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American Academy of Pediatrics
Article

Oropharyngeal Colostrum Administration in Extremely Premature Infants: An RCT

Juyoung Lee, Han-Suk Kim, Young Hwa Jung, Ka Young Choi, Seung Han Shin, Ee-Kyung Kim and Jung-Hwan Choi
Pediatrics February 2015, 135 (2) e357-e366; DOI: https://doi.org/10.1542/peds.2014-2004
Juyoung Lee
aDepartment of Pediatrics, Seoul National University College of Medicine, Seoul, Korea; and
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Han-Suk Kim
aDepartment of Pediatrics, Seoul National University College of Medicine, Seoul, Korea; and
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Young Hwa Jung
aDepartment of Pediatrics, Seoul National University College of Medicine, Seoul, Korea; and
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Ka Young Choi
bDepartment of Pediatrics, Dongtan Sacred Heart Hospital, Hallym University Medical Center, Hwaseong, Korea
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Seung Han Shin
aDepartment of Pediatrics, Seoul National University College of Medicine, Seoul, Korea; and
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Ee-Kyung Kim
aDepartment of Pediatrics, Seoul National University College of Medicine, Seoul, Korea; and
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Jung-Hwan Choi
aDepartment of Pediatrics, Seoul National University College of Medicine, Seoul, Korea; and
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Abstract

OBJECTIVE: To determine the immunologic effects of oropharyngeal colostrum administration in extremely premature infants.

METHODS: We conducted a double-blind, randomized, placebo-controlled trial involving 48 preterm infants born before 28 weeks’ gestation. Subjects received 0.2 mL of their mother’s colostrum or sterile water via oropharyngeal route every 3 hours for 3 days beginning at 48 to 96 hours of life. To measure concentrations of secretory immunoglobulin A, lactoferrin, and several immune substances, urine and saliva were obtained during the first 24 hours of life and at 8 and 15 days. Clinical data during hospitalization were collected.

RESULTS: Urinary levels of secretory immunoglobulin A at 1 week (71.4 vs 26.5 ng/g creatinine, P = .04) and 2 weeks (233.8 vs 48.3 ng/g creatinine, P = .006), and lactoferrin at 1 week (3.5 vs 0.9 μg/g creatinine, P = .01) were significantly higher in colostrum group. Urine interleukin-1β level was significantly lower in colostrum group at 2 weeks (55.3 vs 91.8 μg/g creatinine, P = .01). Salivary transforming growth factor-β1 (39.2 vs 69.7 μg/mL, P = .03) and interleukin-8 (1.2 vs 4.9 ng/mL, P = .04) were significantly lower at 2 weeks in colostrum group. A significant reduction in the incidence of clinical sepsis was noted in colostrum group (50% vs 92%, P = .003).

CONCLUSIONS: This study suggests that oropharyngeal administration of colostrum may decrease clinical sepsis, inhibit secretion of pro-inflammatory cytokines, and increase levels of circulating immune-protective factors in extremely premature infants. Larger studies to confirm these findings are warranted.

  • colostrum
  • extremely premature infant
  • human milk
  • Accepted November 24, 2014.
  • Copyright © 2015 by the American Academy of Pediatrics

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Pediatrics
Vol. 135, Issue 2
1 Feb 2015
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Oropharyngeal Colostrum Administration in Extremely Premature Infants: An RCT
Juyoung Lee, Han-Suk Kim, Young Hwa Jung, Ka Young Choi, Seung Han Shin, Ee-Kyung Kim, Jung-Hwan Choi
Pediatrics Feb 2015, 135 (2) e357-e366; DOI: 10.1542/peds.2014-2004

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Oropharyngeal Colostrum Administration in Extremely Premature Infants: An RCT
Juyoung Lee, Han-Suk Kim, Young Hwa Jung, Ka Young Choi, Seung Han Shin, Ee-Kyung Kim, Jung-Hwan Choi
Pediatrics Feb 2015, 135 (2) e357-e366; DOI: 10.1542/peds.2014-2004
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  • Fetus/Newborn Infant
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