclusively fed with preterm formula and the mother has no intention to express breast milk;

Trial locations and contacts

24 sites in 1 country. Contact the study team or a site near you to ask about taking part.

24 sites in 1 country

China24 sites, 24 recruiting
  • Sichuan Provincial Maternal and Child Health Hospital

    Chengdu, Sichuan, 610045

    Jingmei Hao, 18280350267

    Jingmei Hao

    Recruiting
  • Ganzhou Maternal and Child Health Hospital

    Ganzhou, Jiangxi

    Xiaohua Luo, 18079708860

    Xiaohua Luo

    Recruiting
  • The First Affiliated Hospital of Guilin Medical University

    Guilin, Guangxi

    Yuan Tan, 13707837294

    Yuan Tan

    Recruiting
  • Yongkang Maternity and Child Health Care Hospital

    Guli, Zhejiang, 321300

    Aijuan Yang, 8613506790182, 55724110@qq.com

    Aijuan Yang

    Recruiting
  • Children's Hospital, Zhejiang University School of Medicine

    Hangzhou, Zhejiang, 0571

    Zheng Chen, 0571-13857151000, chenz@zju.edu.cn

    Yanping Xu

    Recruiting
  • Women's Hospital, Zhejiang University School of Medicine

    Hangzhou, Zhejiang, 310006

    Jiajun Zhu, 8613858089111, jiajunzhu@zju.edu.cn

    Jiajun Zhu

    Recruiting
  • Hangzhou Women's Hospital

    Hangzhou, Zhejiang, 310008

    Weinong Mo, 8613606719109, hzxsmwn@126.com

    Weinong Mo

    Recruiting
  • Sir Run Run Shaw Hospital, Zhejiang University School of Medicine

    Hangzhou, Zhejiang, 310016

    Zhou Jiang, 8613588878072, 5200013@zju.edu.cn

    Zhou Jiang

    Recruiting
  • Inner Mongolia Autonomous Region Maternity and Child Health Care Hospital

    Hohhot, Inner Mongolia, 010020

    Arigong Gaowa, 18604710867, 15389716630@163.com

    Arigong Gaowa

    Not yet recruiting
  • Huzhou Maternity and Child Health Care Hospital

    Huzhou, Zhejiang, 313000

    Qinqin Fu, 13967250510, 778748271@qq.com

    Qinqin Fu

    Recruiting
  • Jiaxing Maternity and Child Health Care Hospital

    Jiaxing, Zhejiang, 314000

    Huafei Huang, 8613867344127, 39362000@qq.com

    Huafei Huang

    Recruiting
  • Jinhua Maternity and Child Health Care Hospital

    Jinhua, Zhejiang, 321000

    Yuan Gao, 13605728733, gyuanjh@foxmail.com

    Yuan Gao

    Recruiting
  • Taizhou Hospital of Zhejiang Province

    Linhai, Zhejiang, 317000

    Hongping Lu, 13958559180, luhp@enzemed.com

    Hongping Lu

    Recruiting
  • Linyi People's Hospital

    Linyi, Shandong, 276003

    Fen Cheng, 18253959131

    Fen Cheng

    Not yet recruiting
  • The Affiliated Hospital of Southwest Medical University

    Luzhou, Sichuan

    Lan Kang, 13982762269

    Lan Kang

    Recruiting
  • Ningbo Women and Children's Hospital (The Affiliated Women and Children's Hospital of Ningbo University)

    Ningbo, Zhejiang, 315012

    Qin Lv, 8613738822179, artose@sina.com

    Yanhong Li

    Recruiting
  • Keqiao District Maternity and Child Health Care Hospital

    Shaoxing, Zhejiang, 312030

    Hongwei Wang, 15988211719, whw918@126.com

    Hongwei Wang

    Not yet recruiting
  • Enze Hospital, Taizhou Enze Medical Center (Group)

    Taizhou, Zhejiang, 318053

    Linghua Wang, 13957652116, wanglh6019@enzemed.com

    Linhua Wang

    Not yet recruiting
  • Hubei Maternity and Child Health Care Hospital

    Wuhan, Hubei, 430070

    Yi Zhang, 13871586428, 491768583@qq.com

    Yi Zhang

    Recruiting
  • Peking University First Hospital Ningxia Women and Children's Hospital (Ningxia Hui Autonomous Region Maternal and Child Health Hospital)

    Yinchuan, Ningxia

    Yuhua Wu, 17709589568

    Yuhua Wu

    Recruiting
  • Yiwu Maternity and Child Health Care Hospital (Yiwu Branch of The Children's Hospital, Zhejiang University School of Medicine)

