Effect of Oropharyngeal Colostrum Administration in Premature Infants on Nosocomial Infections

Main Article Content

Wunnapa Tungtang
Tipawan Daramas
Jariya Wittayasooporn



            The present quasi-experimental research study aimed at investigating the effects of oropharyngeal colostrum administration on nosocomial infections in preterm infants.  The study sample consisted of 60 preterm infants who were admitted into the neonatal intensive care unit. Thirty subjects in the experimental group received oral administration of 0.2 ml. of colostrum every three hours for seven days, while the other 30 subjects in the control group received only usual nursing care.  The data of nosocomial infections were gathered from the medical records of the hospital, and data analysis was conducted using Chi-square test and odds ratio. The findings showed that there was no statistically significant difference of nosocomial infections rate in preterm infants who received oropharyngeal colostrum administration and those who received only usual nursing care(OR = .6; 95% CI = .17-2.08, p = .65).Therefore, more research is needed to understand better how to use oropharyngeal colostrum in premature infants for improving nosocomial infections. However, the results of  this study can be used to develop nursing practice guidelines  on oropharyngeal colostrum administration in preterm infants and promote breastfeeding in sick newborn in neonatal intensive care unit.


Article Details

How to Cite
Tungtang W, Daramas T, Wittayasooporn J. Effect of Oropharyngeal Colostrum Administration in Premature Infants on Nosocomial Infections. Nurs Res Inno J [Internet]. 2018 Oct. 3 [cited 2024 Feb. 22];24(2):109-21. Available from: https://he02.tci-thaijo.org/index.php/RNJ/article/view/112942


1. Askin DF, Wilson D. The high-risk newborn and family. Wong’s nursing care of infants and children. 8th ed.
Philadelphia: Mosby/Elsevier; 2007:318-89.

2. Sharma AA, Jen R, Butler A, Lavoie PM. The developing human preterm neonatal immune system: a case for more
research in this area. J Immunol Res. 2012;145(1):61-8.

3. Crivaro V, Bogdanovic L, Bagattini M, Iula VD, Catania M, Raimondi F, et al. Surveillance of healthcareassociated
infections in a neonatal intensive care unit in Italy during 2006–2010. BMC Infect Dis. 2015;15(1):152-9.

4. Geffers C, Baerwolff S, Schwab F, Gastmeier P. Incidence of healthcare-associated infections in high-risk neonates:
results from the German surveillance system for verylow-birthweight infants. J Hosp Infect. 2008;68(3):214-21.

5. Vergnano S, Menson E, Kennea N, Embleton N, Russell AB, Watts T, et al. Neonatal infections in England:
theNeonin surveillance network. Arch Dis Child Fetal Neonatal Ed. 2011;96(1):F9-F14.

6. March of Dimes, WHO, PMNCH, Save the Children. The Global Action Report on Preterm Birth; 2012. (cited 2015
April 13). Available from March of Dimes Website:https://www.marchofdimes.org/glue/

7. Dudeck MA, Weiner LM, Allen-Bridson K, Malpiedi PJ, Peterson KD, Pollock DA, et al. National Healthcare Safety
Network (NHSN) report, data summary for 2012,Device-associated module. Am J Infect Control. 2013;41(12):1148-66.

8. Payne NR, Carpenter JH, Badger GJ, Horbar JD, Rogowski J. Marginal increase in cost and excess length of stay
associated with nosocomial bloodstream infections in surviving very low birth weight infants. Pediatrics.2004;114(2):348-55.

9. Shah DK, Doyle LW, Anderson PJ, Bear M, Daley AJ,Hunt RW, et al. Adverse neurodevelopment in preterm
infants with postnatal sepsis or necrotizing enterocolitis is mediated by white matter abnormalities on magnetic
resonance imaging at term. J Pediatr. 2008;153(2):170-5.

10. Wormald F, Tapia JL, Torres G, Canepa P, González M,Rodriguez D, et al. Stress in parents of very low birth
weight preterm infants hospitalized in neonatal intensive care units: a multicenter study. Arch Argent Pediatr.

11. Patel AL, Johnson TJ, Engstrom JL, Fogg LF, Jegier BJ, Bigger HR. Impact of early human milk on sepsis and
health-care costs in very low birth weight infants. J Perinatol. 2013;33(7):514-19.

12. Lawrence RM, Pane CA. Human breast milk: current concepts of immunology and infectious diseases. Curr Probl Pediatr Adolesc Health Care. 2007;37(1):7-36.
13. Araújo ED, Gonçalves AK, CornettaMdC, Cunha H,Cardoso ML, Morais SS, et al. Evaluation of the secretory
immunoglobulin A levels in the colostrum and milk of mothers of term and pre-trerm newborns. Braz J Infect
Dis. 2005;9:357-62.

