TY - JOUR

T1 - Bovine Colostrum for Preterm Infants in the First Days of Life

T2 - A Randomized Controlled Pilot Trial

AU - Juhl, Sandra Meinich

AU - Ye, Xuqiang

AU - Zhou, Ping

AU - Li, Yanqi

AU - Iyore, Elisabeth Omolabake

AU - Zhang, Lixia

AU - Jiang, Pingping

AU - Van Goudoever, Johannes B.

AU - Greisen, Gorm

AU - Sangild, Per Torp

PY - 2018

Y1 - 2018

N2 - Objectives: Mother's own milk (MM) is the best nutrition for newborn preterm infants, but is often limited in supply just after birth. Pasteurized human donor milk (DM), and especially preterm infant formula (IF) are less optimal diets than MM. We hypothesized that it is feasible to use bovine colostrum (BC), the first milk from cows, as a supplement to MM, during the first weeks after preterm birth. Methods: In an open-label, randomized, controlled pilot safety trial, supplementation of MM with BC was compared with DM supplementation (Danish unit) or IF supplementation (Chinese unit). If MM was limited or lacking, BC, DM or IF were given according to local feeding guidelines during the first 14 days of life. Results: Forty infants were included and randomized in Denmark and in China, with gestational ages 29.9 ± 0.4 and 31.1 ± 0.2 weeks, respectively. Infants supplemented with BC received more enteral protein (P < 0.05) and tended to reach full enteral feeding earlier (China only). Eight infants fed BC showed a temporary elevation in plasma tyrosine on day 7, versus 2 infants in the DM/IF groups. There were no differences between diet groups in feeding intolerance or clinical adverse events. Conclusions: Our results indicate that it is feasible to use BC as a supplement to MM during the first weeks of life to increase enteral protein intake in preterm infants. Plasma tyrosine levels may be a good marker for excessive protein intake. A larger randomized trial is required to test the safety and possible short- and long-term clinical benefits of BC supplementation during the first weeks of life for preterm infants.

AB - Objectives: Mother's own milk (MM) is the best nutrition for newborn preterm infants, but is often limited in supply just after birth. Pasteurized human donor milk (DM), and especially preterm infant formula (IF) are less optimal diets than MM. We hypothesized that it is feasible to use bovine colostrum (BC), the first milk from cows, as a supplement to MM, during the first weeks after preterm birth. Methods: In an open-label, randomized, controlled pilot safety trial, supplementation of MM with BC was compared with DM supplementation (Danish unit) or IF supplementation (Chinese unit). If MM was limited or lacking, BC, DM or IF were given according to local feeding guidelines during the first 14 days of life. Results: Forty infants were included and randomized in Denmark and in China, with gestational ages 29.9 ± 0.4 and 31.1 ± 0.2 weeks, respectively. Infants supplemented with BC received more enteral protein (P < 0.05) and tended to reach full enteral feeding earlier (China only). Eight infants fed BC showed a temporary elevation in plasma tyrosine on day 7, versus 2 infants in the DM/IF groups. There were no differences between diet groups in feeding intolerance or clinical adverse events. Conclusions: Our results indicate that it is feasible to use BC as a supplement to MM during the first weeks of life to increase enteral protein intake in preterm infants. Plasma tyrosine levels may be a good marker for excessive protein intake. A larger randomized trial is required to test the safety and possible short- and long-term clinical benefits of BC supplementation during the first weeks of life for preterm infants.

KW - early feeding

KW - milk

KW - nutrition

KW - protein intake

U2 - 10.1097/MPG.0000000000001774

DO - 10.1097/MPG.0000000000001774

M3 - Journal article

C2 - 29019855

AN - SCOPUS:85042421974

VL - 66

SP - 471

EP - 478

JO - Journal of Pediatric Gastroenterology and Nutrition

JF - Journal of Pediatric Gastroenterology and Nutrition

SN - 0277-2116

IS - 3

ER -