Abstract
Objective:
Oral colostrum administration (OCA) for neonates is easy, simple, and safe. Previous studies have reported that OCA decreases the incidence of necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) in preterm infants. However, the optimal duration of OCA has not been established. This study aimed to investigate the effect of OCA for different durations on the incidence of NEC (stage ≥2) and other morbidities.
Methods:
This randomized controlled study recruited premature infants born before 32 weeks of gestation. The infants were categorized into the following three groups: noncolostrum group, did not receive OCA; short-term colostrum group, received oral colostrum for 3 days; and extended colostrum group, received oral colostrum for 10 days. For additional analyses, the infants were also classified into two broader categories: colostrum (combining short-term and extended groups) and noncolostrum groups.
Results:
In this study, 138 infants (46 in each group) were recruited. The incidence rates of NEC in the noncolostrum, short-term colostrum, and extended colostrum groups were 10.9% (n = 5), 4.3% (n = 2), and 0% (n = 0), respectively. Infants in the groups receiving colostrum exhibited a decreased incidence of NEC, although the difference was not significant when analyzed according to duration (OR: 0.19; 95% CI: 0.11–0.0.32, p = 0.057). Compared with the noncolostrum group, infants in the colostrum group achieved full enteral feeding earlier, had a shorter antibiotic duration, and exhibited lower rates of LOS (p = 0.004, p < 0.001, p = 0.004, respectively). The extended colostrum group exhibited the highest exclusive breastfeeding rate at discharge (p = 0.003).
Conclusion:
OCA improved feeding tolerance and reduced LOS in preterm infants. Although the effect on NEC was not significant, extended administration enhanced exclusive breastfeeding rates at discharge.
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