Maternity Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Nutrition Institute Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Nutrition. 2021 Oct;90:111292. doi: 10.1016/j.nut.2021.111292. Epub 2021 Apr 28.
Colostrum is the first secretion produced by the mammary glands and is present through the seventh day after birth. Colostrum has important immunomodulatory components and protective factors that contribute to the protection and development of newborns. The oropharyngeal administration of colostrum (OAC) has been proposed as a potential nutritional option for very low-birth-weight (VLBW) newborns (<1500 g). This study aimed to analyze the clinical outcomes of VLBW infants receiving OAC.
This is a retrospective longitudinal study with nonprobability sampling of VLBW infants on the OAC protocol. VLBW infants for whom no OAC data were available, who received no dose, or who died within the first 7 d of life were excluded. The Mann-Whitney test was used to compare quantitative variables and the Wilcoxon test to assess the evolution of anthropometric values with a significance level of 5% (P < 0.05).
Enteral nutritional therapy was commenced after 1 d (median: 1 d; interquartile range [IQR], 1-1 d). Full enteral feeding was achieved after 11 d (median: 11.0 d; IQR, 9.0-16.0 d). Birth weight was recovered after 11 d (median: 11 d; IQR, 7.0-14.0 d). OAC was commenced at 3 d of life, and 32.5 doses (IQR, 21.0-44.0 d) were given in total. There were significant differences in the evolution of anthropometric characteristics during hospitalization, with a tendency to recover birth weight more quickly the higher the number of doses administered (P = 0.07). Time to full enteral feeding was significantly longer and time to recovery of birth weight significantly shorter when OAC was commenced ≤3 d after birth (P = 0.023).
OAC was associated with a shorter time to recover birth weight and time to full enteral feeding.
初乳是乳腺分泌的第一阶段产物,存在于出生后第 7 天内。初乳具有重要的免疫调节成分和保护因子,有助于保护和促进新生儿的发育。经口给予初乳(OAC)已被提议作为极低出生体重(VLBW)新生儿(<1500 克)的潜在营养选择。本研究旨在分析接受 OAC 的 VLBW 婴儿的临床结局。
这是一项回顾性纵向研究,采用非概率抽样方法对接受 OAC 方案的 VLBW 婴儿进行研究。排除无 OAC 数据、未接受剂量或在出生后第 7 天内死亡的 VLBW 婴儿。采用 Mann-Whitney 检验比较定量变量,采用 Wilcoxon 检验评估人体测量值的演变,显著性水平为 5%(P < 0.05)。
肠内营养治疗在 1 天后开始(中位数:1 天;四分位距 [IQR],1-1 天)。完全肠内喂养在 11 天后实现(中位数:11.0 天;IQR,9.0-16.0 天)。出生体重在 11 天后恢复(中位数:11 天;IQR,7.0-14.0 天)。OAC 在出生后第 3 天开始,共给予 32.5 剂(IQR,21.0-44.0 天)。在住院期间,人体测量特征的演变存在显著差异,给予的剂量越高,体重恢复的速度越快(P=0.07)。当 OAC 在出生后≤3 天开始时,完全肠内喂养的时间显著延长,体重恢复的时间显著缩短(P=0.023)。
OAC 与体重恢复和完全肠内喂养时间缩短有关。