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TerminatedNCT03130543Updated Apr 6, 2021

A Trial of Thickened Feeds to Treat Gastroesophageal Reflux in Children Admitted After Choking Spell

An interventional study of Rice cereal and Enfamil AR in Apparent Life Threatening Event, Gastroesophageal Reflux and Aspiration, sponsored by Boston Children's Hospital. Terminated at 1 site in United States. Open to participants aged 0 Years to 1 Year. Per ClinicalTrials.gov, last updated 2021-04-06.

Sponsored by Boston Children's Hospital · Not applicable, Interventional, and Treatment

Why this study was terminated
Focusing on observational cohort study due to limited enrollment in trial
Phase
Not applicable
Study type
Interventional
Enrollment
3
Allocation
Randomized
Ages
0 Years to 1 Year
Sex
All
01

Study summary

Infants often present to the hospital with episodes of coughing, choking, gagging, change in muscle tone, and/or change in skin color, known as brief resolved unexplained event. Many studies have tried to address why infants have these symptoms and if there is a way to prevent them from happening again. Currently, there is no clear agreement on the most common cause of these symptoms or how to prevent them. Some studies have suggested that gastroesophageal reflux can cause these symptoms. The investigators are conducting a study of infants who are admitted to Boston Children's Hospital with episodes of coughing, choking, gagging, change in muscle tone, and/or change in skin color, symptoms that could be reflux. The investigators want to determine if these symptoms can be prevented by changing the way infants are fed, either by giving them a formula to treat reflux or by thickening their feeds to treat reflux. The goal of the study is to determine if different types of feeding interventions prevent infants from coming back to the hospital.

02

Conditions studied

  • Apparent Life Threatening Event
  • Gastroesophageal Reflux
  • Aspiration

Keywords

  • Brief resolved unexplained event
03

Who can participate

Ages eligible
0 Years to 1 Year
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patients less than 12 months of age who have been admitted to the hospital after brief resolved unexplained event

Exclusion criteria

Exclusion Criteria:

  • Patients with any pre-existing significant medical diagnosis (congenital heart disease, known neurologic impairment with or without seizure disorder, other congenital anomalies)
  • Patients with any prior hospitalization for BRUE
  • Patients with food allergies such that they cannot be on a milk or rice based diet
  • Any patient exclusively breastfed because change to a formula or adding thickening is not possible unless patients choose to pump breast milk and stop all nursing
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
3 participants (actual)

Study arms

  • No intervention
    Standard Formula

    This is the group of subjects randomized to receive their standard formula

  • Experimental
    Standard Formula with Rice Cereal

    This is the group of subjects randomized to receive their standard formula with rice cereal added

    Dietary Supplement: Rice cereal

  • Experimental
    Enfamil AR

    This is the group of subjects randomized to receive Enfamil AR

    Dietary Supplement: Enfamil AR

Interventions

  • Dietary supplementRice cereal

    Standard formula thickened with rice cereal

  • Dietary supplementEnfamil AR

    Enfamil AR formula

05

What researchers measure

Primary outcomes

  1. Choking episodes

    Frequency of choking episodes

    Time frame: 2 weeks

Secondary outcomes

  1. Choking episodes

    Frequency of choking episodes

    Time frame: 12 months

  2. Repeat hospital admission

    Number of hospitalizations after randomization

    Time frame: 12 months

  3. Microbiome changes

    Prior studies have suggested that infant thickeners can be associated with necrotizing enterocolitis in infants; the aim of this secondary outcome measure will be to evaluate for changes in microbiome (particularly toward a more pathogenic microbiome) after randomization

    Time frame: 2 months

  4. Urine concentration

    Change in urine concentration after randomization

    Time frame: 2 months

06

Study locations

1 site
  • Boston Children's Hospital
    Boston, Massachusetts 02115, United States
07

References and documents

Publications

  • Duncan DR, Amirault J, Mitchell PD, Larson K, Rosen RL. Oropharyngeal Dysphagia Is Strongly Correlated With Apparent Life-Threatening Events. J Pediatr Gastroenterol Nutr. 2017 Aug;65(2):168-172. doi: 10.1097/MPG.0000000000001439. PubMed 27741062 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03130543
Lead sponsor
Boston Children's Hospital
Responsible party
Rachel Rosen (Associate Professor of Pediatrics, Boston Children's Hospital) — Principal investigator
First posted
Apr 26, 2017
Start date
Apr 24, 2017
Primary completion
Apr 2, 2021
Completion
Apr 2, 2021
Last update
Apr 6, 2021

Study contacts

Rachel L Rosen, MD, MPH
principal investigator · Boston Children's Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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