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Oropharyngeal Colostrum for Preterm Infants: A Systematic Review and Meta-Analysis

Harshad Panchal1,2,3, Gayatri Athalye-Jape1,2,3, Sanjay Patole1,3

  • 1Neonatal Directorate, King Edward Memorial Hospital for Women, Perth, Western Australia.

Advances in Nutrition (Bethesda, Md.)
|June 1, 2019
PubMed

Insights

Oropharyngeal colostrum (OPC) administration is safe for preterm infants but did not significantly improve key health outcomes like necrotizing enterocolitis or sepsis in this review. Further research is needed to confirm potential benefits.

Area of Science:

  • Neonatal Medicine
  • Pediatric Gastroenterology
  • Immunology

Background:

  • Oropharyngeal colostrum (OPC) administration is a potential intervention for preterm infants.
  • Previous studies suggest OPC may be safe, feasible, and beneficial for this vulnerable population.
  • The immunomodulatory and nutritional effects of OPC warrant further investigation.

Purpose of the Study:

  • To systematically review and assess the effects of oropharyngeal colostrum (OPC) administration in preterm infants.
  • To evaluate the impact of OPC on major neonatal outcomes including necrotizing enterocolitis, sepsis, and mortality.
  • To synthesize evidence from randomized controlled trials (RCTs) and non-RCTs regarding OPC's efficacy and safety.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs).
  • Comprehensive literature search across multiple databases (MEDLINE, EMBASE, Cochrane) and gray literature up to April 2018.
  • Inclusion of 6 RCTs (n=269) and 4 non-RCTs (n=737); one RCT on bovine colostrum was excluded.

Main Results:

  • Meta-analysis of RCT data revealed no significant differences in the incidence of stage 2 necrotizing enterocolitis, late-onset sepsis, or all-cause mortality.
  • OPC administration did not significantly alter the duration of hospital stay or time to full enteral feeds in preterm infants.
  • OPC increased secretory IgA and lactoferrin concentrations and had a transient effect on the oral microbiome; no adverse events were reported.

Conclusions:

  • Current evidence suggests oropharyngeal colostrum (OPC) is safe and feasible for preterm infants but does not demonstrate significant benefits for major clinical outcomes.
  • The overall quality of evidence is very low, highlighting limitations in existing studies.
  • Larger, adequately powered RCTs are essential to definitively establish the potential nutritional and immunomodulatory benefits of OPC in preterm neonates.

Keywords:
human colostrummeta-analysisoropharyngeal colostrumpreterm infantssystematic review

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