Oropharyngeal Colostrum Positively Modulates the Inflammatory Response in Preterm Neonates

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.

Keywords: clinical outcomes; colostrum administration; inflammation; premature neonates.

Figure 1

Flowchart showing participant progress and dropouts in the study.

Figure 2

Effect of oropharyngeal mother’s milk administration on the levels of IL-6 (A), IL-8 (B), IL-10 (C), and IL1-ra (D) in serum. Results are expressed as mean ± standard error of the mean. A line between bars means statistically significant differences between groups (p < 0.05). Different letters in every group indicate significant differences due to the time (mother’s milk (A, B, C), control (a, b, c) (p < 0.05)). M1: Birth (basal value), M2: 3rd day of postnatal life; M3: 15th day of postnatal life, M4: 30th day of postnatal life.

Figure 3

Effect of oropharyngeal mother’s milk administration on the levels of TNF-α (A) and INF-γ (B) in serum. Results are expressed as mean ± standard error of the mean. A line between bars means statistically significant differences between groups (p < 0.05). Different letters in every group indicate significant differences due to the time (mother’s milk (A, B, C), control (a, b, c) (p < 0.05)). M1: Birth (basal value), M2: 3rd day of postnatal life, M3: 15th day of postnatal life, M4: 30th day of postnatal life.