Goat Infant Formula Feeding and Eczema (the GIraFFE Study)
Study Details
Study Description
Brief Summary
To determine the relative risk of developing atopic dermatitis in infants fed a study formula based on whole goat milk compared to infants a study formula based on cow milk protein.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
The study is a randomized, double-blind, parallel-group trial to study the effect of feeding infants goat milk or cow milk formula in the first year of life on the risk of allergy and other health outcomes, including growth, tolerance and quality of life in the first 5 years of life.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Experimental formula Infant and follow-on goat milk formula |
Dietary Supplement: Infant formula and follow-on formula made from whole goat milk
Infant formula and follow-on formula made from whole goat milk
|
| Active Comparator: Control formula Infant and follow-on cow milk formula |
Dietary Supplement: Infant formula and follow-on formula made from cow's milk ingredients
Infant formula and follow-on formula made from cow's milk ingredients
|
Outcome Measures
Primary Outcome Measures
- Cumulative incidence of atopic dermatitis up to the age of 12 months [Age 12 months]
Cumulative incidence of atopic dermatitis up to the age of 12 months diagnosed by study personnel (defined as meeting the UK Working Party Diagnostic Criteria for atopic dermatitis)
Secondary Outcome Measures
- Cumulative incidence of atopic dermatitis up to the age of 24 and 60 months [Age 24 and 60 months]
Cumulative incidence of atopic dermatitis up to the age of 24 and 60 months diagnosed by study personnel (defined as meeting the UK Working Party Diagnostic Criteria for atopic dermatitis)
- Cumulative incidence of parental reported diagnosis of atopic dermatitis up to the age of 12, 24 and 60 months [Age 12, 24 and 60 months]
Cumulative incidence of parental reported diagnosis of atopic dermatitis up to the age of 12, 24 and 60 months, defined as meeting the UK Working Party Diagnostic Criteria for atopic dermatitis
- Point incidence of atopic dermatitis [at 4, 6, 12, 24 and 60 months of age]
Point incidence of study and parental diagnosis of atopic dermatitis, defined as meeting the UK Working Party Diagnostic Criteria for atopic dermatitis at the age of 4, 6, 12, 24 and 60 months
- Time to onset of atopic dermatitis [Age 12, 24 and 60 months]
Age at first study or reported diagnosis of atopic dermatitis up to the age of 12, 24 and 60 months
- Severity of atopic dermatitis [at 4, 6, 12, 24 and 60 months of age]
Atopic dermatitis severity in children with diagnosed (study diagnosis or reported diagnosis) atopic dermatitis, using the SCORing Atopic Dermatitis (SCORAD; Severity Score: 0 to 104, with a higher score indicating more severe eczema) questionnaire completed by a study nurse at all face-to-face visits at 4, 6, 12, 24 and 60 months of age.
- Severity of atopic dermatitis [at 4, 6, 8, 10, 12, 18, 24, 36, 48 and 60 months of age]
Atopic dermatitis severity in children with diagnosed (study diagnosis or reported diagnosis) atopic dermatitis, using the Patient Orientated Eczema Measure (POEM; Severity Score: 0 to 28, with a higher score indicating more severe eczema) questionnaire completed by parents at 4, 6, 8, 10, 12, 18, 24, 36, 48 and 60 months of age
- Cumulative use of atopic dermatitis-related medication [Age 12, 24 and 60 months of age]
Cumulative use of eczema-related medication or skin care for eczema up to 12, 24 and 60 months of age
- Cumulative incidence of atopic dermatitis in risk-related subgroups [Age 12, 24 and 60 months of age]
Cumulative incidence of atopic dermatitis in risk-related subgroups up to 12, 24 and 60 months of age
- Incidence of parental reported food allergy [Age 12, 24 and 60 months of age]
Parental report of a clinical diagnosis of food allergy at 12, 24 and 60 months of age
- Incidence of allergic sensitization to food or non-food allergens [Age 12 and 60 months of age]
Allergic sensitization at 12 and 60 months of age to any of the common allergens (specific and total IgE)
- Incidence of hay fever, asthma and asthma-related diseases [Age 12, 24 and 60 months]
Parental reported hay fever and asthma-related diseases (wheezing and allergic rhinitis) up to 12, 24 and 60 months of age
- Biochemical markers: blood markers [at 4, 12 and 60 months of age]
Blood: complete blood count (given numbers of different cells per volume and suitable ratios) at 4, 12 and 60 months of age
- Biochemical and metabolic markers: blood markers [at 4, 12 and 60 months of age]
Blood: lipidome and metabolome (including more than 300 compounds reported in µmol/liter) at 4, 12 and 60 months of age
- Biochemical and metabolic markers: blood markers [at 4, 12 and 60 months of age]
