Clinical adaptation and the state of innate and humoral im- munity of premature infants with extremely low body weight who received oropharyngeal administration of colostrum

Abstract

   Breast milk is the optimal food for premature infants. However, the serious condition of premature newborns requires a complex of primary resuscitation care in the maternity unit, which makes it impossible to carry out early attachment to the breast and start breastfeeding. Currently, the neonatal community is actively discussing the immune effects of an alternative method of oropharyngeal administration of colostrum on the child’s adaptation to extrauterine existence.   Purpose. To assess the clinical outcomes, the state of the monocytic immunity, the production of sIgA in coprofiltrates in premature infants with extremely low body weight who received colostrum in the first hours of life.   Material and methods. 39 premature infants with extremely low body weight who received oropharyngeal administration of colostrum were examined. The expression of CD14+CD282+, CD14+CD284+, CD14+HLA-DR, CD14+CD64+, CD14+CD11b+, CD14+CD11c+ monocytes and the phagocytic ability of mononuclear cells in blood serum were determined by laser flow cytometry. The secretory IgA concentration was assessed in coprofiltrates.   Results. In premature infants who did not receive oropharyngeal colostrum, there was an increase in leukocyte phagocytosis, the level of monocyte expression, which was due to an increased infectious morbidity. Mucosal immunity of children who received colostrum was characterized by an increased concentration of secretory IgA.   Conclusion. It was found that children who received oropharyngeal administration of colostrum have a faster correction of transient hypoglycemia after birth, a shorter duration of parenteral nutrition, greater body weight at the time of discharge, and a decrease in the incidence of infectious pathology.