ISRCTN ISRCTN37687716
DOI https://doi.org/10.1186/ISRCTN37687716
ClinicalTrials.gov number NCT01561612
Secondary identifying numbers MOP-53155
Submission date
25/02/2005
Registration date
09/09/2005
Last edited
03/06/2021
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Pregnancy and Childbirth
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
The Promotion of Breastfeeding Intervention Trial (PROBIT) is a study in the Republic of Belarus involving 31 maternity hospitals and affiliated clinics across the country. The study was designed to help scientists, health care providers, and the general public understand the effects of infant feeding on child health and development. In 1995, 16 hospitals and clinics were randomly allocated to a breastfeeding promotion intervention based on World Health Organization materials and procedures, while 15 continued breastfeeding practices in place at the time of random allocation. Mothers and babies were recruited from June 1996 to December 1997. In total, 17,046 mothers and their babies were recruited into the study. Of these, 16,492 (97%) were followed at regular intervals until the infants were 12 months of age. Detailed information was recorded at each follow-up visit about infant feeding, digestive and lung infections, and rashes. When PROBIT children were six and a half years old, 13,889 (81%) were examined for height, weight, body fat, blood pressure, behaviour, dental health, intelligence quotient (IQ), asthma and allergy. At age 11 and a half years, 13,879 (81%) were again examined for height, weight, body fat, blood pressure, and also had blood tests to measure diabetes and heart disease risk factors. Currently we are seeing the children at age 16 years.

Who can participate?
Mothers and their babies joined the study during their delivery hospital stay. Mothers could take part if they started breastfeeding, and they and their baby were healthy.

What does the study involve?
At the current visit, when the child is 16, the pediatrician:
1. Measures the child’s height, waist, blood pressure, weight and body fat.
2. Tests the child's vision by asking him/her to read letter charts. A small number of children are also tested using an instrument that assesses whether they need glasses.
3. Examines the child’s skin for rashes.
4. Tests the child’s lung health by asking him or her to blow into a tube three to eight times to measure the capacity of the lungs.
5. Asks the child to take a computer-administered test of brain development (including memory, ability to solve problems, attention, perception, verbal skills, information processing and motor skills).
6. Administers a questionnaire to assess other aspects of the child’s health and physical development.

What are the possible benefits and risks of participating?
The lung function assessment involves blowing hard into a tube several times. Repeated blowing may cause some people to become wheezy. The pediatrician has asthma medication on hand to relieve these symptoms if they occur. None of the other measures or tests carries any risk to the child. As a result of the examination, the pediatrician may identify previously undiagnosed eye, lung or blood pressure problems in the child, which will then be followed up appropriately.

Where is the study run from?
The study is run from the The National Research and Applied Medicine Mother and Child Centre (Minsk, Belarus), in collaboration with the School of Social and Community Medicine, University of Bristol (Bristol, UK), Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine (Montreal, Canada), and Harvard Medical School and Harvard Pilgrim Health Care Institute (Boston, USA).

When is the study starting and how long is it expected to run for?
The study started in January 1995 and is expected to run until December 2015. We hope the study will extend beyond this time as we intend to look at the children’s health over many years.

Who is funding the study?
This study is supported by a grant from the Canadian Institutes of Health Research (CIHR) and the US National Institutes of Health (NIH). The study has previously been funded by the National Health Research and Development Program (NHRDP) Health Canada, European Union’s project on Early Nutrition Programming: Long-term Efficacy and Safety Trials, the Thrasher Research Fund (USA), the United Nations Children’s Fund (UNICEF), and the European Regional Office of the World Health Organization (WHO).

Who is the main contact?
Prof. Michael S Kramer
Michael.Kramer@mcgill.ca

Study website

Contact information

Dr Michael S. Kramer
Scientific

The Montreal Children's Hospital
2300 Tupper Street, T-118
Montreal
H3H 1P3
Canada

Phone +1 (0)514 4124400 ext. 22687
Email michael.kramer@mcgill.ca

Study information

Study designRandomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typePrevention
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titleBreastfeeding duration and exclusivity: impact on child health and development
Study acronymPROBIT
Study hypothesisCurrent study hypothesis as of 11/03/2009:
Experimental intervention will lead to increased exclusivity and duration of breastfeeding, and hence to improved infant and child health.

Initial information at time of registration:
Experimental intervention will lead to increased exclusivity and duration of breastfeeding, and hence to reduced infection and eczema in infancy.
Ethics approval(s)Research Ethics Board of McGill University Health Centre, 28/11/2001
Added 02/09/2013: Research Ethics Board of McGill University Health Centre, 18/06/2012, ref: 11-190-PED
ConditionHealthy, full-term, breastfed infants
InterventionExperimental group: breastfeeding promotion intervention at maternity hospitals and affiliated polyclinics
Control group: continuation of maternity hospital and polyclinic practices existing at time of
randomisation
Intervention typeBehavioural
Primary outcome measureOne or more episodes of gastrointestinal infection in first 12 months of life.
Secondary outcome measuresCurrent secondary outcome measures as of 09/01/2013:
1. Respiratory infections in first 12 months
2. Atopic eczema in first 12 months
3. Weight, length, and head circumference at 1, 2, 3, 6, 9, and 12 months
4. Blood pressure (BP) at age 6.5 and 9 years
5. Asthma, hay fever, atopic eczema, and allergy skin tests at age 6.5 years
6. Intelligence quotient (IQ) and behaviour at age 6.5 years
7. Oral/dental health at age 6.5 years
8. Anthropometry, lipoproteins, glucose, insulin, adiponectin, and IGF at age 11 years
9. Maternal height and weight at 6.5 and 11.5 years postpartum
10. Maternal body composition at 11.5 years postpartum
11. Maternal blood pressure at 11.5 years postpartum
12. Child metabolic syndrome at age 11.5 years
13. Eating attitudes at age 11.5 years
14. Child blood pressure at age 6.5, 11.5 and 16 years
15. Child body composition at age 11.5 and 16 years
16. Eczema, asthma, cognition, vision and lung function at age 16 years
17. Length/height and weight throughout childhood

