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Maximizing Mothers' Milk for Preterm Infants
Key findings: - Stay Tuned!
The purpose of this study is to determine the best way to add nutrients to milk (fortification) to improve the growth and neurodevelopment of infants born 1250 grams or less or born less than 30 weeks post-conception and less than 1500 grams.
Welcome to CanDo Trial: Enhancing Infant Health through Research
At CanDo Trial, we're passionate about promoting the health and well-being of infants through our research. Here's a friendly overview of what we're all about:
Our Mission:
Human milk is a precious resource, especially for our little ones. Research has shown that human donor milk can provide numerous health benefits for preterm infants. Many late preterm and term infants admitted to well-baby units may need supplementation for various reasons, such as hypoglycemia, weight loss, or a limited supply of their parent's milk. However, the decision of which supplement to provide has limited guidance. Despite this, more hospitals are introducing donor milk in well-baby units due to the recognized health advantages of human milk.
Our Goals:
Our primary goal is to compare the effects of supplementing parent's milk with donor milk versus formula in infants at increased risk for supplementation. This includes infants born to mothers with diabetes or infants with lower-than-expected birth weights. We're particularly interested in their exclusive human milk feeding rates at 4 months of age. We also have several secondary aims, including looking at feeding rates at 1, 2, and 3 months, as well as infant health and growth during hospital stays and up to 4 months. We'll even assess breastfeeding self-efficacy scores. And there's more – we're also exploring infant temperament, parental mental health, milk cortisol concentrations, the use of informally shared milk, and the financial costs of a donor milk program versus formula.
Our Approach:
We're conducting a randomized, controlled, single-center trial with two intervention groups. Participants will receive either donor milk or formula in bottles during their baby's initial hospitalization. We'll follow up with monthly phone calls and a virtual or in-person assessment at 4 months. Throughout the study, we'll collect data on breastfeeding self-efficacy, infant health, and temperament. We'll also measure your baby's growth and assess parental well-being. We're even analyzing cortisol concentrations in milk samples. Our team is a blend of experts in nursing, medicine, dietetics, and milk banking, all with experience in newborn feeding interventions and donor milk trials.
Our Vision:
Our research holds the potential to bring about real change in public health. With a significant number of level I nursery admissions in Canada each year and high rates of formula supplementation, there's a clear opportunity for improvement. We're dedicated to promoting exclusive human milk feeding, shaping evidence-based practices, and reducing the reliance on informal milk sharing. By doing so, we aim to enhance the well-being of both parents and infants while deepening our understanding of early parent-child interactions.
Thank you for visiting the CanDo Trial website. Your support and interest in our work mean the world to us. Together, we can make a difference in the lives of infants and their families.
Stay connected with us! If you have any questions or would like to get in touch, please don't hesitate to reach out. You can contact us via email at CanDoTrial@sinaihealth.ca or give us a call at 437-335-6368. We're here to help and look forward to connecting with you.
Warm regards,
The CanDo Trial Team
OptiMoM Grows Up
Key findings: - Stay Tuned!
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The OptiMoM Grows Up Study is a 5.5-year follow-up for families part of the OptiMoM trial. See the OptiMoM Grows Up Study poster for more informaton!
Global Health Work
In this study, we want to understand how a mother's nutrition, the composition of her breastmilk, and her child's growth and neurodevelopment are all connected. We will do this by looking at data from mothers and their children in rural Pakistan, in collaboration with the Aga Khan University. Some of the mothers in the study took multivitamins, while others did not. We want to see if the breastmilk from the mothers who took multivitamins is different from those who did not, and whether or not child growth and neurodevelopment are affected at four years of age.
Funding for this study has been provided to by The SickKids Centre for Global Child Health Catalyst Grant and The Thrasher Research Fund.​​
GreEAT Study
Key findings: - Stay Tuned!
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The Growth Eating & Appetite Together (GrEAT) Study will see how nutrition supports young children's growth and development. See the GrEAT Study poster for more information!
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Completed Research
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DoMINO
Donor Milk for Improved Neurodevelop-mental Outcomes
Key findings:
Donor milk does not improve neurodevelopment above preterm formula, but it reduces the risk of a serious bowel disease called necrotizing enterocolitis.
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Donor milk and preterm formula result in similar growth at 5.5 years of age for children born very low birth weight (VLBW).
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There is no difference in cost between donor milk and preterm formula to the healthcare system or families.
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Preterm infants fed mother's own milk develop unique gut microbiotas.
OptiMoM
Optimizing Mothers' Milk for Preterm Infants
Key findings:
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Human milk-based fortifier does not improve feeding tolerance above bovine milk-based fortifier.
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Human milk-based fortifier does not improve neurodevelopment above bovine milk-based fortifier.
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Each mother of preterm infants has a unique milk microbiota and it changes over time.
Covid Study
Key findings: - Stay Tuned!
Publications
Representative Key Publications
O'Connor, D. L., et al. (2016). Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months. JAMA, 316(18), 1897–1905. [DOI: 10.1001/jama.2016.16144]
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O'Connor, D. L., et al. (2018). Nutrient enrichment of human milk with human and bovine milk-based fortifiers for infants born weighing <1250 g: a randomized clinical trial. The American Journal of Clinical Nutrition, 108(1), 108–116. [DOI: 10.1093/ajcn/nqy067]
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Francis, J., et al. (2020). Vulnerable mothers' experiences breastfeeding with an enhanced community lactation support program. Maternal & Child Nutrition, 16(3), e12957. [DOI: 10.1111/mcn.12957]
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Asbury, M. R., et al. (2022). Human milk nutrient fortifiers alter the developing gastrointestinal microbiota of very-low-birth-weight infants. Cell Host & Microbe, 30(9), 1328–1339.e5. [DOI: 10.1016/j.chom.2022.07.011]
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SickKids Research Institute
Peter Gilgan Centre for Research and Learning
686 Bay Street
Toronto, Ontario, Canada
M5G 0A4
Department of Nutritional Sciences
University of Toronto
1 King's College Circle
Toronto, Ontario, Canada
M5S 1A8
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