ClinicalTrials.gg
Not yet recruitingNCT06652698ESCAPE-PLUpdated Jul 17, 2025

Early Supplementation for Cow's Milk Allergy Prevention

An interventional study of Cow's milk formula [CMF] and Amino-acid formula [AAF] in Food Allergy and Cow's Milk Allergy, sponsored by Medical University of Warsaw. Not yet recruiting at 1 site in Poland. Open to participants aged Up to 24 Hours, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-07-17.

Primary conditionMilk HypersensitivityRegistry: Food HypersensitivityReclassifiedWhy we changed it
Registry
Food Hypersensitivity — the first condition term the registry derived for this study.
ClinicalTrials.gg
Milk Hypersensitivity
Why
  1. The study's listed conditions name Milk Hypersensitivity, a narrower term within Food Hypersensitivity.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by Medical University of Warsaw · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
1,000
Allocation
Randomized
Ages
Up to 24 Hours
Sex
All
01

Study summary

Cow's milk allergy (CMA) is a common food allergy in infants and young children that can have a significant impact on the individual and their family due to dietary restrictions, risk of nutritional deficiencies, social limitations, and decreased quality of life. It also represents a financial burden for families and healthcare resources.

There is an ongoing debate about the significance of early exposure to cow's milk proteins within hours or days after birth and its relationship to the risk of developing CMA later in life. Current recommendations for early introduction of cow's milk proteins in infants who cannot be breastfed vary and are inconsistent due to a lack of clear evidence. This knowledge gap underscores the need for further research to provide a definitive understanding of the relationship between early exposure to cow's milk proteins and the development of CMA, which will ultimately inform evidence-based prevention strategies to improve the health and well-being of affected individuals and their families.

This trial aims to investigate whether early supplementation with various nutritional interventions (cow's milk formula [CMF], amino acids formula [AAF], donor human milk [DHM], or high-pressure processed "pascalized" donor human milk [DHM-P]) could serve as an effective strategy for the primary prevention of CMA in breastfed neonates.

This study is an open-label randomized, controlled, head-to-head trial with four parallel arms and allocation 1:1:1:1.

02

Conditions studied

  • Food Allergy
  • Cow's Milk Allergy

Browse trials for

03

In context

Milk Hypersensitivity Reclassified

147 studies on the registry are indexed under Milk Hypersensitivity; 26 are open to participants now.

This study's planned enrollment of 1,000 is above the median of 68 across 95 interventional studies indexed under Milk Hypersensitivity.

Browse Milk Hypersensitivity studies →

Lead sponsor

Medical University of Warsaw is the lead sponsor of 326 studies on the registry; 87 are open to participants now.

Compared within Milk Hypersensitivity, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Food Hypersensitivity. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
Up to 24 Hours
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Healthy newborns of mothers who express the intention to exclusively breastfeed for first 6 months of infant's life
  2. Full-term infants (defined as gestational age of at least 37 weeks)
  3. Infant birth weight at least 2500 g and ≤ 4500 g
  4. Age at enrolment \<24 h of life
  5. Regardless of any atopic condition in parents
  6. Written of the caregiver

Exclusion criteria

Exclusion criteria:

  1. Infants of parents who intend to partially or fully formula feed
  2. Serious congenital anomalies or any other medical condition that would preclude the consumption of any of the study formulas, or interfere with nutrition or growth
  3. Contradictions to exclusive breastfeeding
  4. Multiple pregnancy
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
1,000 participants (estimated)

Study arms

  • Experimental
    CMF

    Other: Cow's milk formula [CMF]

  • Experimental
    AAF

    Other: Amino-acid formula [AAF]

  • Experimental
    DHM

    Other: Donor human milk [DHM]

  • Experimental
    DHM-P

    Other: High-pressure processed "pascalized" donor human milk [DHM-P]

Interventions

  • OtherCow's milk formula [CMF]

    At least 10 ml daily of cow's milk formula (Bebiko 1 NUTRIFlor Expert®, Nutricia; formula with galactooligosaccharides and without probiotics); and if additional supplementation will be needed (i.e., insufficient, partial, or discontinuation of breastfeeding), the randomly assigned nutritional intervention until the end of 4 months of age will be provided.

  • OtherAmino-acid formula [AAF]

    At least 10 ml daily of amino-acid formula (Nutramigen Pureamino®, Reckitt Benckiser Group PLC); and if additional supplementation will be needed (i.e., insufficient, partial, or discontinuation of breastfeeding), the randomly assigned nutritional intervention until the end of 4 months of age will be provided.

  • OtherDonor human milk [DHM]

    At least 10 ml daily of donor human milk; and if additional supplementation will be needed (i.e., insufficient, partial, or discontinuation of breastfeeding), the randomly assigned nutritional intervention until the end of 4 months of age will be provided.

  • OtherHigh-pressure processed "pascalized" donor human milk [DHM-P]

    At least 10 ml daily of high-pressure processed "pascalized" donor human milk; and if additional supplementation will be needed (i.e., insufficient, partial, or discontinuation of breastfeeding), the randomly assigned nutritional intervention until the end of 4 months of age will be provided.

