The aim of the MOONRISE Study is to determine whether supplementing mothers of extremely preterm infants (≤32 weeks gestation) with a vitamin B3 derivative called nicotinamide riboside (NR) is effective for increasing milk production during early postpartum. Breastfeeding has well-established immunity and developmental benefits for newborns, as well as protective benefits for mothers, yet many women who have delivered a preterm infant struggle to establish a milk supply and provide sufficient breast milk.^1–3 B-vitamins and their derivatives are used by the body for carrying out energy-intensive processes, including lactation. NR has been approved as safe for long-term use in adults and is effective for increasing circulating energy-carrying molecules in the blood, with no harmful effects on babies who consume it through breast milk, since NR is already present in small amounts in human milk.⁴

NR has yet to be studied as a supplement for increasing milk production in lactating human women; however, in mice and rats, it has shown potential for improving efficiency of lactation while providing metabolic benefits for the mother and lasting cognitive, physical, and behavioral advantages for their babies.⁵ We hypothesize that the supplement could be similarly effective in humans.

In the MOONRISE study, we will investigate the effect of a standard dose of NR versus a placebo supplement on milk production. Mothers will receive both supplements over the course of the study, but the order in which they receive them for each week-long intervention period will be randomized. We will be using a commercially available product called Niagen® as the study supplement.

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