Oropharyngeal Colostrum Positively Modulates the Inflammatory Response in Preterm Neonates
Estefanía Martín-Álvarez1, Javier Diaz-Castro2,3, Manuela Peña-Caballero1
1Unit of Neonatology, Pediatric Service, Hospital Universitario Materno-Infantil Virgen de las Nieves, 18014 Granada, Spain.
Insights
Administering mother's milk to the mouth of premature infants (PMI) reduced inflammatory markers and helped them achieve full enteral feeding sooner. This practice may positively impact immune system development in preterm neonates.
Area of Science:
- Neonatology
- Immunology
- Pediatrics
Background:
- Premature infants often struggle with swallowing, missing crucial breastfeeding benefits.
- Inflammatory signaling plays a key role in the health and development of extremely premature infants.
Purpose of the Study:
- To evaluate the impact of oropharyngeal mother's milk administration on inflammatory signaling in extremely premature infants.
- To assess if this intervention affects the time to achieve full enteral feeding.
Main Methods:
- A randomized controlled trial involving 100 neonates (<32 weeks gestation or <1500 g) divided into two groups.
- One group received 0.2 mL of oropharyngeal mother's milk every 4 hours for 15 days; the control group did not.
- Serum inflammatory markers (IL-6, IL-8, IL-10, IL-1ra, TNF-α, IFN-γ) were measured at postnatal days 1, 3, 15, and 30.
Main Results:
- The mother's milk group achieved full enteral feeding earlier than the control group.
- Significant decreases in pro-inflammatory markers (IL-6, IL-8, TNF-α, IFN-γ) were observed in the mother's milk group.
- Increases in anti-inflammatory markers (IL-1ra, IL-10) were noted in the mother's milk group.
Conclusions:
- Oropharyngeal mother's milk administration for 15 days effectively reduces the pro-inflammatory state in preterm neonates.
- This intervention facilitates earlier achievement of full enteral nutrition, potentially benefiting immune system development and inflammatory response.
- The findings suggest a positive influence on overall infant development outcomes.
Abstract:
During the first days of life, premature infants have physiological difficulties swallowing, thereby missing out on the benefits of breastfeeding. The aim of this study is to assess the effects of oropharyngeal mother's milk administration in the inflammatory signaling of extremely premature infants. Neonates (n = 100) (<32 week's gestation and/or <1500 g) were divided into two groups: mother's milk group (n = 48), receiving 0.2 mL of oropharyngeal mother's milk every 4 h for the first 15 days of life, and a control group (n = 52), not receiving oropharyngeal mother's milk. Serum concentrations of interleukin (IL) IL-6, IL-8, IL-10, IL-1ra, tumor necrosis factor alpha (TNF-α), and interferón gamma (IFN-γ) were assessed at 1, 3, 15, and 30 days of postnatal life. Maternal and neonatal outcomes were collected. The rate of common neonatal morbidities in both groups was similar. The mother's milk group achieved full enteral feeding earlier, and showed a decrease in Il-6 on days 15 and 30, in IL-8 on day 30, and in TNF-α and INF-γ on day 15, as well as an increase in IL-1ra on days 3 and 15 and in IL-10 on day 30. Oropharyngeal mother's milk administration for 15 days decreases the pro-inflammatory state of preterm neonates and provides full enteral nutrition earlier, which could have a positive influence on the development of the immune system and inflammatory response, thereby positively influencing other developmental outcomes.