06

What researchers measure

Primary outcomes

  1. A cumulative incidence of cow's milk allergy confirmed by open oral food challenge

    Time frame: At 4-6 and 12 months of age

Secondary outcomes

  1. A cumulative incidence of sensitization to cow's milk protein (cut-off levels for specific IgE level ≥0.35 allergen units [UA/mL] and ≥3 mm of wheal size in the skin prick test against cow's milk

    Time frame: at 6 and 12 months of age

  2. A point prevalence of cow's milk allergy confirmed by open oral food challenge

    Time frame: at 4-6, and 12 months of age

  3. An incidence of sensitization to cow's milk protein (cut-off levels for specific IgE level ≥0.35 allergen units [UA/mL] against cow's milk)

    Time frame: at 4-6, and 12 months of age

  4. In a subgroup of children with confirmed cow's milk allergy, the percentage of children with tolerance acquisition to cow's milk

    Tolerance acquisition to cow's milk will be assessed by subsequent OFC with baked milk (in the form of biscuit or muffin); if baked milk is tolerated, the assessment of tolerance acquisition will be continued with the use of milk ladder.

    Time frame: at 9 and/or 12 months

  5. Percentage of children who received a full 3-day nutritional supplementation (3x10 ml according to the randomization) and then were exclusively or predominantly breastfed until 4 months of age

    Time frame: Up to 4 month of age

  6. A total score in the Cow's Milk-related Symptom Score (CoMiSS)

    The total CoMiSS score ranges from 0 to 33, a score of ≥10 indicates CMA.

    Time frame: at 4-6 and 12 months of age

  7. Percentage of children exclusively breastfed

    Time frame: at 4 and 6 months of age

  8. Percentage of children with mixed feeding

    Time frame: at 4 and 6 months of age

  9. Change in Body Mass Index (BMI)-for-age z-score

    weight and length will be checked each month in a telephone interview or parental report, or during follow-up visit assessed by study physician; change in mean value will be assessed between baseline and each time point

    Time frame: at 4, 6 and 12 months of age

  10. Change in length-for-age z-score

    length will be checked each month in a telephone interview or parental report, or during follow-up visit assessed by study physician; change in mean value will be assessed between baseline and each time point

    Time frame: at 4, 6 and 12 months of age

  11. Adverse events related to the nutritional intervention (according to the randomization)

    defined as any harmful events that may occur during the trial; the process of decision whether an adverse event is related to the intervention (attribution) will be made by the non-blinded principal investigator

    Time frame: up to 12 months of age

  12. A cumulative incidence of atopic dermatitis (defined as meeting the UK Working Party diagnostic Criteria)

    Time frame: at 6 and 12 months of age

  13. A cumulative incidence of allergic rhinitis (confirmed by study physician)

    Time frame: at 6 and 12 months of age

  14. A cumulative incidence of feeding difficulties who will be screened with The Montreal Children's Hospital Feeding Scale (MCH-FS scale)

    Total score range from 14 to 98, score of 46 or higher indicates feeding difficulties.

    Time frame: at 6 and 12 months of age

  15. Human milk energy value (kcal/100 mL)

    Time frame: at 4-14 days postpartum and 6 months of age

  16. Total and true protein concentrations in human milk samples (g/100 mL)

    Time frame: at 4-14 days postpartum and 6 months of age

  17. Fat concentration in human milk samples (g/100 mL)

    Time frame: at 4-14 days postpartum and 6 months of age

  18. Lactose concentration in human milk samples (g/100 mL)

    Time frame: at 4-14 days postpartum and 6 months of age

  19. Dry mass content g/100 mL

    Time frame: at 4-14 days postpartum and 6 months of age

  20. IgA-anty CMA concentration in human milk samples (pg/mL)

    Time frame: at 4-14 days postpartum

  21. IL-1B, IL-6, IL-10, and TGF-beta concentrations in human milk samples (pg/mL)

    Time frame: at 4-14 days postpartum

07

Study locations

1 site
08

References and documents

Publications

  • Horvath A, Wesolowska A, Strozyk A, Bzikowska-Jura A, Ambrozej D, Dumycz K, Feleszko W, Szajewska H. Early supplementation for cow's milk allergy prevention in breastfed infants in Poland (ESCAPE-PL): a protocol for randomised controlled trial. BMJ Open. 2025 Aug 5;15(8):e096217. doi: 10.1136/bmjopen-2024-096217. PubMed 40764079 ↗

Individual participant data

Plan to share: Yes — The anonymized datasets used and/or generated during this study will be made available from a corresponding author on reasonable request, after the publication of results, no later than 3 years from the completion of data analysis.

Supporting information: Clinical study report

Time frame: After the publication of results, no later than 3 years from the completion of data analysis.

Access criteria: The anonymized datasets used and/or gener.ated during this study will be made available from a corresponding author on reasonable request

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Jul 2025; primary completion for Dec 2030, 65 months later.

Of 34 interventional studies with no phase under Milk Hypersensitivity, half reached primary completion within 30 months of starting (the median), counting those still running; a quarter within 17 and three quarters within 48. This study's planned 65 months is above that.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 23, 2024
First posted
Oct 22, 2024
StartEst.
Jul 2025
Primary completionEst.
Dec 2030
CompletionEst.
Mar 2031
Last update
Jul 17, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jul 17, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06652698
Collaborators
Medical Research Agency, Poland
Responsible party
Sponsor
First posted
Oct 22, 2024
Start date
Jul 2025 (estimated)
Primary completion
Dec 2030 (estimated)
Completion
Mar 2031 (estimated)
Last update
Jul 17, 2025

Study contacts

Andrea Horvath, Assoc Prof
Contact
andrea.horvath@wum.edu.pl
22 317 9444
Andrea Horvath, Assoc Prof, MD
study chair · Medical University of Warsaw
Aleksandra Wesołowska, Assoc Prof
principal investigator · Medical University of Warsaw
Hanna Szajewska, Prof, MD
principal investigator · Medical University of Warsaw

Oversight

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

Not currently enrolling

This study is not yet recruiting, as verified in Mar 2025. You cannot join it, but the record below documents what was studied.

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