Colostrum and Preterm Babies: A Systematic Review

Abstract

Colostrum from mothers is rich in immunomodulating bio-factors such as immunoglobulins (IgA), lactoferrin, and oligosaccharides and supports gut microbial and inflammatory processes. The support in these processes may provide some relief for infants who are born pre-term. Pre-term infants are more likely to develop necrotizing enterocolitis (NEC), late-onset sepsis (LOS), and ventilator-acquired/associated pneumonia (VAP). Due to the components of colostrum, there may be incentives towards early administration for preterm infants. An extensive literature review was done using ProQuest, ScienceDirect, and PubMed. Only meta-analyses and experimental studies were used. The search included the keywords ‘colostrum and preterm’ and ‘colostrum and necrotizing enterocolitis’. The initial search generated 13,543 articles and was narrowed to 25 articles through comprehensive inclusion and exclusion criteria. There were significantly higher levels of Lactobacillus and Bifidobacterium in pre-term infants given colostrum and a decrease in Moraxellaceae and Staphylococcaceae . Salivary secretory IgA increased following oral colostrum administration in pre-term infants along with downregulation of interleukin (IL)-1b and IL-8. It was also observed that tumor necrosis factor (TNF)-a, and interferon-gamma (IFN-g) were significantly higher in the control group. There was no significant difference in the incidence of LOS, NEC, or VAP between pre-term infants receiving colostrum and those who did not. Secondary outcomes such as time to full enteral feeding were improved in pre-term infants receiving oral colostrum in addition to reduced hospital stays. Lastly, there was no difference in mortality between pre-term infants that received colostrum compared to those who did not.

Science and Faith to Understand Milk Bioactivity for Infants

“…In some cultures, discarding colostrum has been practiced [ 125 ], but the biological and clinical importance of human colostrum has received much attention, especially for the most vulnerable, preterm infants. Recent meta-analyses and systemic reviews showed that even very small amounts of a mother’s colostrum reduce the incidences of colitis, sepsis, lung disease, feeding problems, and growth deficits [ 126 , 127 ]. These findings are supported by some reviews [ 128 ], but questioned in others [ 129 ], and the mechanisms underlying this are unknown.…”

New policies on skin-to-skin contact warrant an oxytocin-based perspective on perinatal health care

“…We may have been unaware of it, but likely full-term infant self-attachment supported by the Baby Friendly Hospital Initiative has led to this normal biological benefit ( Garofoli et al, 2023 ). However, the role of colostrum has been downplayed by our current separation paradigm, and it deserves greater attention, especially for the preterm neonate ( Slouha et al, 2023 ).The first hour colostrum will almost certainly contain high levels of oxytocin, and this has an important role in multiple gastrointestinal functions that are subjected to neuronal regulation ( Welch et al, 2014a ). The enterocytes (stomach lining) have been shown to have oxytocin receptors, contributing to early protection against inflammation ( Gross Margolis et al, 2017 ).…”