Oropharyngeal Colostrum Administration in Premature Infants: Impact on Immune Status and Incidence of Common Morbidities.

Background: Enteral feeding of preterm infants with maternal colostrum has well-known effects on protecting them, especially against serious infections. This study was conducted to determine whether oropharyngeal administration of colostrum to these infants, soon after birth, has any additional effect on their clinical outcomes and stimulation of their immune system.

Methods: In this double-blind randomized clinical trial, 60 preterm infants ≤30 weeks' gestation with birth weight ≤1500 g were randomly assigned to receive oropharyngeal colostrum (OAC group) or distilled water (DW group). Primary outcomes were urinary concentration of IgA on days 1, 8, and 15 of birth and incidence of late onset sepsis (LOS) and necrotizing enterocolitis (NEC). Data were analyzed by independent samples t-test, repeated measures ANOVA, and Chi-square test using SPSS v. 25.

Results: The frequency of LOS, NEC, CLD, and mortality and the mean duration of hospitalization and the time to reach full enteral feeding were similar in both groups (P > 0.05). The mean of urinary IgA levels increased significantly from the 1^st day of birth to the 15^th day of birth in the OAC group (P = 0.013) but decreased significantly from the 1^st day of birth to the 8^th and 15^th days of birth in the DW group (P = 0.04). Results of repeated measures ANOVA test regarding the impact of the two interventions during the studied times on the level of IgA showed that the differences between the means were statistically significant [F (2,116) = 5.12, P = 0.007].

Conclusions: Oropharyngeal administration of colostrum within the first days of life in preterm infants increases the concentration of IgA in urine. The impact of this immune response on common morbidities of these infants, particularly extremely low gestational age neonates, still needs to be investigated more in other larger studies.