Oropharyngeal colostrum in preventing mortality and morbidity in preterm infants

Nasuf, Amna W; Ojha, Shalini; Dorling, Jon

doi:10.1002/14651858.cd011921

Cited by 30 publications

(47 citation statements)

References 36 publications

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“…However, our study was not powered or sample sized to detect this effect. Our results were in consistency with what was reported by Nasuf et al, who found that oropharyngeal colostrum did not affect the incidence of BPD in preterm infants compared with control practices …”

Section: Discussionsupporting

confidence: 93%

“…Previous research has found that routine oral mouth care, as part of a bundle to reduce nosocomial pneumonia, was associated with a significant decrease in the incidence of VAP in the NICU . In the recent meta‐analysis by Nasuf et al, 3 of the 6 included trials did not find that oropharyngeal colostrum decreased the incidence of pneumonia . However, oropharyngeal colostrum was applied early within 48 hours for a duration of 48 hours only in the 3 trials that reported VAP, which may not be an adequate duration to protect against VAP, compared with the long‐term OPAMM practice in our study.…”

Section: Discussionmentioning

confidence: 99%

“…This could be explained by the immune defense of the GIT system, which prevents spread, transformation, and invasion of pathogenic microorganisms along different partitions of the GIT and the fact that GIT is not the only source for invasive bacteria in neonates. A recent meta‐analysis of 6 trials that compared oropharyngeal colostrum to different controls (water, saline, placebo, or no intervention) found no significant differences in the incidence of late‐onset sepsis (Risk ratio 0.86, 95% CI 0.56‐1.33) . However, the effect of intervention was uncertain because of small sample sizes of the included trials and the imprecision in study results.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Oropharyngeal Administration of Mother's Milk Prior to Gavage Feeding in Preterm Infants: A Pilot Randomized Control Trial

Abd-Elgawad

Eldegla

Khashaba

et al. 2019

J Parenter Enteral Nutr

126

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Background: Oropharyngeal administration of mother's colostrum in early days has an immunoprotective effect in preterm infants. Objectives: Our aim was to study the effect of oropharyngeal administration of mother's milk (OPAMM) on decreasing the incidence of nosocomial sepsis. Methods: In a pilot prospective randomized study on preterm (<32 weeks gestation and 1500 g weight) infants, we compared OPAMM practice (applying 0.2 mL of mother's colostrum or milk prior to gavage feeding until full oral feeding is reached) with regular gavage feeding. The primary outcome was incidence of culture-proven nosocomial sepsis. Secondary outcomes included bacterial colonization of the gastrointestinal tract, feeding intolerance, time to reach full feeding, incidence of necrotizing enterocolitis, ventilator-associated pneumonia, duration of respiratory support, incidence of bronchopulmonary dysplasia (BPD), length of hospital stay, and neonatal mortality. Results: The outcomes of 200 neonates (100 in each group) were analyzed. OPAMM practice did not significantly reduce the incidence of culture proven nosocomial sepsis (8% vs 13%, P = 0.35). Infants in the OPAMM group had a significantly lower growth of Klebsiella species in the oropharyngeal pouch, borderline lower incidence of ventilator-associated pneumonia, shorter duration of oxygen therapy, less episodes of feeding intolerance, reached full feeding earlier, and had a shorter length of hospital stay. OPAMM practice did not affect the incidence of necrotizing enterocolitis, BPD, or neonatal mortality. Conclusion: OPAMM prior to gavage feeding does not reduce the incidence of nosocomial sepsis but had beneficial effects on early achievement of feeding, and early hospital discharge in preterm very low-birth-weight infants. (JPEN J Parenter Enteral Nutr. 2020;44:92-104) Clinical Relevancy StatementGavage feeding in preterm infants deprives the oropharyngeal pouch from the beneficial effect of mother's colostrum and milk. Previous reports have shown immunoprotective and anti-inflammatory effects for mother's colostrum when given early to the oropharyngeal pouch. We found that oropharyngeal administration of mother's milk prior to gavage feeding was associated with shorter duration to achieve full feeding, duration of oxygen support, and length of hospital stay in preterm infants.From the

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Oropharyngeal Administration of Mother's Milk Prior to Gavage Feeding in Preterm Infants: A Pilot Randomized Control Trial

Abd-Elgawad

Eldegla

Khashaba

et al. 2019

J Parenter Enteral Nutr

126

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“…They concluded that although OAC showed no reduction in the incidence of NEC, LOS, death before hospital discharge, and length of hospital stay, there was significant reduction in days to reach full enteral feeds. 34…”

Section: Discussionmentioning

confidence: 99%

Role of Oropharyngeal Administration of Colostrum in Very Low Birth Weight Infants for Reducing Necrotizing Enterocolitis: A Randomized Controlled Trial

et al. 2019

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Objective This study aimed to study the role of oropharyngeal administration of colostrum (OAC) in very-low-birth-weight infants for reducing necrotizing enterocolitis (NEC). Study Design In this randomized controlled trial, 117 infants were enrolled, 59 were randomized to OAC group and 58 to routine care group. Infants with birth weight ≤ 1,250 g and/or gestational age ≤ 30 weeks were enrolled. Infants in OAC group received maternal colostrum (0.2 mL), 0.1 mL on either side, after 24 hours of postnatal life and were given every 2 hour for the next 72 hours irrespective of the enteral feeding status of the neonate. The primary outcome of the study was the incidence of NEC (stage 2 or 3). Results Baseline characteristics were comparable between the two groups. There was no significant reduction in the incidence of NEC in OAC group (0 [0%] vs. 3 [7.1%]; p = 0.11). There was significant reduction of 7 days of hospital stay in OAC group (34.2 ± 5.7 vs. 41.5 ± 6.7 days; p = 0.04).The incidence of early-onset sepsis, late-onset sepsis, blood culture positive sepsis, and ventilator-associated pneumonia were comparable between the two groups. Conclusion OAC is safe and reduces the duration of hospital stay.

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“…A multicentric double‐blinded large RCT ( n = 622 neonates) is ongoing that may achieve the desired outcomes. There is one Cochrane systematic review in process that aims to assess the role of oropharyngeal colostrum in the prevention of morbidity and mortality in preterm (<37 weeks of gestation) neonates .…”

Section: Discussionmentioning

confidence: 99%

Effect of oropharyngeal colostrum therapy in the prevention of necrotising enterocolitis among very low birthweight neonates: A meta‐analysis of randomised controlled trials

Garg

Balasubramanian

Kabra

et al. 2018

J Human Nutrition Diet

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Oropharyngeal colostrum in preventing mortality and morbidity in preterm infants

Abstract: Oropharyngeal colostrum in preventing mortality and morbidity in preterm infants.

Cited by 30 publications

References 36 publications

Oropharyngeal Administration of Mother's Milk Prior to Gavage Feeding in Preterm Infants: A Pilot Randomized Control Trial

Oropharyngeal Administration of Mother's Milk Prior to Gavage Feeding in Preterm Infants: A Pilot Randomized Control Trial

Role of Oropharyngeal Administration of Colostrum in Very Low Birth Weight Infants for Reducing Necrotizing Enterocolitis: A Randomized Controlled Trial

Effect of oropharyngeal colostrum therapy in the prevention of necrotising enterocolitis among very low birthweight neonates: A meta‐analysis of randomised controlled trials

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