Blood: inflammation markers (including immunoglobulins and cytokines reported as relative units/liter and ng/ml, respectively) at 4, 12 and 60 months of age
- Genetic markers: blood markers [at 12 months of age]
Blood: filaggrin gene at 12 months of age
- Gut microbiome profile [at 4, 12 and 60 months of age]
Stool: microbiome
- Growth parameters [at baseline, 4, 6, 12, 24 and 60 months of age]
Anthropometry: weight (in kg) at baseline, 4, 6, 12, 24 and 60 months of age
- Growth parameters [at baseline, 4, 6, 12, 24 and 60 months of age]
Anthropometry: recumbent length (in cm) at baseline, 4, 6, 12, 24 and standard height (in cm) at 24 and 60 months of age
- Growth parameters [at baseline, 4, 6, 12, 24 and 60 months of age]
Anthropometry: BMI (weight and height will be combined to report BMI in kg/cm2) at baseline, 4, 6, 12, 24 and 60 months of age
- Growth parameters [at baseline, 4, 6, 12, 24 and 60 months of age]
Anthropometry: weight-for-age, length-for-age and BMI-for-age z-scores (WHO growth standards) at baseline, 4, 6, 12, 24 and 60 months of age
- Gastrointestinal symptoms [at 4, 6 and 12 months of age]
Parental report of gastrointestinal symptoms using the Infant Gastrointestinal Symptom Questionnaire (IGSQ; Index Score range from 13 to 65, with higher scores indicating greater gastrointestinal symptom burden) at 4, 6 and 12 months of age
- Sleep [at 4, 6 and 12 months of age]
Parental report of sleep using the Brief Infant Sleep Questionnaire (BISQ; data in time: hours and minutes of sleep time) at 4, 6 and 12 months of age
- Child's wellbeing [at 4, 12, 24 and 60 months of age]
Parental report of quality of life in children using the Infant Toddler Quality of Life questionnaire™ (ITQOL; infant and parent item scales range from 0 to 100, with a higher score indicating better health) at 4, 12, 24 and 60 months of age
- Nutrition [at age 4, 6, 8, 10, 12 and 60 months of age]
Nutrition questionnaire at 4, 6, 8, 10, 12 and 60 months of age
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Having obtained written informed consent (signed and dated) of the child's parent(s)/caregiver(s), indicating that the child's parent(s)/caregiver(s) has/have been informed of all pertinent aspects of the study
-
Born full term (≥37 weeks +0 days and ≤ 41 weeks +6 days of gestation)
-
Age at enrolment < 3 months of age (<90 days)
-
Birth weight ≥2.5 kg and ≤4.5 kg
-
Born from a singleton pregnancy
-
Child's parent(s)/caregiver(s) is/are of legal age of consent
-
The child's parent(s)/caregiver(s) have sufficient local language skills to understand the study information, the informed consent, and to comply with the study procedure
-
The child's parent(s)/caregiver(s) is/are willing and deemed able to fulfil the requirements of the study protocol and procedures
-
Mother has expressed the intention to partially (in combination with breastfeeding) or fully formula-feed
Exclusion Criteria:
-
Diagnosed disorder considered to interfere with nutrition, growth or development of the immune system
-
Participation of the child in any other interventional trial or participation of the mother in any intervention trial with child follow-up
-
Infant has a doctor's diagnosis of atopic dermatitis or a severe widespread skin condition prior to randomization that would make the detection or assessment of atopic dermatitis difficult
-
Infant has consumed an infant formula for more than 4 weeks prior to enrolment
-
Cow milk allergy or intolerance
-
Institutionalized infant
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Dr. von Hauner Children's Hospital, LMU University Hospital Munich | Munich | Germany | ||
| 2 | Wojewodzki Specjalistyczny Szpital Dzieciecy | Olsztyn | Poland | ||
| 3 | Karol Jonscher's University Hospital | Poznań | Poland | ||
| 4 | Medical College of Rzeszow University | Rzeszów | Poland | ||
| 5 | Children's Memorial Health Institute | Warsaw | Poland | ||
| 6 | Unit of Pediatric Gastroenterology and Nutrition, Torrecardenas University Hospital | Almería | Spain | ||
| 7 | EURISTIKOS Excellence Centre for Paediatric Research, University of Granada | Granada | Spain | ||
| 8 | Department of Neonatology, Hospital Universitario La Paz | Madrid | Spain | ||
| 9 | Hospital Universitari Sant Joan de Reus | Reus | Spain | ||
| 10 | Hospital Universitari Joan XXIII de Tarragona | Tarragona | Spain | ||
| 11 | INCLIVA Health Research Institute | Valencia | Spain | ||
| 12 | Hospital Clinico Universitario Lozano Blesa, Instituto de investigacion Sanitaria de Aragon | Zaragoza | Spain |
Sponsors and Collaborators
- Dairy Goat Co-operative (N.Z.) Limited
- Klinikum der Universität München
Investigators
- Principal Investigator: Berthold Koletzko, MD, PhD, Dr. von Hauner Children's Hospital, LMU University Hospital Munich
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- DGC201911