Does providing a very small volume of maternal colostrum into the mouth of preterm babies (oropharyngeal colostrum (OPC)) prevent complications and improve health outcomes?
Placing a small volume of colostrum – the first milk produced by the mother during the first few days of life – directly onto the inside of the cheeks of preterm infants may provide immunological and growth factors that stimulate the immune system and enhance growth of the intestine. These benefits could potentially reduce infections, including severe infections in the intestine known as necrotising enterocolitis (NEC), thereby improving survival and long-term outcomes.
We searched for both published and unpublished studies comparing oropharyngeal colostrum versus a control such as water, placebo, or no oral priming. We included only clinical trials reporting outcomes in preterm babies (< 37 weeks’ gestation). The evidence is up-to-date as of August 2017. We did not limit the review to any particular region or language.
Six studies were eligible for inclusion, involving 335 preterm infants with gestational ages ranging from 25 to 32 weeks’ gestation and birth weights of 410 to 2500 grams. Reviewers noted no differences between OPC and control for rate of NEC, infection, or death before hospital discharge. Similarly, they observed no difference in length of hospital stay between OPC and control babies. Infants who received OPC achieved full milk feeds on average 2.5 days earlier than those given placebo or no intervention. However, included studies were small, data were insufficient, and study designs were not ideal. Combining study data did not provide sufficient evidence to recommend the use of colostrum for oral priming to prevent complications in preterm infants. Five of the included studies reported no harms (adverse effects); however, no numerical data are available from these studies. Included studies were of very low quality; therefore the effects of OPC remain uncertain.
Larger, better quality clinical trials would be needed to evaluate more precisely and reliably the effects of OPC on important outcomes for preterm infants. .