Does oral care with mother's colostrum reduce the risk of late-onset sepsis in preterm infants? A randomized clinical trial.

Abstract

BackgroundOral care with mother's colostrum (OCC) for very-low-birth-weight (VLBW) preterm newborns may provide immune-protective effects that potentially reduce the risk of late-onset sepsis (LOS) and death. Our objective was to assess the effect of OCC on the risk of LOS and mortality in VLBW premature neonates.MethodsA single-center randomized clinical trial was conducted on 65 VLBW preterm neonates. The intervention was oral care administrated every 6 hours, starting in the first 24 hours of life and lasting for 5 days, using either own mother's colostrum (colostrum group) or sterile water (placebo group).ResultsNeonates in the colostrum group were significantly less likely to have LOS (62.5% vs 93.9%, RR = 0.66, p = 0.002), ventilator-associated pneumonia (VAP) (21.9% vs 48.5%, RR = 0.45, p = 0.025), feeding intolerance (56.3% vs 84.3%, RR = 0.66, p = 0.01), and mortality (18.8% vs 57.6%, RR = 0.3, p = 0.001). The time to start enteral nutrition in the colostrum group was shorter (p = 0.04) than in the placebo group. In multivariate analysis, OCC decreased the risk of LOS (OR = 0.12, p = 0.01) and death (OR = 0.14, p = 0.004). Moreover, OCC practice was associated with a faster time to regain birth weight (p = 0.027) and a shorter duration of hospitalization (p = 0.04) in surviving preterm infants.ConclusionOCC is a simple and safe practice that may yield a significant impact in reducing the risk of LOS, VAP, feeding intolerance, and mortality; can shorten time to start enteral feeding with faster regain to birth weight; and can shorten the length of hospital stay in VLBW preterm infants.