Pasteurized Donor Human Milk for HIV-Exposed Infants: A Pilot Study

Status: Recruiting
Location: See location...
Intervention Type: Other
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Pasteurized Donor Human Milk (PDHM) is recognized as providing vital immunological and nutritional benefits to vulnerable infants. Although PDHM is widely used in neonatal intensive care units (NICUs) to prevent infections (necrotizing enterocolitis) and improve infant health outcomes, its use for other populations, such as HIV-exposed infants, has been minimal. Pasteurized donor human milk is included in the 2023 Canadian Paediatric Society clinical consensus as a potential way to provide HIV-exposed infants some of the immunological benefits of human milk in a safe manner, as opposed to exclusive formula feeding (which is currently considered the gold standard for HIV-exposed infants). These new consensus guidelines also include recommendations to support those who wish to breastfeed using a harm reduction approach (e.g., increased viral load monitoring by peds infectious diseases), given the low risk of transmission in those adhering to antiretroviral medications. However, mixed feeding (e.g., breastfeeding and provision of infant formula) is not recommended, due to the potential for micro abrasions in the gastrointestinal epithelium as a result of the protein size in infant formula (which is larger and more abrasive than in human milk), which may increase the risk of HIV transmission if the HIV virus is present in breastmilk. As such, donor milk also presents a possible solution to support those who choose to breastfeed, but who may require a temporary supplement for whatever reason (e.g., nipple cracks, mastitis, etc.), as donor milk is human milk, thus has the same size of proteins and does not pose the same risk as infant formula in damaging the epithelial layer in the gut. Overall, major obstacles remain that prevent newborns outside of the NICU from regularly having access to donor human milk. These obstacles are illustrated by the high cost of donor milk, which is not covered by government programs, and the lack of information about the clinical benefits (for both those who choose to breastfeed or formula feed), acceptability of caregivers for this feeding option, and feasibility of providing donor human milk outside of a hospital setting. The investigators aim to determine whether giving PDHM to infants exposed to HIV is a practical possibility and learn from caregivers about any challenges associated with this feeding option. The results of this study will guide future research and a potential provincial initiative to expand access to PDHM for this population.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 15
Healthy Volunteers: f
View:

• ≥15 years of age

• Pregnant or recently gave birth and living with HIV or is the primary caregivers of an HIV-exposed infant

• Being followed by SHA Pediatric Infectious Disease

• Saskatoon resident (living within \

⁃ 25 km from the University of Saskatchewan)

• Have a household freezer

• Willing to participate

Locations
Other Locations
Canada
University of Saskatchewan
RECRUITING
Saskatoon
Contact Information
Primary
Kelsey M Cochrane, PhD
kelsey.cochrane@usask.ca
(306) 966-1310
Backup
Chloe Langen, MSc (Candidate)
Chloe.langen@usask.ca
(306) 537-2257
Time Frame
Start Date: 2025-04-15
Estimated Completion Date: 2026-12-31
Participants
Target number of participants: 10
Treatments
Experimental: Pasteurized Donor Human Milk
Pasteurized donor human milk sourced from the Norther Star Mother's Milk Bank (Calgary, AB, Canada)
Sponsors
Leads: University of Saskatchewan

This content was sourced from clinicaltrials.gov