Early Administration of Oropharyngeal Colostrum to Extremely Low Birth Weight Infants

Seigel, Jonathan K.; Smith, P. Brian; Ashley, Patricia L.; Cotten, C. Michael; Herbert, Claudia C.; King, Beth; Maynor, Angela; Neill, Sara; Wynn, James L.; Bidegain, Margarita

doi:10.1089/bfm.2013.0025

Cited by 75 publications

(85 citation statements)

References 27 publications

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“…A prospective study of 15 extremely low birth weight infants demonstrated that the time to reach full enteral feeding was reduced, 15 and 1 retrospective study reported that oropharyngeal administration of colostrum resulted in starting feeding earlier and reaching birth weight sooner. 16 However, no published data have illustrated the clinical advantages of oropharyngeal colostrum administration in relation to the immune system.…”

Section: Discussionmentioning

confidence: 99%

“…19 The oropharyngeal mucosal route was recently proposed as a solution for providing maternal colostrum to the sickest infants during the early postnatal period. 11-14, 16 Rodriguez et al 12 described the expected mechanisms through which cytokines and other immunologic factors in colostrum stimulate the immature neonatal immune system via lymphoid tissues in the oropharynx and gut, resulting in the development of a protective mucosal immune barrier.…”

Section: Discussionmentioning

confidence: 99%

“…11,13 Although theoretical and preclinical support for this practice exists, there is insufficient evidence that oropharyngeal administration of colostrum is beneficial to date. [13][14][15][16] We aimed to evaluate the immunologic effects of oropharyngeal colostrum administration in extremely premature infants.…”

Section: What This Study Addsmentioning

confidence: 99%

“…The colostrum group had less clinical sepsis (50% vs 92%, P = .003) and shorter total antibiotic duration (6 [IQR: 3.8-8.5] vs 9.5 [IQR: [7][8][9][10][11][12][13][14][15][16][17][18][19]] days, P = .014), but no difference in cultureproven sepsis (46% vs 58%, P = .56) ( Table 2). The significant effect of colostrum administration on clinical sepsis was also validated in a regression analysis with all possible confounders, including mechanical ventilation, H2 blocker use, probiotic use, postnatal steroid use, feeding status and types (exp[B] = 67.3, 95% confidence interval: 3.8-1186.9, P = .004).…”

Section: Figurementioning

confidence: 99%

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Oropharyngeal Colostrum Administration in Extremely Premature Infants: An RCT

et al. 2015

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To determine the immunologic effects of oropharyngeal colostrum administration in extremely premature infants. METHODS:We conducted a double-blind, randomized, placebo-controlled trial involving 48 preterm infants born before 28 weeks' gestation. Subjects received 0.2 mL of their mother's colostrum or sterile water via oropharyngeal route every 3 hours for 3 days beginning at 48 to 96 hours of life. To measure concentrations of secretory immunoglobulin A, lactoferrin, and several immune substances, urine and saliva were obtained during the first 24 hours of life and at 8 and 15 days. Clinical data during hospitalization were collected.RESULTS: Urinary levels of secretory immunoglobulin A at 1 week (71.4 vs 26.5 ng/g creatinine, P = .04) and 2 weeks (233.8 vs 48.3 ng/g creatinine, P = .006), and lactoferrin at 1 week (3.5 vs 0.9 mg/g creatinine, P = .01) were significantly higher in colostrum group. Urine interleukin-1b level was significantly lower in colostrum group at 2 weeks (55.3 vs 91.8 mg/g creatinine, P = .01). Salivary transforming growth factor-b1 (39.2 vs 69.7 mg/mL, P = .03) and interleukin-8 (1.2 vs 4.9 ng/mL, P = .04) were significantly lower at 2 weeks in colostrum group. A significant reduction in the incidence of clinical sepsis was noted in colostrum group (50% vs 92%, P = .003).CONCLUSIONS: This study suggests that oropharyngeal administration of colostrum may decrease clinical sepsis, inhibit secretion of pro-inflammatory cytokines, and increase levels of circulating immune-protective factors in extremely premature infants. Larger studies to confirm these findings are warranted. WHAT'S KNOWN ON THIS SUBJECT:Immunerelated bioactive proteins are highly concentrated in the colostrum of mothers who deliver preterm infants. Oropharyngeal administration was proposed as a safe and feasible alternative method of providing colostrum to immunocompromised premature infants. WHAT THIS STUDY ADDS:Oropharyngeally administered colostrum during the first few days of life increased urinary secretory immunoglobulin A and lactoferrin, decreased urinary interleukin-1b, reduced salivary transforming growth factor-b1 and interleukin-8, and reduced the occurrence of clinical sepsis in extremely premature infants.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: What This Study Addsmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

See 2 more Smart Citations

Oropharyngeal Colostrum Administration in Extremely Premature Infants: An RCT

et al. 2015

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“…La administración por vía orofaríngea no equivale a la administración oral, sino que consiste en colocar pequeñas cantidades de calostro (0,2 ml) directamente en la mucosa oral con la expectativa de que el líquido, o cualquiera de sus componentes, sea absorbido por la mucosa orofaríngea. Los estudios demuestran que es una práctica segura, factible y bien tolerada incluso por los bebés prematuros más pequeños (14,17). La administración orofaríngea del calostro sería considerada un complemento y no un sustituto de la nutrición enteral trófica.…”