Amended as of 11/03/2009:
8. Anthropometry, lipoproteins, glucose, insulin, adiponectin, and IGF at age 11 years

Initial information at time of registration:
1. Respiratory infections in first 12 months
2. Atopic eczema in first 12 months
3. Weight, length, and head circumference at 1, 2, 3, 6, 9, and 12 months
4. Blood pressure (BP) at age 6.5 and 9 years
5. Asthma, hay fever, atopic eczema, and allergy skin tests at age 6.5 years
6. Intelligence quotient (IQ) and behaviour at age 6.5 years
7. Oral/dental health at age 6.5 years
8. Lipids, lipoproteins, glucose, insulin, and HbA1c at age 9 years
Overall study start date01/01/1995
Overall study end date31/12/2015

Eligibility

Participant type(s)Patient
Age groupNeonate
SexBoth
Target number of participants17046
Participant inclusion criteria1. Birth weight equal and above 2500 g, either sex
2. Gestational age equal and above 37 weeks
3. Maternal intention to breastfeed
Participant exclusion criteria1. Neonatal disease or condition contraindicating breastfeeding
2. Neonatal disease or condition making breastfeeding difficult or impossible
3. Maternal psychosis
4. Maternal human immunodeficiency virus (HIV) or active tuberculosis (TB)
5. Maternal chemotherapy or radioisotopes
Recruitment start date01/01/1995
Recruitment end date31/12/2015

Locations

Countries of recruitment

  • Belarus
  • Canada

Study participating centre

The Montreal Children's Hospital
Montreal
H3H 1P3
Canada

Sponsor information

McGill University (Canada)
University/education

845 Sherbrooke Street West
James Administration Bldg., Suite 429
Montreal
H3A 2T5
Canada

Website http://www.mcgill.ca/
ROR logo "ROR" https://ror.org/01pxwe438

Funders

Funder type

Research organisation

Canadian Institutes of Health Research (ref: MOP-53155)
Government organisation / National government
Alternative name(s)
Instituts de Recherche en Santé du Canada, Canadian Institutes of Health Research (CIHR), CIHR_IRSC, Canadian Institutes of Health Research | Ottawa ON, CIHR, IRSC
Location
Canada
UNICEF
Government organisation / International organizations
Alternative name(s)
United Nations Children's Fund, United Nations Children's Emergency Fund, Fonds des Nations Unies pour l'enfance, Fondo de las Naciones Unidas para la Infancia, صندوق الأمم المتحدة للطفولة, 联合国儿童基金会
Location
United States of America
Thrasher Research Fund (USA)
Private sector organisation / Trusts, charities, foundations (both public and private)
Alternative name(s)
TRF
Location
United States of America
National Health Research and Development Program (NHRDP) - Health Canada (Canada)

No information available

European Union (EU)

No information available

National Institutes of Health (NIH) (USA)
Government organisation / National government
Alternative name(s)
Institutos Nacionales de la Salud, US National Institutes of Health, NIH
Location
United States of America

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 20/10/2007 Yes No
Results article results 01/12/2007 Yes No
Results article results 01/03/2008 Yes No
Results article results 01/05/2008 Yes No
Results article results 01/12/2011 Yes No
Results article results 13/03/2013 Yes No
Results article results 01/07/2013 Yes No
Results article results 21/01/2014 Yes No
Other publications cohort profile 01/06/2014 Yes No
Results article results 01/07/2014 Yes No
Results article results 01/08/2014 Yes No
Results article secondary analysis results 03/07/2017 Yes No
Results article secondary analysis results 01/04/2018 Yes No
Results article secondary analysis results 01/02/2019 29/01/2020 Yes No
Results article secondary analysis results 01/09/2019 15/09/2020 Yes No
Results article 23/01/2021 03/06/2021 Yes No

Editorial Notes

03/06/2021: Publication reference added.
15/09/2020: Publication reference added.
29/01/2020: Publication reference added.
12/04/2018: Publication reference added.
02/05/2017: Publication reference added.
02/09/2013: The overall trial start date was changed from 01/04/2002 to 01/01/1995.
09/01/2013: The following changes were made to the record:
1. The overall trial end date for this trial was changed from 01/12/2011 to 31/12/2015.
2. Belarus was added to the countries of recruitment, and Canada was removed.
25/03/2009: The overall trial end date was changed from 31/03/2008 to 01/12/2011.