    Yiwu, Zhejiang, 322000

    Shujun Chen, 8618314930492, 12444229204@qq.com

    Shujun Chen

    Recruiting
  • Yiyang Central Hospital

    Yiyang, Hunan

    Xianglian Liu, 15898439990

    Xianglian Liu

    Recruiting
  • Yulin Maternity and Child Health Care Hospital, Guangxi

    Yulin, Guangxi, 537000

    Yaoxun Wu, 13768963338, 17825765@qq.com

    Yaoxun Wu

    Recruiting
  • The First Affiliated Hospital of Zhengzhou University

    Zhengzhou, Henan

    Qianya Xu, 13203805371

    Qianya Xu

    Recruiting

Other trials in China

About this study

Official title: The Effects of Different Enteral Feeding Regimens on Necrotizing Enterocolitis, Mortality, and Neurodevelopment in Very Preterm Infants: A Multicenter Double-Randomized Trial

The goal of this clinical trial is to evaluate whether supplementing with pasteurized donor human milk (pHDM) or preterm formula (PTF) when own mother's milk (OMM) is insufficient can improve outcomes in very preterm infants born before 29 weeks of gestation. It also aims to assess whether routine use of human milk fortifiers benefits this population. The main questions it aims to answer are:

Does supplementing OMM with pHDM or PTF improve survival without surgery-requiring necrotizing enterocolitis (NEC) by 34 weeks corrected gestational age? Is routine fortification of human milk better than selective fortification based on growth faltering?

Read more

Researchers will compare:

pHDM vs. PTF to see which better supports survival without severe NEC. Routine fortification vs. selective fortification to assess the impact on growth and long-term neurodevelopment.

Participants will:

Be randomized twice:

  • First, within the first week of life to receive either pHDM or PTF when OMM is insufficient
  • Second, in the second week of life to receive either routine fortification or selective fortification only if growth faltering occurs Receive feeding and care as per standard clinical practice Complete neurodevelopmental assessment at 2 years corrected age using the Griffiths Mental Development Scales.

This multicenter, double-randomized, open-label randomized controlled trial is embedded in routine neonatal care and uses real-world data to assess both short- and long-term outcomes.

COLLABORATE-China is being run in partnership with the UK-wide COLLABORATE trial sponsored by Imperial College London.

Being tested
Pasteurized Donor Milk for Insufficient Breastfeeding, Preterm Formula for Insufficient Breastfeeding, Routine fortification, Rescue fortification
Medical subject headings
Enterocolitis, Necrotizing

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Pasteurized Donor Milk for Insufficient BreastfeedingDietary supplement

    Participants receive pasteurized donor human milk (pHDM) as supplemental feeding when the clinician determines maternal milk supply is insufficient.

    Randomization 1 will occur when the clinician determines that supplemental feeding is required due to insufficient breast milk supply.

  • Preterm Formula for Insufficient BreastfeedingDietary supplement

    Participants receive preterm formula (PTF) as supplemental feeding when the clinician determines maternal milk supply is insufficient.

    Randomization 1 will occur when the clinician determines that supplemental feeding is required due to insufficient breast milk supply.

  • Routine fortificationDietary supplement

    Randomization 2 will be conducted when the total daily intake of human milk (including own mother's milk [OMM] and/or donor pasteurized human milk [pHDM] ) reaches between 60-120 mL/kg

  • Rescue fortificationDietary supplement

    Randomization 2 will be conducted: Add fortifiers when the infant meets predefined criteria for growth faltering (Preterm infants exhibit a sustained decline in growth velocity for weight, length, or head circumference, demonstrated by a downward crossing of centiles on growth curves, despite tolerating and consuming at least 180 mL/kg/day of breast milk or formula. Blood urea levels in these infants remain consistently below 1.5 mmol/L, and there are no severe complications such as active sepsis or the need for vasoactive medications to maintain circulatory stability. Chronic sodium depletion has also been ruled out, as this condition alone can lead to growth failure. Additionally, preterm infants are unable to tolerate high-volume feeding of 180 mL/kg/day due to specific reasons, such as severe gastroesophageal reflux or the presence of a high-output stoma following surgical procedures).

Study groups in NCT07045844
Study groupRoleWhat they receive
Pasteurized Donor Milk for Insufficient BreastfeedingExperimentalParticipants receive pasteurized donor human milk (pHDM) as supplemental feeding when the clinician determines maternal milk supply is insufficient.
Receives: Dietary Supplement: Pasteurized Donor Milk for Insufficient Breastfeeding; Dietary Supplement: Routine fortification; Dietary Supplement: Rescue fortification
Preterm formula for Insufficient BreastfeedingExperimentalParticipants receive preterm formula (PTF) as supplemental feeding when the clinician determines maternal milk supply is insufficient.
Receives: Dietary Supplement: Preterm Formula for Insufficient Breastfeeding; Dietary Supplement: Routine fortification; Dietary Supplement: Rescue fortification

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Survival without surgical NEC

    Survival to 34 weeks corrected gestational age without surgical necrotizing enterocolitis (NEC)

    Measured: 34 weeks corrected gestational age

Secondary outcomes (16)
  1. NEC requiring surgical intervention

    Measured: 34 weeks gestational age

  2. Survival

    Measured: 28 days after birth

  3. Survival that occurred during hospitalization

    Survival: Survival outcome indicators measure the success of enduring life-threatening conditions, eg. survival rate.

