Enhancement of immune response mediated by oropharyngeal colostrum administration in preterm neonates

• Published in: Pediatric allergy and immunology Vol. 30; no. 2; pp. 234 - 241
• Main Authors: Moreno‐Fernandez, Jorge, Sánchez‐Martínez, Belén, Serrano‐López, Laura, Martín‐Álvarez, Estefanía, Diaz‐Castro, Javier, Peña‐Caballero, Manuela, Martín‐Peregrina, Francisca, Alonso‐Moya, Mercedes, Maldonado‐Lozano, José, Ochoa, Julio J., Hurtado‐Suazo, Jose A.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-03-2019
• Subjects: clinical outcomes; Colostrum; Gestation; Immune response; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Immunoglobulins; Immunomodulation; Infants; Lactoferrin; Morbidity; Neonates; Newborn babies; oropharyngeal colostrum; preterm neonates; Serum levels; clinical outcomes; preterm neonates; immunoglobulins; oropharyngeal colostrum; immune response
• ISSN: 0905-6157; 1399-3038
• DOI: 10.1111/pai.13008

Background
The immune system of preterm infants is immature, being a significant cause of morbidity and mortality, particularly in the preterm infant. Oropharyngeal colostrum administration could be an immunomodulatory aid. Our aim was to evaluate the effect of oropharyngeal colostrum on the serum levels of immunoglobulins, lactoferrin, and resistin during the first month of life and to track the clinical outcome of the neonates.
Methods
One hundred preterm neonates born at <32 weeks of gestation and/or weighing < 1500 g and assisted in the Neonatal Intensive Care Unit were enrolled and divided into two groups: colostrum (n = 48) and control (n = 52). The subjects assigned to the colostrum group received 0.2 mL of colostrum (oropharyngeal route) every 4 hours for the first 15 days of life, and if mothers have inability to breastfeed, they were included in the control group (no oropharyngeal colostrum). Serum concentrations of IgA, IgM, and IgG1, lactoferrin, and resistin were assessed in both groups at 1, 3, 15, and 30 days of life. Clinical data during hospitalization were collected.
Results
IgA and IgM increased in preterm neonates who were administered colostrum for 15 and 30 days. Lactoferrin increased after 30 days, and resistin increased after 15 days of supplying oropharyngeal colostrum. The colostrum group underwent full enteral nutrition before, and no differences were observed in the common neonatal morbidities.
Conclusion
Oropharyngeal colostrum administration is safe in preterm neonates and improves their immunologic profile, showing a potential role as an immunomodulatory agent.