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Effect of Oral Colostrum Administration Duration on Clinical Outcomes in Preterm Infants: A Randomized Controlled

Elif Ceren Oruc1, Kiymet Celık2, Sema Arayici2

  • 1Department of Pediatrics, Faculty of Medicine, Akdeniz University, Antalya, Turkey.

Breastfeeding Medicine : the Official Journal of the Academy of Breastfeeding Medicine
|December 30, 2025
PubMed

Insights

Oral colostrum administration (OCA) in preterm infants improved feeding tolerance and reduced late-onset sepsis (LOS). Extended OCA also increased exclusive breastfeeding rates at discharge.

Area of Science:

  • Neonatal Medicine
  • Pediatric Gastroenterology
  • Clinical Nutrition

Background:

  • Oral colostrum administration (OCA) is a safe intervention for neonates.
  • Previous studies suggest OCA reduces necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) in preterm infants.
  • The optimal duration of OCA remains undetermined.

Purpose of the Study:

  • To evaluate the impact of different durations of OCA on NEC incidence (stage ≥2) and other morbidities in preterm infants.
  • To compare short-term (3 days) and extended (10 days) OCA versus no OCA.

Main Methods:

  • A randomized controlled study involving preterm infants born before 32 weeks gestation.
  • Infants were divided into three groups: no OCA, short-term OCA (3 days), and extended OCA (10 days).
  • Additional analysis compared combined colostrum groups (short-term and extended) with the noncolostrum group.

Main Results:

  • The incidence of NEC was 10.9% in the noncolostrum group, 4.3% in the short-term group, and 0% in the extended group.
  • While not statistically significant by duration, OCA groups showed decreased NEC rates (OR: 0.19; 95% CI: 0.11-0.32).
  • OCA groups achieved earlier full enteral feeding, had shorter antibiotic durations, and lower LOS rates (p=0.004, p<0.001, p=0.004).
  • The extended OCA group had the highest exclusive breastfeeding rate at discharge (p=0.003).

Conclusions:

  • Oral colostrum administration improves feeding tolerance and reduces late-onset sepsis in preterm infants.
  • Extended OCA administration is associated with higher exclusive breastfeeding rates at discharge.
  • While not reaching statistical significance in this study, OCA demonstrated a trend towards reduced NEC incidence.
Abstract

Keywords:
breastfeedingnecrotizing enterocolitisoral colostrum administrationpreterm

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