Effect of Early Administration of Oropharyngeal Colostrum in Reducing Late Onset Neonatal Sepsis

Abstract

Background: Early administration of colostrum by oropharyngeal route plays a tremendous role in preventing mortality and morbidity in preterm infants. The objective of this study was to determine if oropharyngeal administration of mother’s own colostrum within 24 hrs of life can reduce rates of Late Onset Neonatal Sepsis (LONS) in preterm neonates. Methods: This randomized, placebo-controlled study was conducted in the Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka from July, 2019 to June, 2021. Neonates with birth weight ≤ 1800 g and/or gestational age ≤ 34 weeks were enrolled in this study. Intervention group received maternal colostrum (0.2 mL), within 24 hours of birth, every 3 hrly for the next 3 days. Serum IgA was measured at 24hrs and 7th day of postnatal age. Results: A total of 104 neonates were enrolled, 52 were randomized to oropharyngeal administration of colostrum group and 52 to placebo group. Finally, 40 patients among the placebo group completed the study. There was reduction in the incidence of LONS 55.7% vs. 85% (p = 0.003); probable sepsis 46.1% vs. 70% (p = 0.033), proven sepsis 36.5% vs. 57.5% (p = 0.058). Among the secondary outcome there was reduction of DIC 23% vs. 55% (p = 0.002), use of mechanical ventilators 21.1% vs 55% (p = 0.001), no of inotropes 1.18±0.395 vs 1.61±0.497 (p = 0.002), duration of inotropes 19.77±14.249 vs. 36.57±17.502; (p = 0.002). Conclusion: This study concluded that the incidence of late-onset neonatal sepsis, DIC, use of MV and inotropes, duration of inotropes can be significantly reduced in preterm neonates by oropharyngeal administration of mother’s own colostrum.