Document Detail


A pilot study to determine the safety and feasibility of oropharyngeal administration of own mother's colostrum to extremely low-birth-weight infants.
MedLine Citation:
PMID:  20697221     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine the safety of oropharyngeal administration of own mother's colostrum to ELBW infants in first days of life. A secondary purpose was to investigate the feasibility of (1) delivering this intervention to ELBW infants in the first days of life and (2) measuring concentrations of secretory immunoglobulin A and lactoferrin in tracheal aspirate secretions and urine of these infants.
SUBJECTS: Five ELBW infants (mean birth weight and gestational age = 657 g and 25.5 weeks, respectively).
DESIGN: Quasi-experimental, 1 group, pretest-posttest design.
METHODS: Subjects received 0.2 mL of own mother's colostrum administered oropharyngeally every 2 hours for 48 consecutive hours, beginning at 48 hours of life. Concentrations of secretory immunoglobulin A and lactoferrin were measured in tracheal aspirates and urine of each subject at baseline, at the completion of the intervention and again 2 weeks later.
RESULTS: All infants completed the entire treatment protocol, each receiving 24 treatments. A total of 15 urine specimens were collected and 14 were sufficient in volume for analysis. A total of 15 tracheal aspirates were collected, but only 7 specimens (47%) were sufficient in volume for analysis. There was wide variation in concentrations of secretory immunoglobulin A and lactoferrin in urine and tracheal aspirates among the 5 infants; however, several results were outside the limits of assay detection. All infants began to suck on the endotracheal tube during the administration of colostrum drops. Oxygen saturation measures remained stable or increased slightly during each of the treatment sessions. There were no episodes of apnea, bradycardia, hypotension, or other adverse effects associated with the administration of colostrum.
CONCLUSIONS: Oropharyngeal administration of own mother's colostrum is easy, inexpensive, and well-tolerated by even the smallest and sickest ELBW infants. Future research should continue to examine the optimal procedure for measuring the direct immune effects of this therapy, as well as the clinical outcomes such as infections, particularly ventilator-associated pneumonia.
Authors:
Nancy A Rodriguez; Paula P Meier; Maureen W Groer; Janice M Zeller; Janet L Engstrom; Lou Fogg
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Advances in neonatal care : official journal of the National Association of Neonatal Nurses     Volume:  10     ISSN:  1536-0911     ISO Abbreviation:  Adv Neonatal Care     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-10     Completed Date:  2010-11-08     Revised Date:  2014-09-13    
Medline Journal Info:
Nlm Unique ID:  101125644     Medline TA:  Adv Neonatal Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  206-12     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Bodily Secretions / metabolism
Colostrum / immunology*
Enteral Nutrition / adverse effects,  methods*
Female
Humans
Immunoglobulin A, Secretory / metabolism*,  urine
Infant, Extremely Low Birth Weight
Infant, Newborn
Infant, Premature
Lactoferrin / metabolism*,  urine
Male
Pilot Projects
Trachea / immunology
Grant Support
ID/Acronym/Agency:
F31 NR007584-05/NR/NINR NIH HHS; F31NR007584/NR/NINR NIH HHS; NR010009/NR/NINR NIH HHS; R01 NR010009/NR/NINR NIH HHS; R01 NR010009-02/NR/NINR NIH HHS; R01 NR010009-05/NR/NINR NIH HHS
Chemical
Reg. No./Substance:
0/Immunoglobulin A, Secretory; EC 3.4.21.-/Lactoferrin
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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