Analysis of clinical outcomes of oropharyngeal colostrum administration in very low-birth-weight preterm newborns

Abstract

Objectives: Colostrum is the first secretion produced by the mammary glands and is present through the seventh day after birth. Colostrum has important immunomodulatory components and protective factors that contribute to the protection and development of newborns. The oropharyngeal administration of colostrum (OAC) has been proposed as a potential nutritional option for very low-birth-weight (VLBW) newborns (<1500 g). This study aimed to analyze the clinical outcomes of VLBW infants receiving OAC.

Methods: This is a retrospective longitudinal study with nonprobability sampling of VLBW infants on the OAC protocol. VLBW infants for whom no OAC data were available, who received no dose, or who died within the first 7 d of life were excluded. The Mann-Whitney test was used to compare quantitative variables and the Wilcoxon test to assess the evolution of anthropometric values with a significance level of 5% (P < 0.05).

Results: Enteral nutritional therapy was commenced after 1 d (median: 1 d; interquartile range [IQR], 1-1 d). Full enteral feeding was achieved after 11 d (median: 11.0 d; IQR, 9.0-16.0 d). Birth weight was recovered after 11 d (median: 11 d; IQR, 7.0-14.0 d). OAC was commenced at 3 d of life, and 32.5 doses (IQR, 21.0-44.0 d) were given in total. There were significant differences in the evolution of anthropometric characteristics during hospitalization, with a tendency to recover birth weight more quickly the higher the number of doses administered (P = 0.07). Time to full enteral feeding was significantly longer and time to recovery of birth weight significantly shorter when OAC was commenced ≤3 d after birth (P = 0.023).

Conclusions: OAC was associated with a shorter time to recover birth weight and time to full enteral feeding.

Keywords: Colostrum; Human milk; Oral immunotherapy; Oropharyngeal administration of colostrum; Preterm newborns.