Early administration of oropharyngeal colostrum to extremely low birth weight infants.

Published

Journal Article

BACKGROUND: Human milk reduces morbidities in extremely low birth weight (ELBW) infants. However, clinical instability often precludes ELBW infants from receiving early enteral feeds. This study compared clinical outcomes before and after implementing an oropharyngeal colostrum (COL) protocol in a cohort of inborn (born at our facility) ELBW infants. STUDY DESIGN: This is a retrospective cohort study of inborn ELBW infants admitted to the Duke Intensive Care Nursery from January 2007 to September 2011. In November 2010, we initiated a COL protocol for infants not enterally fed whose mothers were providing breastmilk. Infants received 0.1 mL of fresh COL to each cheek every 4 hours for 5 days beginning in the first 48 postnatal hours. We assessed demographics, diagnoses, feeding history, and mortality and for the presence of medical necrotizing enterocolitis (NEC), surgical NEC, and spontaneous perforation. Between-group comparisons were made using Fisher's exact test or Wilcoxon rank sum testing where appropriate. RESULTS: Of the 369 infants included, 280 (76%) were born prior to the COL protocol (Pre-COL Cohort [PCC]), and 89 (24%) were born after (COL Cohort [CC]). Mortality and the percentage of infants with surgical NEC and spontaneous perforations were statistically similar between the groups. The CC weighed an average (interquartile range) of 1,666 (1,399, 1,940) g at 36 weeks versus 1,380 (1,190, 1,650) g for the PCC (p<0.001). In a multivariable analysis with birth weight as a covariable, weight at 36 weeks was significantly greater (37 g; p<0.01). CONCLUSIONS: Initiating oropharyngeal COL in ELBW infants in the first 2 postnatal days appears feasible and safe and may be nutritionally beneficial. Further research is needed to determine if early COL administration reduces neonatal morbidity and mortality.

Full Text

Duke Authors

Cited Authors

  • Seigel, JK; Smith, PB; Ashley, PL; Cotten, CM; Herbert, CC; King, BA; Maynor, AR; Neill, S; Wynn, J; Bidegain, M

Published Date

  • December 2013

Published In

Volume / Issue

  • 8 / 6

Start / End Page

  • 491 - 495

PubMed ID

  • 23805944

Pubmed Central ID

  • 23805944

Electronic International Standard Serial Number (EISSN)

  • 1556-8342

Digital Object Identifier (DOI)

  • 10.1089/bfm.2013.0025

Language

  • eng

Conference Location

  • United States