Oropharyngeal Colostrum for Immune Stimulation in Very Low Birth Weight Infants

Colostrum, mothers' early breastmilk, contains multiple factors that provide immune
protection to very low birth weight (VLBW) infants, a population at high risk for
hospital-acquired infections. However, critical illness during the first few days of life
often prevents the initiation of enteral feeds, placing these infants at even higher risk
for morbidities including feeding intolerance and infection. Oropharyngeal administration
has been proposed as an alternative route of delivery for colostrum and the immune benefits
it provides. Research from animal and adult human models supports oropharyngeal
administration as a potentially safe and effective mode of delivery for immune therapies.
Immune components of colostrum, such as secretory IgA, may have both direct and indirect
effects on the immune system. The purpose of this proposed randomized, placebo-controlled
pilot study is to determine the effect of oropharyngeally administered colostrum (OAC) on
immune stimulation in VLBW infants, as measured by secretory IgA (sIgA) levels. In addition
to measuring sIgA response to OAC the investigators will also collect clinical data to
determine if OAC has effects on tolerance of enteral feedings and rates of infection. The
investigators hypothesize OAC will have a moderate effect on salivary secretory IgA
concentration in VLBW infants. If proven efficacious, utilization of OAC in VLBW infants
could have far reaching consequences for these highly fragile babies including lower rates
of infection, improved tolerance of enteral feedings, and shorter NICU stays.