Gut priming with oral Bovine Colostrum for preterm neonates: A randomized control trial

Abstract

Abstract Objective to determine whether gut priming with bovine colostrum reduces nosocomial sepsis episodes, feeding intolerance and necrotizing enterocolitis (NEC) in premature infants and to evaluate the possible effects of bovine colostrum on T regulatory cells (Treg) levels. Study Design a prospective, placebo-controlled, double-blind, randomized trial, infants born before 34 weeks were assigned to receive either placebo (n 48), or bovine colostrum (n 32) as gut priming. Episodes of nosocomial sepsis by using Rodwell and Töllner sepsis score, feeding intolerance and NEC according to Bell’s criteria were recorded. The level of FOXP3 + CD4 + CD25hi lymphocytes was studied by flow cytometry at birth and after 10 days. Results Fewer sepsis episodes were observed in bovine colostrum-treated infants (3 vs. 10, p-value 0.174) with none developing NEC (0 vs. 5, p-value 0.059). Also bovine colostrum gut priming significantly reduced feeding intolerance (1 vs. 9, p-value 0.038) and mortality (0 vs. 8, p-value 0.015). Treg levels initially and follow up were similar, However, Treg levels change difference were higher in the bovine colostrum group (p-value 0.8) with statistically significant difference in FOXP3 expression (p-value 0.018). Conclusion Gut priming with oral Bovine Colostrum decreases feeding intolerance, NEC, late onset sepsis and mortality in preterm neonates. We recommend bovine colostrum usage as gut priming.