    Measured: From birth until hospital discharge (up to approximately 44 weeks postmenstrual age)

  4. Medically treated NEC that occurred during hospitalization

    Medically treated NEC: Diagnosis of necrotizing enterocolitis that required medical (non-surgical) treatment, such as bowel rest and antibiotic therapy.

    Measured: From birth until hospital discharge (up to approximately 44 weeks postmenstrual age)

  5. Treated retinopathy of prematurity (ROP) that occurred during hospitalization

    Treated retinopathy of prematurity (ROP): ROP that progressed to a stage requiring medical or surgical intervention, including laser therapy or intravitreal injections.

    Measured: From birth until hospital discharge (up to approximately 44 weeks postmenstrual age)

  6. Hearing impairment that occurred during hospitalization

    Hearing impairment: Documented hearing loss identified through newborn hearing screening or diagnostic audiology tests, potentially requiring follow-up or intervention.

    Measured: From birth until hospital discharge (up to approximately 44 weeks postmenstrual age)

  7. Severe brain injury that occurred during hospitalization

    Severe brain injury: Presence of significant brain injury such as Grade III or IV intraventricular hemorrhage (IVH) or periventricular leukomalacia (PVL) as diagnosed by cranial imaging.

    Measured: From birth until hospital discharge (up to approximately 44 weeks postmenstrual age)

  8. Length of hospital stay

    Length of hospital stay: Total number of days from birth until discharge from the hospital.

    Measured: From birth until hospital discharge (up to approximately 44 weeks postmenstrual age)

  9. Number of episodes of bloodstream infection that occurred during hospitalization

    Number of episodes of bloodstream infection: Total number of confirmed bloodstream infections (positive blood cultures) during the hospital stay.

    Measured: From birth until hospital discharge (up to approximately 44 weeks postmenstrual age)

  10. Events that occurred during hospitalization

    Number of days of antibiotic treatment: Cumulative number of days the infant received systemic antibiotic therapy during hospitalization.

    Measured: From birth until hospital discharge (up to approximately 44 weeks postmenstrual age)

  11. Number of days on parenteral nutrition that occurred during hospitalization

    Number of days on parenteral nutrition: Total number of days the infant received intravenous nutritional support due to inability to tolerate full enteral feeds.

    Measured: From birth until hospital discharge (up to approximately 44 weeks postmenstrual age)

  12. Number of days of NPO that occurred during hospitalization

    Number of days of NPO: Total number of days the infant was designated "nil per os" (NPO), meaning no enteral feeding was given.

    Measured: From birth until hospital discharge (up to approximately 44 weeks postmenstrual age)

  13. Body weight

    Growth parameters (weight): Measurements of the infant's body weight at 2 years corrected age.

    Measured: From birth until 2 years corrected age.

  14. Body length

    Body length: Measurements of the infant's body length at 2 years corrected age.

    Measured: From birth until 2 years corrected age.

  15. Head circumference

    Head circumference: Measurements of the infant's head circumference at 2 years corrected age.

    Measured: From birth until 2 years corrected age.

  16. Griffiths Mental Development Scales

    Survival without moderate to severe cognitive or language impairment. Assessment using the Griffiths Mental Development Scales at a corrected age of 2 years.

    Measured: At 2 years corrected age

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Jul 2025
  2. Study start23 Jan 2026
  3. Primary completion31 Jul 2028 (estimated)
  4. Study completion31 Jul 2030 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
2,324 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07045844
Sponsor's protocol ID
2025-IRB-0232-P-04
Status last verified
Oct 2026
First submitted
17 Jun 2025
Last updated
26 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A study testing Pasteurized Donor Milk for Insufficient Breastfeeding, Preterm Formula for Insufficient Breastfeeding and Routine fortification in people with Very Preterm Infant and Necrotizing Enterocolitis (NEC), run by The Children's Hospital of Zhejiang University School of Medicine at 24 sites in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 26 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 24 sites in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Yanping Xu (8613685757726, xuyanping726@zju.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Survival without surgical NEC (time frame: 34 weeks corrected gestational age). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Oct 2026.

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