Colostrum Use and the Immune System of Premature Newborns: A Systematic Review and Meta-Analysis
Tamy Colonetti1, Isabela de Carvalho Florêncio2, Pâmela Figueiredo2
1Laboratory of Biomedicine Translational, Postgraduate Program in Health Sciences, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, Santa Catarina, Brazil.
Insights
Human colostrum therapy may increase urinary lactoferrin levels in premature infants. This intervention involves applying raw colostrum to the oropharyngeal mucosa, potentially supporting immune function in newborns unable to breastfeed.
Area of Science:
- Neonatal Medicine
- Immunology
- Gastroenterology
Background:
- Human colostrum is used for preterm infants unable to breastfeed.
- Colostrum therapy, involving oropharyngeal mucosal exposure to raw colostrum, is an emerging area of research.
- This therapy is explored for its potential benefits in preterm newborns.
Purpose of the Study:
- To systematically review the scientific evidence on colostrum therapy in premature infants.
- To investigate the effects of colostrum therapy on the immune system of preterm newborns.
Main Methods:
- A systematic review adhering to the PRISMA statement was conducted.
- Searches were performed in Medline, Scopus, Web of Science, Cochrane Library, and Embase up to March 10, 2021.
- Two reviewers independently screened studies, including 12 studies with 996 participants.
Main Results:
- A significant increase in urinary lactoferrin levels was observed after 1 week of colostrum intervention (SMD 0.70; p = .04).
- This finding was based on two studies with 112 participants and is considered very low-quality evidence.
- The heterogeneity (I² = 65%) indicates variability between the studies.
Conclusions:
- Colostrum therapy appears to elevate urinary lactoferrin levels in premature infants.
- Further high-quality research is needed to confirm these findings and understand the immune system influences.
Background:
Human colostrum has been used in a number of investigations when preterm human infants cannot, for any reason, breastfeed directly from their mothers. One of the growing fields in these investigations is colostrum therapy, which consists of exposing the oropharyngeal mucosa of these preterm newborns to small amounts of raw colostrum.
Research Aim:
To critically review the scientific evidence about colostrum therapy in premature infants and to explore its influences on the immune system.
Methods:
This systematic review was performed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA statement). The following databases were searched for potentially eligible studies up to March 10, 2021: Medline, Scopus, Web of Science, Cochrane Library, Embase. Two reviewers independently screened all titles, abstracts, and full texts for eligibility.
Results:
A total of 12 studies with 996 participants were included. A significant difference in lactoferrin levels in the urine was found (SMD 0.70; 95% CI [0.03,1.36]; p = .04; I² = 65% two studies, 112 participants, very low-quality evidence).
Conclusion:
Colostrum seems to result in increasing lactoferrin levels in the urine of premature newborns after 1 week of intervention.
Clinical Trial Registration:
The study was registered at PROSPERO with the number CRD42017073624, submitted on August 9, 2017.