14. Castellote C, Casillas R, Ramírez-Santana C, Pérez-Cano FJ, Castell M, Moretones MG, et al. Premature delivery
influences the immunological composition of colostrum and transitional and mature human milk. J Nutrit.

15. Spatz D, Edwards T. The use of colostrum and human milk for oral care in the neonatal intensive care unit. NatlAssoc Neonatal Nurses E-News. 2009;1(4):1-3.

16. Rodriguez NA. Colostrum as a Therapeutic for Premature Infants. In: Watson RR, Grimble G, Preedy VR, Zibadi
S, editors. Nutrition in Infancy: Volume 1. Totowa, NJ:Humana Press; 2013. p. 145-55.

17. Gregory KE, Walker WA. Immunologic factors in human milk and disease prevention in the preterm infant.
CurrPediatr Rep. 2013;1(4):222-8

18. Rodriguez N, Meier P, Groer M, Zeller J. Oropharyngeal administration of colostrum to extremely low birth weight
infants: theoretical perspectives. J Perinatol. 2009;29(1):1-7.

19. Lee J, Kim H-S, Jung YH, Choi KY, Shin SH, Kim E-K,et al. Oropharyngeal colostrum administration in extremely
premature infants: an RCT. Pediatr Res. 2015;135(2):e357-e66.

20. Seigel JK, Smith PB, Ashley PL, Cotten CM, Herbert CC,King BA, et al. Early administration of oropharyngeal
colostrum to extremely low birth weight infants. Breastfeed Med.2013;8(6):491-5.

21. Rodriguez NA, Meier PP, Groer MW, Zeller JM, Engstrom JL, Fogg L. A pilot study to determine the safety and
feasibility of oropharyngeal administration of own mother’s colostrum to extremely low birth weight infants. Adv
Neonatal Care. 2010;10(4):206-12.

22. Newburg DS, Walker WA. Protection of the neonate by the innate immune system of developing gut and of human
milk. Pediatr Res. 2007;61(1):2-8.

23. Sharma AA, Jen R, Butler A, Lavoie PM. The developing human preterm neonatal immune system: a case for more
research in this area. ClinImmunol. 2012;145(1):61-8.

24. Strunk T, Currie A, Richmond P, Simmer K, Burgner D. Innate immunity in human newborn infants: prematurity
means more than immaturity. J Matern Fetal Neonatal Med. 2011;24(1):25-31.

25. Torrazza RM, Neu J. The developing intestinal microbiome and its relationship to health and disease in the neonate. J Perinatol. 2011;31(S1):S29-S34.

26. Lawrence RM, Pane CA. Human breast milk: current concepts of immunology and infectious diseases. Curr
Probl Pediatr Adolesc Health Care. 2007;37(1):7-36.

27. Reis Machado J, Soave DF, da Silva MV, de Menezes LB, Etchebehere RM, Monteiro MLGdR, et al. Neonatal sepsis and inflammatory mediators.MediatorsInflamm. 2014;2014:1-10.

28. Penhila IA. Milk-derived transforming growth factov-beta and the infant immune response. J Pediats. 2010;

29. Gephart SM, Weller M, Gephart S. Colostrum as oral immune therapy to promote neonatal health. Adv Neonatal
Care. 2014;14(1):44-51.

30. Rodriguez NA, Vento M, Claud EC, Wang CE, Caplan MS. Oropharyngeal administration of mother’s colostrum,
health outcomes of premature infants: study protocol for a randomized controlled trial. Trials. 2015;16(1):453-66.

31. Bocci V. Absorption of cytokines via oropharyngealassociated lymphoid tissues. Clin Pharmacokinet.1991;21(6):411-7.

32. Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical power analyses using G* Power 3.1: tests for correlation
and regression analyses. Behavior Research Methods. 2009;41(4):1149-60.

33. Gross SJ, Buckley RH, Wakil SS, McAllister DC, David RJ, Faix RG.Elevated Ig Aconcentrationin milk produced
by mothers delivered of preterm infants. J Pediatr. 1981;99:389–93

34. Hutchens TW, Henry JF, Yip T-T, Hachey DL, Schanler RJ, Motil KJ, et al. Origin of intact lactoferrinandits DNAbinding fragments found in the urine of human milk-fed preterminfants. Evaluation by stable isotopic enrichment.
Pediatr Res. 1991;29(3):243-50.

35. Rodriguez NA, Groer MW, Zeller JM, Engstrom JL, Fogg L, Du H, et al. A randomized controlled trial of the
oropharyngeal administration of mother’s colostrum to extremely low birth weight infants in the first days of life.
Neonatal Intensiv Care. 2011;24(4):31-5.

36. Zhang Y, Ji F, Hu X, Cao Y, Latour JM. Oropharyngeal colostrum administration in very low birth weight infants:
a Randomized Controlled Trial. Pediatr Crit Care Med. 2017;18(9):869-75.