Section: Introductionunclassified

Efectos de la administración de calostro orofaríngeo en recién nacidos prematuros sobre los niveles de inmunoglobulina A

Álvarez¹,

Cabanillas²,

Peña‐Caballero³

et al. 2016

Nutr Hosp

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Introducción: el recién nacido prematuro de muy bajo peso (RNMBP) es inmunológicamente inmaduro y además presenta una alteración de las barreras naturales de defensa. Objetivo: evaluar los efectos que pueda tener la administración de calostro orofaríngeo, administrado durante los primeros 15 días posnatales, sobre los niveles de inmunoglobulina A (IgA) sérica en recién nacidos prematuros de muy bajo peso durante el primer mes de vida. Material y métodos: se desarrolló un estudio de intervención no aleatorizado con grupo control, en el que se incluyeron 38 recién nacidos con ≤ 32 + 6 semanas de gestación y/o menores de 1.500 g de peso. Los sujetos recibieron 0,2 ml de calostro de su madre cada 4 h, iniciándose el procedimiento en las primeras 24 h de vida hasta el 15.o día postnatal. Se midieron los niveles de IgA en la sangre al nacimiento, 3. er , 15.o y 30.o días de vida. Se registraron datos perinatales al nacimiento y durante el periodo de seguimiento. Resultados: IgA sérica aumentó de forma estadísticamente significativa en el grupo de intervención (M1 15,84 μg/ml, M2 20,07 μg/ml, M3 23,65 μg/ml, M4 30,34 μg/ml, p 0,001) y en el grupo control (M1 12,48 μg/ml, M2 16,48 μg/ml, p 0,018; M3 19,41 μg/ml, M4 22,48 μg/ml, p 0,001). Al mes de vida, los niveles de IgA sérica fueron significativamente mayores en el grupo de intervención que en el grupo control (p 0,026). Conclusiones: este estudio sugiere que la administración de calostro orofarínge

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Effects on Growth of Smell and Taste of Milk During Tube Feeding of Preterm Infants

et al. 2021

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IMPORTANCE Smell and taste of food increase food anticipation, activate gut motility, and stimulate digestion and metabolism. Despite poor growth of many preterm infants in neonatal intensive care units, the smell and taste of milk with tube feeding are not generally considered a regular component of care.OBJECTIVE To determine the effect of smell and taste of milk with tube feeding on weight z scores at discharge from the hospital. DESIGN, SETTING, AND PARTICIPANTSA randomized, controlled, nonblinded, superiority trial was conducted at 2 perinatal centers between May 9, 2017, and February 1, 2020. Eligible infants (n = 659) were born at less than 29 weeks' postmenstrual age (PMA) and/or with a birth weight of less than 1250 g. INTERVENTIONSInfants were randomly assigned to receive either the smell and taste of milk with each tube feeding or routine care without the provision of smell and taste of milk. MAIN OUTCOMES AND MEASURESThe primary outcome was weight z score at discharge from any hospital. Secondary outcomes included anthropometric measures at predefined time points, time to full enteral feeds, and other health outcomes associated with prematurity. RESULTSOf the 658 infants, a total of 396 infants were randomized; some parents had not been approached for consent (n = 144) or declined participation (n = 117), and 1 infant with consent was not randomized. Of the 396 infants, 196 were assigned to the treatment group (51% male; mean [SD] PMA at birth, 27.5 [2.2] weeks) and 200 were assigned to the control group (52% male; mean [SD] PMA at birth, 27.6 (2.3) weeks). Mean weight z scores at discharge were −0.87 (95% CI, −1.02 to −0.72) for the treatment group and −0.97 (95% CI, −1.11 to −0.83) for the control group (P = .40). The mean difference in z scores between the treatment and control groups at 36 weeks' PMA was 0.21 (95% CI, 0.01 to 0.4; P = .04) for head circumference and 0.26 (95% CI, 0.05 to 0.51; P = .04) for length. There were no clinically notable differences between the study groups for any other anthropometric, feeding, or health outcomes. CONCLUSIONS AND RELEVANCEIn this randomized clinical trial, regular smell and taste of milk included with tube feeding did not improve weight at discharge in preterm infants. Secondary outcomes suggest exposure to smell and taste may improve head circumference and length at 36 weeks' PMA, but not at discharge. Regular exposure to the smell and taste of milk is a simple and inexpensive intervention with potential benefits and no apparent adverse effects.

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Early Administration of Oropharyngeal Colostrum to Extremely Low Birth Weight Infants

Cited by 75 publications

References 27 publications

Oropharyngeal Colostrum Administration in Extremely Premature Infants: An RCT

Oropharyngeal Colostrum Administration in Extremely Premature Infants: An RCT

Efectos de la administración de calostro orofaríngeo en recién nacidos prematuros sobre los niveles de inmunoglobulina A

Effects on Growth of Smell and Taste of Milk During Tube Feeding of Preterm Infants

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