Bovine colostrum to supplement the first feeding of very preterm infants: The PreColos randomized controlled trial

Yan, Xudong1,2; Pan, Xiaoyu3; Ding, Lu1,2; Dai, Yiheng4; Chen, Jun5; Yang, Yong6; Li, Yuefeng7; Hao, Hu8; Qiu, Huixian9; Ye, Zhenzhi10; Shen, Liang3,11; Li, Yanqi3,12; Ritz, Christian13; Peng, Yueming1,2; Zhou, Ping14; Gao, Fei3,15; Jiang, Ping-Ping3; Lin, Hung-Chih16; Zachariassen, Gitte17; Sangild, Per Torp3,11,17,18; Wu, Benqing10,19

2023-08-01

10.1016/j.clnu.2023.06.024

CLINICAL NUTRITION   Impact Factor & Quartile

0261-5614

1532-1983

Background & aims: Gut immaturity leads to feeding difficulties in very preterm infants (<32 weeks gestation at birth). Maternal milk (MM) is the optimal diet but often absent or insufficient. We hypothesized that bovine colostrum (BC), rich in protein and bioactive components, improves enteral feeding progression, relative to preterm formula (PF), when supplemented to MM. Aim of the study is to determine whether BC supplementation to MM during the first 14 days of life shortens the time to full enteral feeding (120 mL/kg/d, TFF120).Methods: This was a multicenter, randomized, controlled trial at seven hospitals in South China without access to human donor milk and with slow feeding progression. Infants were randomly assigned to receive BC or PF when MM was insufficient. Volume of BC was restricted by recommended protein intake (4-4.5 g/kg/d). Primary outcome was TFF120. Feeding intolerance, growth, morbidities and blood parameters were recorded to assess safety. Results: A total of 350 infants were recruited. BC supplementation had no effect on TFF120 in intentionto-treat analysis [n (BC) = 171, n (PF) = 179; adjusted hazard ratio, aHR: 0.82 (95% CI: 0.64, 1.06); P = 0.13]. Body growth and morbidities did not differ, but more cases of periventricular leukomalacia were detected in the infants fed BC (5/155 vs. 0/181, P = 0.06). Blood chemistry and hematology data were similar between the intervention groups.Conclusions: BC supplementation during the first two weeks of life did not reduce TFF120 and had only marginal effects on clinical variables. Clinical effects of BC supplementation on very preterm infants in the first weeks of life may depend on feeding regimen and remaining milk diet. Trial Registration: http:// www.clinicaltrials.gov: NCT03085277. & COPY; 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Preterm infant Bovine colostrum Maternal milk Early enteral feeding Time to full enteral feeding

SCI

English

Others

Innovation Fund Denmark, University of Copenhagen[6150-00004B]

Nutrition & Dietetics

Nutrition & Dietetics

WOS:001040497500001

CHURCHILL LIVINGSTONE

CLINICAL MEDICINE

Web of Science

1.Jinan Univ, Shenzhen Peoples Hosp, Dept Neonatol, Clin Med Coll 2, Guangzhou, Peoples R China
2.Southern Univ Sci & Technol, Affiliated Hosp 1, Shenzhen, Guangdong, Peoples R China
3.Univ Copenhagen, Fac Hlth & Med Sci, Comparat Pediat & Nutr, Frederiksberg, Denmark
4.Foshan Maternal & Child Hlth Hosp, Dept Neonatol, Foshan, Peoples R China
5.Shenzhen Nanshan Matern & Child Healthcare Hosp, Dept Neonatol, Shenzhen, Peoples R China
6.Dongguan Maternal & Child Hlth Care Hosp, Dept Neonatol, Dongguang, Peoples R China
7.Shenzhen Luohu Maternal & Child Hlth Hosp, Dept Neonatol, Shenzhen, Peoples R China
8.Sun Yat Sen Univ, Affiliated Hosp 6, Dept Neonatol, Guangzhou, Peoples R China
9.Longgang Dist Cent Hosp Shenzhen, Dept Neonatol, Shenzhen, Peoples R China
10.Univ Chinese Acad Sci, Shenzhen Hosp, Dept Neonatol, Shenzhen, Peoples R China
11.Copenhagen Univ Hosp, Dept Neonatol, Rigshosp, Copenhagen, Denmark
12.NBCD A S, Herlev, Denmark
13.Univ Southern Denmark, Natl Inst Publ Hlth, Copenhagen, Denmark
14.Baoan Women & Childrens Hosp, Dept Neonatol, Shenzhen, Peoples R China
15.NEOMICS Inst, Shenzhen, Peoples R China
16.China Med Univ Childrens Hosp, Dept Pediat, Taichung, Taiwan
17.Univ Southern Denmark, Odense Univ Hosp, Dept Pediat, Odense, Denmark
18.Univ Copenhagen, Fac Hlth & Med Sci, Comparat Pediat & Nutr, Dyrlaegevej 68, DK-1870 Frederiksberg, Denmark
19.Univ Chinese Acad Sci, Shenzhen Hosp, 39 Hua Xia Lu, Shenzhen 518106, Peoples R China

Yan, Xudong,Pan, Xiaoyu,Ding, Lu,et al. Bovine colostrum to supplement the first feeding of very preterm infants: The PreColos randomized controlled trial[J]. CLINICAL NUTRITION,2023,42(8).

Yan, Xudong.,Pan, Xiaoyu.,Ding, Lu.,Dai, Yiheng.,Chen, Jun.,...&Wu, Benqing.(2023).Bovine colostrum to supplement the first feeding of very preterm infants: The PreColos randomized controlled trial.CLINICAL NUTRITION,42(8).

Yan, Xudong,et al."Bovine colostrum to supplement the first feeding of very preterm infants: The PreColos randomized controlled trial".CLINICAL NUTRITION 42.8(2023).